LET us be honest with ourselves. We are stuck with Covid, and we are in a mess. An honest confession is often, if not always, the first step towards setting things right. If we are comfortably numb and okay with wave after wave of alternating economic depression and Covid oppression, then we should not worry or be apprehensive at all. Life is temporary anyway and some find peace, as the sages say, only in the grave. Laissez-faire is an approach too!

We are a difficult lot to manage indeed, yet we can give up kite-flying and Basant, if and when the government wants to establish its writ. We are capable of changing our behaviours, but need a little education, a little enforcement, a little encouragement, a little enabling and a little engineering to nudge us in the right direction.

Assuming we are willing to get out of this conundrum, first and foremost we need to place the right person at the right job. In this day and age, it is unfair to demand from bureaucrats with a colonial mindset to deliver on public health issues without the help of field specialists. Luckily we have an abundance of such specialists, but there is an unnatural disconnect between community medicine physicians and the corridors where public health decisions are made. Most experts will gladly volunteer if simply asked and given the respect. This bridge between the specialists and administrators, if sustained, will have a beneficial impact on managing a plethora of public health problems even beyond the pandemic.

Secondly, in the fight against Covid, it is vital to make available the right armour; the vaccines. Any and all tried and tested vaccines in the market will do. The equation is simple; vaccinate as many elderly and adults as quickly as possible, so that mortality rate is brought down. The challenge is to convince the sceptical to opt for vaccination. It is not their fault. The onus is on the leadership. If the government can ban Basant, it can do just about anything.

Educating the public on Covid SOPs and vaccines is a critical element, and being a physician and not being a politician are huge pluses to gain public trust in this critical respect. Yet, the minister concerned needs to raise his game by coming on television every day and briefing the public with complete honesty about the situation all over the country. He has to bond with the public and build that trust. And this effort to change people’s behaviour has to be done before Eidul Fitr, otherwise the summer thereafter might well be harsh and hectic.

Many can disagree with what has been said here, but public health practice is common sense application with simple dos and don’ts. It requires a multifaceted approach to harness medical problems in the community. Diseases occur due to interplay among an aggressive agent, such as the coronavirus, a vulnerable host, such as the elderly, and an environment, such as manmade urban living. Viruses evolve by genetic variation. Changes that enable a virus to spread faster and wider, yet being less lethal to human hosts, are more likely to hang around in the community for longer periods of time.

Let us put a lid on this epidemic in the country by maximising efforts in placing expertise at the administrative frontlines of the environment, providing armour to the vulnerable by vaccination, and making people smarter to fight Covid by education.

Dr Saeed ur Rahman
Riyadh, Saudi Arabia

Published in Dawn, April 10th, 2021

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