Preamble

Last year the world was hit badly by COVID 19 pandemic. It was a calamity of an extraordinary proportion. Nobody was prepared for it and innumerable individuals perished fighting it. This is an overview of what happened and where do we stand now. I will be mainly covering it from an Indian perspective.

Indian scenario

Last year in March first COVID 19 case was detected in Kerala, India. The disease was new and we were not very sure about how it will affect us. There were few guidelines given by World Health Organization (WHO) which we followed initially after WHO declared it as a Pandemic. We were actually not mentally prepared to face it but we were very fortunate to have few great minds in central ministry who could foresee its impact on India. Our Honorable Prime Minister Shri Narendra Modi first announced a symbolic “Janata Curfew” on 22nd of March 2020. It was an alarming bell for the catastrophe about to hit us very badly. However, to everyone’s surprise he announced a complete National Lockdown seeing the devastation in Europe and other parts of world which began on 25th of March 2020.

It was all new to all of us. The world just stopped for all healthcare personnel almost. But for a common man it literally stopped completely. There were no people and vehicles on streets. All public places like gardens, restaurants, theaters, malls, worshipping places everything got sealed overnight. Only personnel allowed to go out were healthcare staff, police, and essential services like milk and paper. It was quite an altogether different experience for all.

The golden rules were laid down which were 6 feet of physical distancing, wearing face masks in public places, and strict hand sanitization while handling anything outside. It really created wonders. Innumerable lives were saved whit this 3 simple formulae. Lockdown also saved countless lives. Many intellectuals cursed the central government about the imposition of strict lockdown but it was indeed the need of the hour.

What happened in early days of lockdown was complete cleansing of the environment as a direct result of stopping in vehicle CO₂ emissions, industry coming to standstill, and stopping in chemical plants. It really boosted the regeneration of our green planet. One could hear birds returning to cities and chirping in mornings and air was so pure and ozone layer depletion healed itself which was really a wonderful experience for all of us mainly in cities.

However, as the lockdown continued further it affected healthcare system quite badly. All routine surgeries and patient visits stopped. Only emergency care was there. Again while treating patients COVID RT-PCR (reverse transcription polymerase chain reaction) test became mandatory pre-treatment. Wearing of Personal Protection Kits (PPE) became mandatory. Donning and doffing of them was also quite challenging for all concerned. Those above 55 years were spared for COVID work. Rest all was involved. Yet all were not aware of many finer aspects while treating COVID patients who resulted in many casualties and many good healthcare workers were perished. All who handled the COVID situation efficiently were crowned as “COVID Warriors.” All saluted them with lot of appreciation and gratitude. A special insurance cover of Rs. 50 lakhs was offered to them if they die during performing their duties which was a big morale booster.

Many new protocols were prepared; many new guidelines were modified as per local needs which saved many lives. Special COVID consents were created by surgical societies which were helpful to many while treating the surgical patients. Many treatment protocols were followed meticulously laid down by Ministry of Health and Family Welfare (MOHFW), New Delhi and Indian Council for Medical Research (ICMR). Initially use of plasma was advocated who have recently recovered from COVID in treating the one who are recovering. The Task Force was set up in each state to take an overview of the situation in the state and prepare guidelines and modify them as per need.

One more major change in policy was shift to Online Platform for Education and other purposes [1]. It brought a sea of change for all. All schools were shut and online classes started for all students. It was very challenging for students as well as teachers alike. Higher studies also incorporated similar platforms and Google Classrooms, Microsoft Teams, Zoom, Telegram became daily terms which were earlier reserved only for specific Educationists only. On Academic fronts and in Medical bodies there was a boom of Webinars and Online Zoom meetings and entire sector became dedicated in this including online consultations for patients who needed Doctor Advise and for follow-up patients. It was quite useful for many patients and online money transfer became new normal norm for all. 50% attendance made mandatory in offices but salaries were also not paid in many institutions due to various reasons which made the matter worse for teachers and service providers. Many small-scale shops were closed permanently and many families faced hardship in lockdown.

