PUBLIC AWARENESS RELATED TO SARS-COV-2 HEALTHCARE: AN ANALYSIS
- Arvind Singh Kushwaha
Our India comprises of the most number of diverse people. With the societal and economic development, India has gone through several phases. On the one side, it has one of the rapid developing cities meanwhile on the other side it also has the most number of tribes in the world. This land despite of all the diversity in different fields-physics, society, language, culture and religion-there is a basic unity in Indian cultural history. People’s social habits vary greatly in several aspects. The way of apparel, traditions, eating habits and manners varies. Different types of people have different types of response towards any event.
In the history of healthcare, several events could be easily witnessed. The emergence and outbreak of the plague, Polio, HIV Virus, Swine flu and now novel corona virus are prime examples of such events. The overspread of these diseases can only be encounter by public awareness during the event. With such diversity in our country, it seems a mammoth task for the authorities to create such awareness and maintain best defense against the widespread of the disease. The recent protection steps against the corona virus showed the lack of awareness among public to combat the virus.
In this research, the researcher strives to examine and explore the healthcare attempts dimensions against the recent pandemic within the India, followed by analysis as well as examination of several ongoing relevant situations, case studies, present enactments and policies in current scenario which will throw light on various aspects of public awareness related to novel corona virus healthcare and targets for the overall better development.
Keywords: Sars-cov-2, healthcare, awareness, Public response, vaccination
The purpose of information and awareness among the individuals had a crucial role in order to tackle any form of situation or circumstances, whether it may be for military purpose or to make day to day decisions. With having correct information, a person can deal with the position in a better manner. Thus, the importance of awareness can be inferred from numerous examples. This part also applies to the awareness against the disease which had caused uncountable casualties worldwide.
By looking at the demographic details, it can be easily inferred that our country comprises of the most number of diverse people. At the same time, with having second highest population, it becomes difficult for the authorities to maintain same quality of awareness among people. Featuring the societal and economic development, India has gone through across various levels of development. In order to counter the evolving outbreak of “Severe acute respiratory syndrome coronavirus 2” disease 2019 (also referred as ‘Sars-Cov-2’, ‘COVID-19’ or coronavirus), it requires social distancing and early protective measures to secure general wellbeing. Notwithstanding, awareness and information against it has been inconsistent, conflicting and unclear. The present study aims to assess the level of awareness and readiness to combat Sars-Cov-2 among the general public of India.
Rise of Sars-Cov-2 and Threat of life
The nature of outbreak of Sars-Cov-2 disease was not new for the mankind. In the history of healthcare, several events could be easily witnessed. The emergence and outbreak of the plague, influenza, Polio, HIV Virus, Swine flu and now novel corona virus are prime examples of such events. The overspread of these diseases can only be encounter by public awareness during the event. This disease allegedly initiated from Wuhan City, China (Dec 2019) and later it became a worldwide pandemic within a very short time period by infecting people all over the world. The human civilizations irrespective of nationality, age, sex, race etc. faced threat for their life. 212 countries worldwide faced this threat and reported confirmed case, while World Health Organization (WHO) declared it as ‘Public Health Emergency of International Concern’ on Jan 30, 2020. The first case of the disease was confirmed in the state of Kerala on the same day. Due to high population density and disease being contagious in nature, it infected numerous people within a short span of time.
Till now, India has faced two corona virus waves. The former one was much controlled due to early precautions and awareness about the spread of disease. Despite the awareness the country wasn’t set to handle the second wave, on 5th May 2021, India confirmed 4.12 lakh fresh coronavirus cases in a single day. As of 10th July 2021, 18.5 crore cases are identified all over world and in India 3.08crore cases are discovered with 2.99crore recovered cases and 4.07lakh deaths. The spreading of cases can be deduced from the fact that every sixth infected person is an Indian citizen.
No nations were getting any generous help and arrangement from this pandemic rather to persuade their residents to make mindful and playing it safe by altering their life-style. In addition to it, the absence of vaccine caused a situation of worry among the individuals. Especially, the unfamiliarity and newness to the pandemic heightens public’s perception of its peril, which impacted the advancement of unwanted behavioral changes among public. As the Sars-Cov-2 episode was advancing, a rush of fear, dread and stress in the general public has emerged eventually.
Vulnerability, misinformation, deception, and unconventionality of the virus uplifted the nervousness levels among individuals, particularly those at a high danger of getting the disease. The dread and stress seems to be reasonable as individuals were concern for their health. None of the individuals wanted to get contaminated with a virus that has a generally high danger even resulting into death.
