| Demand of the question Introduction. Contextual introduction. Body. Discuss various stages of public health response to epidemic outbreaks. Mention how India can prepare for any future epidemic risks? Conclusion. Way forward. |
The public health response to any outbreak is critical to control and contain the epidemic and damage it can do. Not only saving the citizens is priority, but providing the poor and vulnerable with utmost care is an intrinsic part of any public health response to epidemics. Generally public health responses involve various stages to prevent epidemic and its spread.
Various stages of public health response to epidemic outbreaks: The public health response to such outbreaks comprises three phases:
- The containment phase: During the containment phase, the aim is to detect and isolate cases and trace people who have been in contact with those infected. The goal is to prevent the disease taking hold in the country for as long as is reasonably possible.
- Delay phase: If containment does not work and the number of cases rise dramatically (there is no clear definition), we enter the delay stage.
- Delay is largely engineered through ‘social distancing’ strategies and personal protection measures.
- These are the main tools to prevent accelerated transmission when no vaccine or prophylaxis is available. This includes school closures, encouraging more home working and reducing large-scale gatherings.
- Another purpose of the delay phase is to push the outbreak away from the winter season. If the peak of the virus can be delayed until the warmer months, it could possibly reduce the risk of transmission as the life of the virus in the environment is expected to be shorter.
- This phase allows time for strengthening the health system to prepare for the patient load.
- Mitigation phase: In the event of the outbreak worsening, the response will escalate and the focus will be on providing optimal care for people who need hospitalisation and ensuring support for those who become infected but do not require hospital treatment. It also involves plans to minimise the impact of disease on society, public services and the economy.
How India can prepare for any future epidemic risks?
- Legal framework: What we require is a legal framework relevant to the current context. There is a need for an integrated, comprehensive, actionable and relevant legal provision for the control of disease outbreaks in India. This should be articulated in a rights-based, people-focused and public health-oriented manner.
- National health bill: A National Health Bill should be drafted for providing essential public health services and powers for an adequate response to public health emergencies through effective collaboration between the Centre and the states.
- Involving private sector: Given that the private sector accounts for nearly 70% of India’s healthcare, this sector has a critical role to play in supporting the traditional public sector-led response to the prevention and tackling of outbreaks. Investing in mechanisms to bring private sector players together is likely to contribute to better coordination, greater resources, more time and expertise during an emergency.
- Maintain standards: During epidemics, there should be provisions in the Act, to maintain standards in quality of care, rationality of treatment, cost of care, treatment protocol and ethical behaviour applicable to both public and private sectors and these need to be regulated through bodies with the involvement of people from both sectors and mutually agreeable professional organisations.
- Public health regulatory authority: A public health regulatory authority such as the Food Safety and Standards Authority of India should be established. A public health regulatory authority can propose, review and revise public health legislations on a periodic basis, recommend and provide scientific advice and technical support for the framing of state rules.
As the epidemic is on the rise and can have more than ever impact in the era of globalisation, there is a need to strengthen legal frameworks to prevent and control the entry, spread and existence of communicable diseases in India. There is a need for an integrated, comprehensive, actionable and relevant legal provision for the control of outbreaks in India.
