key: cord-1026183-i89f0t5m authors: Zirpe, Kapil; Gurav, Sushma title: COVID-19 pandemic in India date: 2021-06-04 journal: COVID-19 Pandemic DOI: 10.1016/b978-0-323-82860-4.00015-x sha: 9a10ead4ed8b4fd713b1a9504412cfa1d982ec34 doc_id: 1026183 cord_uid: i89f0t5m India being the most populous country had to tailor made its approaches to tackle the coronavirus disease 2019 (COVID-19) pandemic. Public health expenditure in India is just above 1% of gross domestic product. The warning signs of pandemic arrival in India were knocking our health-care system since the first few cases surfaced in Kerala. Social distancing as a method of keeping the virus at bay was first officially flagged by the Prime Minister Narendra Modi on March 19 in order to call for a 1-day “Janata Curfew” on March 22. The Epidemic Disease Act was implemented, and special task force was developed to draft guidelines for personal hygiene, surveillance, contact tracing, quarantine, diagnosis, laboratory tests, and the management of COVID-19. The Aarogya Setu app was developed to alert the public about COVID-19 symptoms, contact tracing, and the nearest contact of health-care center. We need to strive to extricate our country from this situation as advised by Krishna, “Uddharet Atmanatmanam—a person has to lift himself up; a man is his own best friend as also enemy.” 3 months after the first COVID-19 case was reported and 2 months after the World Health Organization declared the outbreak a public health emergency of international concern. The Epidemic Disease Act 5 was implemented in entire country which allowed officials to quarantine suspected cases and close down public places. An intensive campaign was initiated, and guidelines were developed for personal hygiene, surveillance, contact tracing, quarantine, diagnosis, laboratory tests, and the management of COVID-19. All health-care facilities were asked to stop regular Slow unlocking outpatient and inpatient services and to continue with only emergency services. Doctors were encouraged to use telemedicine services. The Aarogya Setu app was also launched to connect essential health services with people of India to fight against COVID-19. 6 This app will inform the users of the risk, best practice, and relevant advisories pertaining to the containment of COVID-19. "Lockdown phase" was utilized by individual states to covert amenities like hotels, colleges, railway train coaches, etc. into quarantine facilities and large public places like stadiums/ trade centers were converted into isolation wards to handle an anticipated increased number of cases. Some of the states converted existing hospitals to exclusively handle COVID-19 patients. Personal protective equipment such as ventilators, face shields, and face masks production was put on priority. "Atmanirbhar program" encouraged the local experts to increase the production of necessary amenities. Time had come to prove our indigenous talent. A control room was set up at the headquarters of the General Director of Health Service to address the COVID-19 related queries. The countries of the South Asian Association for Regional Cooperation (SAARC) were invited to tackle this pandemic, and 10 million US dollars were allocated for SAARC countries. Lockdown was extended up to May 3 and further up to May 17 and then up to May 31. Thus it was the longest lockdown (75 days) that any country has imposed in the world. Cases continue to rise even in lockdown phase, thus making us realize about community spread and the third stage of pandemic. See Fig. 1 . Definitely, lockdown has given Indians a greater chance of being alive than citizens of United Kingdom, Italy, Spain, or United States. Indian death rate in covid is 3% as compared to 5%-10% in the above-mentioned 7 countries. It gave us time for preparedness and identify the weakness and strength of this virus. The peak of pandemic in India was postponed from March-April to June, and this has enabled us to save thousands of lives. (1) Task force was created both at the state level and the city level. The task force updated their guidelines frequently as per recent development in treatment and local problems. (2) Lockdown period was used to screen and identify as many cases as we can; isolate them, contact tracing, and quarantine them. This lockdown announcement was not preceded by any official planning, leading to the large-scale movement of the urban poor as they headed for their homes in rural areas. Migrants probably knew that they could be carrying the virus with them and infect their dear ones, but they desperately needed a shred of familiarity, shelter and dignity, as well as food. Some described our official strategy was an example of "too little, too late" as hidden infections were already spreading in all parts of the country, followed then by "too much, too soon" and not enough planning. Long lockdown might be more devastating in India as it could result in economic deflection, increase hunger and poverty, and reduce public resilience to handle infection. A possibility of another peak of COVID-19 cases may occur once lockdown is lifted. A staggered unlocking of lockdown should be planned. Forecasting future COVID-19 pandemic is likely to take several months; social distancing and the use of masks have become important public habit. Increasing testing capacity and precautionary self-isolation of contacts is critical in reducing number of cases. Unlocking of lockdown should be done slow. Improving health-care facilities and pandemic laws to tackle future pandemic. 9 Improving telemedicine facilities, which play vital role in home quarantine facilities. 9,10 To carry fast-track research on vaccines and antibody testing for herd immunity. In any post-pandemic world, whether it is US-centric or China-centric, there is no scenario in which India, a universe in itself, and home to one-sixth of humanity, will not occupy a place. It is up to citizens: Will we emerge as part of the problem or as part of the solution? Will we emerge weaker or stronger as a nation? The pandemic has brought us to an inflection point. How we deal with it will determine our place in the future world order. Pandemics have forced humans to break with the past and imagine their world anew. COVID-19 pandemic is portal, a gateway between one world and the next. We can only hope that the dark cloud of the virus sails away with the present implementation of laws and restrictions on the public. The health-care system and future proof pandemic laws ought to be given priority and must be streamlined to ensure the availability of immediate assistance even in the remotest corners of the country. Ultimately, the individual need to strive to extricate our country from this situation as advised by Krishna, "Uddharet Atmanatmanam-a person has to lift himself up; a man is his own best friend as also enemy." We as individuals should like Arjuna proclaimed "Nashto Moha-my illusion is gone." 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