The public reaction of fear, dread and disgrace against the virus may prompt adverse results of infectious prevention, which was also seen earlier during the spreading of SARS and Ebola virus. Particularly, the coronavirus pandemic evokes behavioral and psychological responses that were probably going to bring about emotional well-being issues among people contingent upon their degree of awareness with the virus. However, the positive behavioral responses base from people’s awareness and optimistic approach kept positive attitude toward the pandemic. In addition to it, the discovery of vaccine was a significant breakthrough which calms the people reaction toward the virus, though even the vaccination awareness toward the vaccination still remains a crucial point.
Initiatives taken for awareness
After the confirmation of first case in India, the country tried to control it with several precautions. The entry into several forms of institute was restricted and often many of the institute was closed temporarily. During this phase, few of the people were aware about the virus, but due to their hectic schedule and involvement in several sections, required attention was not given. However, when the situation was going out of control, the Government of India initiated its lockdown from March 22, 2020. The lockdown was initiated for a fortnight, but was kept on extending due to continuous increase in number of confirmed cases.
Through the lockdown, the free movements of the public were restricted and were made to reside at home in order to avoid any physical contact with anyone. This was the time where Government initiated fully fledged programs to aware people about the disease, how it spread and what precautions could be taken to avoid infection. The awareness was broadcasted by the use means of mass communication including Televisions, online campaigns, commercial advertisements, Newspaper, Display boards and online social networks. Majority of people residing in urban areas were became aware about the virus within a short span of time, however the awareness was quite low in rural areas, due to lack of mass communication means. Few of the rural areas came to know about the disease by the migrants who migrated back to their home in rural areas. Gradually within a period of time, almost every person was aware about the contagious character of the coronavirus.
The government utilized the funds for awareness among the public. Every state was instructed to extra precautions in addition to the guidelines issued by central government. The campaign undertaken was widely successful. Awareness campaign setup by Hon’ble Prime Minister Narendra Modi on October 8, 2020 on putting on masks, keeping safe distance and face-hand hygiene to fight against the disease was aimed to reach out to approximately 90 crore individuals. This campaign was continued till March 2021 and saw a great success in achieving its objective. At the same time, it was also urged to the media to spread awareness through the possible means of communication.
The lockdown was lifted gradually and still public was advised to strictly follow the precautions such as use of mask, sanitizers, social distancing etc. But, within few months after uplift of lockdown, the public faced second wave amounting to record break death tolls. Between these waves, discovery of some vaccines was done and it was prove to be a major achievement against the disease. Also, the discovery of vaccine make people became tension-free which lead to several circumstances where they started to un-follow the guidelines knowingly. Additionally, the relaxations granted by Government were misused, as people were having knowledge that there is a vaccine by which the disease can be treated.
As a result of violations and due to less numbers of vaccines available, it was certain that there will be a second wave. The Second wave strike earlier than expected and re-initiatives were taken with the same objective to make aware people about the seriousness of disease. Though vaccines were discovered, it wasn’t a substantial proof that Sars-Cov-2 has been avoided. Furthermore, the unprecedented rise in deaths and confirmed cases, even on daily basis, showed the concern of lack of awareness among the public. In addition to this, the lack of oxygen cylinders, medical facilities, medicines, hospital beds etc. during second wave automatically aware the people that this disease shall not be taken lightly.
This time the awareness was about more and extra precautions. Various differences in initiatives taken for awareness can be seen evidently in both time of lockdown. In the latter part of awareness, the people were motivated to attain herd immunity within time to combat against the disease effectively and collectively. Moreover, the process of vaccination started step by step in several phases. But at the same time, there was also false information and rumors in several communities about disadvantages of the vaccines as resulting into death. This showed that there was a strict requirement of awareness about vaccination and its positive outcome to combat Sars-Cov-2.
Awareness through Legal Enforcements
The requirement of law always remains a perquisite for having a better society. This pandemic also showed the importance of law through whereby few amendments were made in order to control the individual’s actions. It can be further classified as:
- Activeness of police and law enforcement agencies: From the first day of lockdown, the local police was deployed with full force in the streets of every district. Several check-posts were established for controlling the unnecessary movements of public. The nature of Lockdown was much similar to the nature of curfew as under Section 144 of the CrPC, 1973; however lockdown was imposed due to emergency like situation. District Magistrates were empowered with extra burden to handle the functioning in better manner. There was perquisite of pass and permission for physical movement. Furthermore, they also helped into the awareness campaign by instructing the guidelines to general public and to the people who were not aware about it.
- Imposition of Higher Penalties: Even before the lockdown phases, the government issued guidelines, but it wasn’t followed with such cautions as required. In order to restrict the spreading of disease, the centre instructed state government to impose strict fines against the people who don’t comply with the rules. To prevent individuals from bein wrongdoers, the particular state organizations, police and different offices were forcing powerful fines. The amount of the fine was from Rs. 200 to Rs. 1 lakh depending upon the act violated. Furthermore, there was also provision for confinement of people for a short duration. Such types of provisions were ordained to establish a deterrence effect among the public.
