Indian Journal of Vascular and Endovascular Surgery

EDITORIAL
Year
: 2021  |  Volume : 8  |  Issue : 5  |  Page : 1--2

BEWARE: The soothsayer was not a dreamer


Tapish Sahu1, Dipit Sahu2,  
1 Division of Peripheral Vascular and Endovascular Sciences, Medanta - The Medicity, Gurugram, Haryana, India
2 Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dipit Sahu
Department of Orthopaedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra
India




How to cite this article:
Sahu T, Sahu D. BEWARE: The soothsayer was not a dreamer.Indian J Vasc Endovasc Surg 2021;8:1-2


How to cite this URL:
Sahu T, Sahu D. BEWARE: The soothsayer was not a dreamer. Indian J Vasc Endovasc Surg [serial online] 2021 [cited 2021 Dec 4 ];8:1-2
Available from: https://www.indjvascsurg.org/text.asp?2021/8/5/1/324953


Full Text



The second wave of the COVID-19 pandemic was undoubtedly an unspoken tragedy for the Indian population. As we progressively unlock and open the social floodgates, we must learn and reflect from our recent observations, because they may provide a glimpse in what-lies-ahead [Figure 1]. Briefly speaking, these lessons are: the COVID-appropriate norms will have only a limited appeal and acceptance in our population, the health-care system has to learn and re-learn from its experiences till date, and the virus will never leave us until everyone is immune.{Figure 1}

The second COVID-19 wave in India was a significant learning experience about the Indian population's behavior in response to the onslaught of the pandemic. Our casual attitude of giving up all COVID-appropriate norms that eventually culminated in the drastic second COVID wave were akin to the observed behavior of the Britishers during the world war at the time of the German bombing. During the world war, when London was preparing to be hit by massive German air attacks, it was expected that the damage caused by the German bombers would leave the people psychologically traumatized; but on the contrary, it left many people emboldened by the “remote misses.” The concept of “remote misses” and “near misses” as explained by Malcolm Gladwell, stated that there were two kinds of reactions from the Londoners to the air bombings.[1] The ones who directly witnessed the carnage brought on by the bombings, but were not killed, had “near misses;” these people were traumatized by the visible destruction. However, there were millions of people who had only heard the stories of airstrikes but never actually witnessed the bomb destruction directly; or in other words, had “remote misses.” Those were the ones who felt emboldened and stronger. These people experienced a passive adaption, or in other words, they had “faced their fears” and had come out unscathed. In a similar scenario, the pandemic has infected 20–30 million people in India, but most of the population has escaped either severe infection or not infected at all. The number of people with “remote misses” still outnumbers the ones with “near misses.” Probably, this may be the reason why most of our population feels that they have conquered the virus. Several reports state that COVID-appropriate norms such as masking are also not being followed now, as the country unlocks. There is also an overwhelming record-breaking rush at different holiday spots, making social distancing an unlikely possibility in a country whose very existence is prided and defined by the social cohesiveness between its people. In such circumstances, the government is best advised to make plans considering that COVID-appropriate norms will gain only limited acceptance, and a third wave is highly likely.

The health-care system during the previous peaks faced several challenges with respect to infrastructure, planning, and implementation, but there were lessons to learn. The existing health-care system of our nation is quite unique with respect to other countries as it varies between urban and rural areas and there are structural as well as operational differences between the government and private sector hospitals. Due to the lack of, and maintenance of modern quality health care in the public sector, generally, people prefer private health care which is not affordable for most of the rural population due to lower income and lack of basic insurance policy.

The world as well as our country had not witnessed such a great pressure on the health-care system in recent times.[2] This pandemic caused stress on the medical supplies, oxygen supplies, hoarding of essential items, crippling financial losses, lack of beds, and also threatened the viability of small units if they were not providing COVID-related services. On one hand, a novel infectious illness has increased demand for specialized acute care that has overtaxed some hospitals and imposed unexpected costs on many more. On the other hand, precipitous declines in demand for routine services also reduced providers' revenue.

However, we rearranged, relearned, and revamped the complete health-care infrastructure to bear the increased pressure and demand within a short time. We faltered a lot, but stabilised very soon. There were many pitfalls, noted in everyday management by government, local authorities, and hospital administration, but there were numerous remarkable and stupendous exemplary measures as well.[3] We all hope that lessons learned from the prior experiences would prove as a template for timely regrouping when the situation so necessitates.

Finally, we need to be reminded again that the coronavirus has a considerable mutation capacity. A case in point is the delta variant and the more recent delta plus variant reported from various parts of the country. The virus adapts and attacks again, each time unexpectedly different from earlier. Furthermore, the Indian Council for Medical Research has shown that most of our population is still vulnerable and bereft of anti-coronavirus antibodies. Hence, there are only two ways the pandemic may meet its end: either the virus stops mutating, or the population achieves immunity through repeated infections or the vaccine. As health-care workers, we experience direct hits and near misses on a daily basis throughout our careers. Many of us have fallen ill, cared for loved ones or family members, and treated patients afflicted with COVID-19. We have personally seen and experienced the true devastation this pandemic has caused. We carry with us the stories of suffering and death, as well as those of compassion and caring. These narratives have the capacity to appeal to emotions, to enlighten and educate. We must use them to illustrate to the broader public that we still have a lot to fear from this disease. Remote misses should never feel remote. We need to “feel the blast” caused by anyone who becomes ill with COVID-19, and we need to be “deeply impressed.” For, if we do not value the losses, we are not valuing the lives that are bound to be affected, and that is what is our responsibility now. As we unlock progressively, we should remember and humbly accept that we will need to co-exist with the virus for an uncertain time wherein repeated increase in infections and repeated lockdowns may end up disrupting our social lives and our economy.

However, it may help to remember Haruki Murakami's words:

”And once the storm is over, you won't remember how you made it through, how you managed to survive. You won't even be sure, whether the storm is really over. But one thing is certain. When you come out of the storm, you won't be the same person who walked in. That's what this storm's all about.”

References

1Mourad A. The Remote Misses of COVID-19. Ann Intern Med 2020;173:1010-1.
2Blumenthal D, Fowler EJ, Abrams M, Collins SR. Covid-19-Implications for the health care system. N Engl J Med 2020;383:1483-8.
3Singh A, Deedwania P, Vinay K, Chowdhury AR, Khanna P. Is India's health care infrastructure sufficient for handling COVID 19 pandemic? Int Arch Public Health Community Med 2020;4:041.