The third wave of Covid-19 had seen an unprecedented surge in the number of cases. With a new variant and its higher transmissibility, we mustn’t repeat the mistakes we made with the initial variants. The experience, no matter how painful and traumatic, has given us lessons to fight the battle against Omicron.

The answer to this lies in two words – Systemic Implementation!

The Fall of the System

The three tiers of the Indian Healthcare system had to address several issues at the onset of the pandemic. They were not ready for a war against the Cov-Sars 2.

Community workers like ASHAs were the first line of defense to fall. PHCs and CHCss were grappling with issues like shortage of manpower, equipment, and funding. Though the system met the demand for equipment, there was a shortage of trained personnel for maintenance and smooth functioning.  

Due to the lack of proper and streamlined facilities, individuals from rural regions flocked to cities to seek treatment at tertiary care facilities—the number of deaths that could be avoided climbed to unacceptably high levels.

We missed out on taking action at opportune moments.

We must dive deep into the fundamentals of this systemic problem to propose a holistic solution. All tiers are interrelated; intervening at any level won’t work unless we also boost the others. Hence, we took a multilayered and multi-pronged approach in the district of Vijayapura.

• District authorities and policymakers had to collaborate with the gram panchayat to build a local system. 
• Volunteers were trained. It was essential to track progress and adhere to timetables. 
• Tele-consultation was set up to reach a larger number of people.
• A computerized system was developed to determine where hospital beds are available.
• Employees for the administration of helplines and help desks at hospitals were trained. 

Sambhav’s Intervention at Vijayapura 

What we did:  An intervention focusing on all the layers of the healthcare system was carried out in Vijayapura during the second wave.

How we did: Organizations across various sectors provided and donated medical equipment and other emergency supplies. We partnered with the local district administration team to develop a 360-degree plan to combat the deadly second wave of COVID-19 infections.

What was the Result?

• Training and Deployment:  Across 66 Gram Panchayats, 119 volunteers and four supervisors were trained and deployed to assist ASHA workers. This considerably reduced the pressure on the district level health facilities. You can read more about the ASHAs here: https://www.linkedin.com/pulse/ace-up-our-sleeves-we-keep-forgetting-ashas-gayathri-vasudevan
• Skilling Personnel:  20 vaccinators, 20 CoWIN app entry operators, five data entry coordinators and one program manager were trained and deployed. This cadre provided the necessary support before, during and after visiting a vaccination camp. 
• Planning and Execution:  The planning and execution of these tasks was made possible with the support of the chief medical officer, doctors at the PHCs and the district administration. These efforts strengthened healthcare delivery for the district and empowered the on-ground community workers, doctors, nurses, and non-medical staff.

Did the Concept of Systemic Implementation Work?

The coordinated efforts demonstrated a positive impact on controlling the spread of infection and the district’s overall health. There was an almost 97% reduction in active COVID-19 infections. The number of fatalities for this period was 34 only. Active cases were reduced from 1289 to 27. Over two months, 500,000 vaccines were administered in the district through multiple camps.

The Way Forward

It just took one district to show that a systemic transformation can be achieved with the right amount of work. This multilevel, multi-pronged approach must be carried out in every corner of the country to be successful in our fight against the pandemic.

If you’d like to know more about Vijayapura’s victory against covid-19, check out the full report here: https://sambhavfoundation.org/vijaypura-report-for-sambhav/