Indian states suspends routine immunisation, WHO says it is unfair
Countries, including India, should see to it that concerns of daily wagers and migrant workers are taken care of while imposing blanket lockdowns, the World Health Organization (WHO) said on March 30, 2020.
The statement was made by the organisation’s director general, Tedros Adhanom Ghebreyesus, in response to a query by Down To Earth on the impact of the nationwide lockdown in India on its poor and the mass exodus of migrant workers.
“If we are closing or if we are limiting movement, what is going to happen to these people who have to work on daily basis? Each and every country, based on its condition, should answer this question,” Ghebreyesus said while addressing a virtual press conference from the organisation’s headquarters at Geneva.
“I am from Africa and I know many people actually have to work every single day to win their daily bread. The governments should take this population into account,” he added.
It was not just about the impact on a country’s economy or its Gross Domestic Product due to the lockdown but that on individuals which mattered most, Ghebreyesus said.
If lockdowns had to be effective, it was imperative for governments to clearly spell out the intended objectives to the community, WHO’s director of emergency programmes, Mike Ryan, said. They could only be successful if the community was taken into confidence.
Stay-at-home measures had bought only a little window of time, Ryan reiterated. However, the virus would not go down on its own until aggressive testing measures were ramped up and isolation and care of patients was strengthened.
“When such measures are put in place, it is important they are carried out not only with human rights but also dignity (of individual) at the centre,” Ryan said, adding that lockdowns might be the only alternative for many countries at the moment.
What about different quarantine approaches as some countries had been doing group quarantines? This might differ according to the need of every country. However, what was sure was that most transmission was now happening in the household at family level due to lockdowns, Ryan said.
“Transmission has been taken off streets and is just pushed back into family units. Now we need to go and find people in the families who may be sick and isolate them in a safe and dignified manner,” he noted.
Essential medical services
Many states in India, including Rajasthan and Bihar, have issued orders suspending routine immunisation programmes in their respective territories owing to the lockdown. The Centre has also shut down outpatient departments in the All India Institute of Medical Sciences with several other state governments toeing its line.
The WHO criticised such an approach in the press conference and urged countries to maintain such services without any obstruction.
“Essential health services must not be affected. Immunisation actives as well as the delivery of babies must not be hampered. Life-saving treatment for a range of other diseases must not be adversely affected,” Ghebreyesus said.
Instead of just shutting down essential medical services, countries must adopt a balanced approach while dealing with novel coronavirus disease (COVID-19), the WHO said. This can be ensured by deploying adequate health workforces and rationalising their presence.
The WHO hailed the UK’s approach of using 20,000 retired health workers to manage the situation. However, at the same time, it made a plea to countries to ensure availability of protective gears for doctors.
The COVID-19 pandemic is straining health systems across the world.
“We called upon countries to talk to companies to increase their production and pay specific attention to low-and-middle-income countries in Africa, Latin America and Asia,” Ghebreyesus said referring to his conversation with trade ministers of G-20 countries.
Is anti-malarial drug safe?
A couple of countries, including the US and India, have allowed the use of anti-malarial drug hydroxy-cholorquine (HCQ) for healthcare workers dealing with COVID-19 patients.
“No randomised trials on the drug has been done so far. Some small observational studies in France where patients were given HCQ showed that it can only shorten the length of illness,” Ryan said.
“We have to still distill out the effect of the drug irrespective of the severity of the patient and his / her age and gender profile. We still do not know if they are safe for the human body in the absence of these trials,” Ryan clarified.
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