As business activities slowly crawl back to normalcy and the memories of the second wave of COVID-19 recedes, the looming anticipation of the third wave harrows with each passing day. COVID-19 has continued unabated in India for almost two years, and has experienced, so far, two major surges separated by prolonged lull. Over the last few months experts have been warning about an inevitable third wave, and have projected October as the peak period for it. 

The infection curve in the country currently has entered a declining phase, after peaking earlier in May 2021. In the last two weeks, the daily case count has dropped to about 2.6 lakh from the peak of 4.14 lakh, while the active cases have come down to 32.25 lakh, after touching a high of 37.45 lakh. If the cases continue to rise over the next few weeks or months, it will be considered a fresh surge or the third wave. However, in the meantime few states like Kerala, Assam, Tamil Nadu, Maharashtra, and Andhra Pradesh are experiencing a rise in active cases locally. But as long as the rise in cases does not affect the curve nationally, it cannot be described as a third wave. 

A good amount of policy attention has been targeted at preventing the spread of coronavirus – such as rapid scaling-up of hospital and workforce capacities to manage sudden surges in care demand and overcrowded Intensive Care Units. However, in order to make India’s health system resilient, its primary and community welfare infrastructure must be strengthened. Primary health care acts as the first line of defense against any health crisis in communities. It also reduces pressure on the entire health system by providing comprehensive and preventive care during and after the crisis. 

Building an inclusive and robust healthcare infrastructure must be the focal point of any country. The Indian government has proposed an outlay of INR 2,23,846 Crore for health and well-being, a 137 % increase from the previous year. The government has also earmarked nearly INR 64,180 Crore which will be invested over six years to improve primary, secondary and tertiary healthcare, as part of the newly announced PM Atma Nirbhar Swasth Bharat Yojana. This is exclusive of the goals and objectives of the National Health Mission. The budget also mentions the introduction of the National Commission for Allied Healthcare Professionals Bill, along with the National Nursing and Midwifery Commission Bill. The regulatory improvements and institutional restructuring will hopefully contribute to improving health outcomes and enhancing economic growth. 

The Covid-19 pandemic outbreak took the country by storm and exposed the vulnerabilities of the healthcare systems. The central government announced the ‘India COVID-19 Emergency Response and Health System Preparedness Package: Phase-II (ECRP-II package), in July 2021 with a total corpus of INR 23,123 crores. Drawing from the experience from the last two waves, the Ministry of Health has released 50% of its share from the emergency package, to prepare for the third wave if it hits in the coming months. Taking cognizance from the second wave, where India struggled to supply medical oxygen to infected patients, the government of India has commissioned around 1755 PSA oxygen generating plants. At present, around 375 plants have been commissioned across various states and 500 more are at an advanced stage and are most likely to be set-up soon.

The National Institute of Disaster Management, under the aegis of Ministry of Home Affairs in its recent report titled ‘Third Wave Preparedness’, has warned that the third wave is likely to impact children, and rural India the most. The Ministry confirms that India’s paediatric facilities – doctors, staff, equipment like ventilators, ambulances, etc. are not equipped and at a scale to accommodate if a large number of children are infected. India must prioritize vaccination among children especially the ones with co-morbidities and a special focus on disabled children. 

Around 60% of India’s population lives in rural areas – where people lack health care awareness and amenities. Apart from expanding vaccination efforts, we must focus on awareness campaigns on COVID-19 appropriate behavior and symptoms early on. Local leaders and gram panchayats can act as influencers in rural areas and disseminate information. Mobile medical facilities are a viable option to ramp up access to primary and preventive care in rural areas. 

The government must create a favourable policy environment and encourage public private partnerships (PPPs) for building health infrastructures. India Inc has the strategic experience, capabilities and unmatched reach to remotest corners of the country. Their knowledge, reach and execution expertise can help bolster the government’s efforts at arresting the impact of the pandemic. 

India is a large country and no single government body or think tank can manage and control the mammoth adverse effects of this pandemic. The success lies in integration of all available resources, effective planning and efficient implementation.