- Amendment in laws: During the lockdown phases, several legal amendments were done with a humanitarian and economic approach. With having urgent requirement, the Epidemic Disease Ordinance, 2020 was enforced for 1897 Act to provide action to be taken in pandemic duration and to include prevention of crimes against healthcare personnel. Special powers were conferred on judiciary and legal enforcements to deal with the matter expediently. Moreover, the Disaster Management Act, 2005 was amended for necessitating provision for disaster management authority to deal with the spreading of virus in a better manner.
- Changes made in Goods and Services Tax: In order to reduce the Sars-Cov-2 treatment cost and to make goods easily accessible and available, the GST rate cuts on Covid-19 essentials were introduced. The GST Council in its 43rd Meeting decided to bring down GST rate on 14 goods under Covid essentials. In particulars, it included PPE Kits, sanitizers, masks, gloves, temperature checking equipment, ambulances services, pulse oximeter, testing kits and medicines such as tocilizumab, amphotericin B, remdesivir etc.
- Promote online platform: To abridge the movement and physical contact among public, the institutions favored the use of online platform. Educational institutes took classes online, the courts including Hon’ble Supreme Court took case proceedings online, Interviews were held online, meetings whether political or business were conducted online, deliveries of goods including basic essential commodities and medicines were made online etc. are amongst the prime examples of promotion of online platforms. The employees of all firms experienced work-from-home employment.
- Availability of essential commodities: The government took initiatives for easy availability of ration and related commodities to every person in need. Rations were provided free of cost and in stock to survive longer and to avoid accessing other resources. This was one of its kind initiatives where the government took initiative for going door to door and helping the poor people.
- Targeted scheme Beneficiaries: In light of the information and database available, the Central government targeted the several beneficiaries under different schemes including MNREGA, PM-Awas, PM-Kisan and Ujjawala Yojana. From the other side, the necessitous people also approached the government for taking the benefits under the schemes. This step clearly made a successful attempt to aware the people residing in rural area and it also covered the people already registered or part under any of the abovementioned schemes. The private area companies, businesses and exchange affiliations will likewise roped in with similar schemes to help the maximum number of people.
Analysis of Present Scenario
Presently it is extremely evident that due to all initiatives taken during the continuous COVID‐19 duration i.e. from Jan 2020 to July 2021, almost each and every adult person is aware about the symptoms and precautions required to avoid the spread of Sars-Cov-2. A great part of appreciation goes to the authorities, institutes, organizations and government who gradually covered the lowest level of awareness among the public. But the fight has not been completed yet. Throughout the history of healthcare, it can be seen that the disease is ceased to exist only after proper and full vaccination of affected individuals and general public. The spread of Polio is a recent and best example of it.
Still people are not going or applying for the vaccination voluntarily. Though there was sufficient awareness about disease, yet people are hesitant to get vaccination. It could be possibly sum up in following points:
- Lab Test Results completed: Whenever a vaccine is made, it is out for trial firstly on certain people as part of sampling and to ascertain the real outcome of medicine. This procedure goes through three phases and then only it is out in public domain. It is a basic healthcare routine followed for any medicine newly formulated. In the present scenario, due to high demand and as part of emergent necessity, the vaccine was offered after single trial only. This part questioned the effectiveness of the vaccine for people. Though till July 2021, the vaccine had gone through all tests and available to general public.
- People avoiding from being guinea pig: Many of the individuals didn’t opt for the vaccination voluntarily as they thought that they were be used as guinea pig to test the effectiveness of the vaccines. Additionally, in order to risk their life they adjust on the position to wait and watch the effectiveness. This part can be furthered supported by the evidence that after the test results, India have seen huge number of people getting vaccinated on daily basis.
- Prevailing based over misconceptions and rumors: ‘Vaccine causing death’ related misconceptions and rumors were widely disseminated within several communities. At this time, the public was in a situation to either stay safe in home or to approach the vaccination center as a part of threat to life. These misconceptions and rumors prevented many people from getting themselves vaccinated especially in rural and tribal areas. Several incidents can be seen where the villagers and tribal people escaped from their homes when the healthcare personnel approach them for vaccination. Though, it wasn’t that much concern with urban people, they have turned down spread of such rumors. It implies the lack of proper communication among the rural people.
- Vaccines not 100% effective: Though several countries have discovered many vaccines to combat the disease, yet their effectiveness is not matched with 100% safe. More importantly, the vaccines distributed in India not even crossed the 80% mark. In this scenario, people were more tinted toward the negative impact of the vaccination. Moreover, few of the negative incidents further escalated this worries. The reason for not having 100% accuracy lies with the reason that the Sars-Cov-2 is a single RNA based item which can be highly mutated in nature. The former part was widely circulated however the latter part i.e. the reason wasn’t spread with such efforts. It can be further evident by the fact that we had faced numerous coronavirus variants which were different from basic coronavirus.
