Covid-19 · History of Medicine · Medicine & Doctors · Public health

Epidemics End. Eventually. Sort Of

This is a commentary I wrote, on how to think about and approach the “end” of the COVID pandemic in India. It was published in The Wire Science on 31st October 2021. Here is the link. Below is an excerpt from the article.

As Sivaramakrishnan says, policymakers prefer to conceptualise epidemics as finite, circumscribed events with a beginning, a middle and an end. That helps them project achievements and successes in terms of disease control and eradication. But these neat boundaries of beginnings and ends just evaporate at the doorsteps of millions of Indians for whom structural factors have given rise to an almost permanent state of ill health and poor healthcare.

Even when COVID-19 is ultimately brought under control in India, outbreaks and epidemics of infectious diseases, old and new, will continue to occur in many parts of the country and will cause disproportionate, preventable suffering among members of underprivileged communities. Policy discussions risk losing sight of these constant outbreaks if they stop at some endpoints based on selective statistics.

What an administrator or an elite commentator considers to be an endpoint makes little sense in the life of a vulnerable person – for whom the endemic and structural risk factors frequently go far beyond the epidemiological transmission of a microbe.

Let us not forget that vertical public health strategies focused on the control of a single disease have never led to sustainable and long-term healthcare improvements. While eliminating a deadly pandemic is a noble goal, we should not lose sight of what needs to be our larger, consistent goal: the elimination of suffering and the eradication of the injustice and inequalities that give rise to such suffering.


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