By July end the lockdown was partly lifted and life could breathe again for common man and small-scale industries. Still many local restrictions were there which eventually people started ignoring. Basically common man could not take the lockdown any longer and its patience worn off. By November 2020 almost everything came back to near normal. Unfortunately again people started ignoring the three basic COVID care measures which were told earlier. Lot of migrant workers returned to their native places in massive numbers and that also shifted the focus of spread from one place to remote villages which were quite catastrophic indeed. Somehow we could control it last year but again this year the same picture is seen. The announcement of lockdown by the Government is quite unfortunate scenario.

Vaccination was introduced in time by the Government and all healthcare workers were given preference for taking it as they were frontline workers. Initially COVISHIELD and COVAXIN were introduced. Majority of healthcare staff were vaccinated with COVISHIELD and few with COVAXIN. Everyone was instructed to take two doses four weeks apart initially and major healthcare staff was covered. Then vaccination started for aged 45 and above. Later the gap between two doses increased to 6–8 weeks as per observations and modifications. Initially Convalescent Plasma Therapy (CPT) was considered as ray of hope for treating the advanced COVID patients [2] but soon plasma treatment was struck off by Task Force just recently.

However, as the vaccination was rolled people started behaving carelessly and casually. They started mass gatherings, weddings, birthday parties, outings and all places like malls, theaters, worshipping places, gardens were opened which created a huge setback to all year long measures taken meticulously by all of us. Moreover, the second wave of COVID started in February 2021. In March it grew and April it has peaked. Now daily 3.16 lakh people are getting affected and deaths have started mounting too [3]. It is a very scary situation for all. Again a fresh lockdown has been imposed by many states. Maharashtra being on forefront dubiously is facing massive surge in COVID cases with possibility of a different strain. Due to vaccination the overall morbidity and mortality is on lower scale but the spread is like a wildfire.

Now, Government of India has announced for vaccination for all above 18 years of age from 1st May 2021. Let’s hope that we can get them all vaccinated efficiently alike first two phases. However, now there is shortage of Oxygen supply and injection Remdesivir which is a very grim situation. Central Government has urged for installation of Oxygen plants all over the major healthcare delivery points and adequate supply of injection Remdesivir. It has also sanctioned three more foreign vaccines like Sputnik from Russia thus making more options available to individuals and across the counter too.

Still there is lot to work on. People are still not serious about basic norms following and there is lack of discipline which is very dangerous. Already healthcare workers and police are overburdened with duties and there is shortage of manpower everywhere which the common citizen has to understand. It is time to give back to the society and not just ask for self and family from the society and government.

The future is not yet set but with judicious care and vigilance from all we can control this menace of COVID 19 pandemic. All need to realize that COVID is here to stay for long time as complete vaccination of 135 crore population effectively is not a simple task but a herculean job to perform and all need to be highly disciplined and have to follow all due care all throughout. This is new normal for all which all have to realize clearly.

Summary

So as to summarize, what is important for all of us is to realize that if we don’t learn from history it will repeat itself and that is what exactly happening now with us in India. When few countries were engulfed in the COVID second wave we just watched and didn’t do enough preparations or any awareness to stop the second wave in India. We should have kept a contingency plan ready for it and then we could have seen a different and better picture than the one seen today. Now, even Supreme Court of India had to intervene to take a stock of COVID situation in India.

Future

Still we have to be ready for a possible third wave which few experts are predicting in near future. We need to remain disciplined and must adhere to standard strict norms which were laid down 1 year ago which are 6 feet of physical distancing, wearing face masks in public places, and strict hand sanitization while handling anything outside. Let’s first change ourselves and try to be disciplined, so we can protect our near and dear ones. God bless India and all humanity.

1. World Health Organization (WHO) COVID report & database
2. Ministry of Health and Family Welfare. Government of India [Internet] COVID-19 INDIA
3. Indian Council of Medical Research (ICMR) database
4. Government of Maharashtra Guidelines
5. Association of Surgeons of India (ASI) Guidelines
6. Mumbai Surgical Society - Special Consent
7. Association of Medical Consultants – Guidelines