- Personal autonomy: Considering the huge number of people not approaching for vaccination voluntarily, the Supreme Court left the decision of getting vaccination upon their personal choice and stated that neither the Government nor any organization or institute can force an individual to get vaccinated against his will. In presence of such decision, the only safest means left with the government is to spread the positive outcomes of the vaccine against the disease through awareness only.
- Distrust in government: This part was highly circulated by the leftist. People who were against the ruling political parties questioned every procedure taken by the government to combat the disease, which create a dilemma in mind of general public as to whether approach for vaccination or not. The Hon’ble Prime Minister neglected all such views and urged the people to overcome the hesitancy for vaccination.
- Dilemma of cure vs. religious belief: Some of Muslim people voluntarily avoided the vaccination over vaccine being considered as anti-religious. They are left in a dilemma whether to go with cure or to support the religious belief. The logic offered by Islamic Scholars during deliberation that the pork and associated products are used which are considered as haraam or impure in Islam. This concern not only in India but also overseas. In the medical science, it has seen that pork derived gelatin is used widely as a stabilizer for safe and effective vaccine storage and transportation. However, the vaccine companies such as Pfizer, Moderma and Astra Zenneca has denied this part stating that no such ingredients are used for corona-related vaccines.
- Less number of vaccines available: It was assumed that the healthcare companies will be producing 90 million doses monthly by July and August, however considering the huge population, it is not still enough to have an impact. It might be only sufficient for the fixed vaccination drive i.e. for people having age of 45+. These people have to be cured firstly as they amounts to 80 percent mortality rate.
- Lack of proper healthcare infrastructure: The vaccines are being supplied directly to the government and are distributed within the government hospitals only. The less number of private hospitals with power to give vaccination have overburdened the government hospitals. Furthermore due to coming of uncountable people on government hospitals everyday and proper guidelines not being followed among the coming public, people are still hesitant after second have and want to defer their vaccination date.
The death tolls of second wave also questioned the healthcare infrastructure of the country and somehow it aware the people to not solely rely on government resources. To counter this lacuna, people were made aware about positive impacts of maintaining a good and healthy life system by doing yogas and maintaining a healthy diet. People were inspired to become atmanirbhar (self-reliant) in order to combat the diseases on individual basis. This campaign can also be seen as an advance step toward herd immunity. The role of spread of awareness within due time played a crucial role to control the Sars-Cov-2.
With the rise in spread of disease, each and every person’s day-to-day life was affected. The coronavirus pandemic has triggered fear and anxiety amongst people from the time since it started, regardless of their level of awareness. The lower level of positive behavioral changes toward the pandemic was due to the lack of a sense of crisis events and public’s lack of awareness or concern about their contribution towards the society. People’s reactions to the outbreak of Sars-Cov-2 virus have influenced their passionate, emotional and psychiatric well-being, inciting the choice of trivial practices among individuals. Meanwhile, the governments keep on great demanding impediments on improvement of people’s livelihoods, extended levels of hopelessness, melancholy, and the progression of ruinous alcohol and medicine use, and self-hurt. The findings strongly hint that effective awareness programme and better healthcare system have been delivered to the persons in need. The lack of proper awareness cost us the second wave which shook the entire nation. People witnessed several shocking scenes that have been encountered outside healthcare institutions and clinics whereby the individuals biting the dust without obtaining medicines, beds, oxygen cylinders and treatment. It demonstrated the horrid truth of healthcare infrastructure. On the economic side of the country, with the innumerable list of expenses incurred during the pandemic to handle the situation, the governments invested all its deposits to save and support the public health. A glance of the Budget of 2020 and 2021 are evident to this. With such diversity in our country, it was a mammoth task for the authorities to create such awareness and maintain best defense against the widespread of the disease. The Sars-Cov-2 awareness required a correlation with optimistic attitude approach towards the treatment and to deal it in a better manner. The consequences we had faced till now were worse in nature resulting into huge number of death tolls. The situation could be much more controlled if people followed the guidelines more strictly. Though every possible measure was taken to aware people, the outcome remains a major concern throughout the analysis. The focus shall be not on the initiatives made for the awareness but on the positive outcomes through awareness. The level of readiness and preparation among the institutions and service providers towards the Sar-Cov-2 pandemic was empowering. All things considered, more viable and practical stands required to ensure full inclusion with hand cleanliness alternatives openly ventures. Quite possibly the main components in the fight against the disease was to engage and empower the public with exact and precise information and awareness which empowered them to avoid potential. Intermittent assessment and evaluation of specialist organizations awareness and readiness for any conceivable outbreak ought to be set up to guarantee supportability of endeavors.
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