Rockefeller Foundation recommends roadmap to control Covid-19 in India

The prestigious Rockefeller Foundation on Thursday recommended a strategic roadmap to not only control COVID-19 in India, but also to manage future waves of the deadly pandemic which has killed over 2,80,000 people in the country.

The Rockefeller report, The Road Ahead for Smart COVID-19 Testing and Tracing in India, prepared in collaboration with experts and other prominent organisations outlines how India can strengthen its testing and tracing capacity to adapt to this moment, break the surge, and control future outbreaks, focusing on five critical opportunities for devising an equitable, cost-effective, and scalable COVID-19 response.

To effectively protect the population from COVID-19, it said testing and tracing strategies should be further strengthened and contextualised through a cafeteria-style approach to testing (enabling the availability of a diverse portfolio of tests with clear guidance); undertaking well-designed sero-surveys; setting regulatory pathways and quality checks on new testing technologies; ensuring equitable access to testing; and scaling genome sequencing efforts.

The report said that testing capacity, availability, and accessibility must be improved through using pooled procurement through a consortium facilitated by the Centre to reduce testing costs by a third, incentivise domestic production of testing kits and components, and control testing prices.

It seeks to enhance the demand forecast of testing for equilibrium. Doing so will ensure that testing and tracing systems are proactive and testing suppliers are response-ready, it said.

Recommending collaboration and communication for uniform and lucid information dissemination, the report says building collaboration and trust with the public must be prioritised through implementing a transparent data collection and sharing policy for researchers and citizens.

It also recommends to scale crucial components of tracing systems. Tracking and tracing require human and technological resources to effectively curb virus outbreaks and provide dignified, destigmatised support to those that test COVID-19 positive.

This focused report, with actionable recommendations, can serve as a resource in informing us specifically in areas of testing and tracing, said Principal Scientific Advisor to the Government of India, Prof. K. Vijay Raghavan.

Since the outbreak of the pandemic, constant testing and tracing has benefited us significantly. This was possible due to the speedy advancement through science, technology, and innovation, he said.

Quick recalibration of priorities and impact-driven public-private partnerships have steered us to achieve better capacity in testing, diagnostics, therapeutics, vaccines, Raghavan said.

Rajiv Shah, president of The Rockefeller Foundation said that the recommendations in the report make a case for reinforced testing and tracing measures to limit the ongoing pandemic and avert impending ones.

Overcoming the challenges posed by COVID-19 requires continuous learning and application of insights to improve public health outcomes, he said.

This is why we are proud to work with an incredible roster of experts and the office of the Principal Scientific Advisor to support the development of more inclusive testing and tracing strategies for India, Shah said.

In its report, the Rockefeller Foundation says that it is essential to create an enabling environment where independent researchers can quickly access authentic data and analyse it to offer valuable insights for policymakers. Communication channels should be strengthened to bust rampant misinformation and allay fears of people.

Building a detailed tracing protocol that combines the best of manual and digital practices and a pool of trained healthcare workers is needed. Tracing and tracking as strategies should also be perfected, and practiced in times when infections are low, so that they can be ramped up, if next waves of the pandemic hit, or other infectious outbreaks strike in future.

The intensity of contact-tracing should be calibrated as per data from gene-sequencing, test positivity, gradient of caseload, and guidance of sero-surveys, it said.

The report notes that it is important to include backward or retrospective tracing as an important aspect of contact-tracing programmes especially since COVID-19 transmission has this typical attribute where few cases cause many and many cases do not cause any transmission.

To attain a three-fold reduction in cost of COVID-19 testing, states should procure kits and consumables through a consortium facilitated by the Centre rather than independently.

Variable cost caps across states without accounting for the diverse cost components will make it unviable for the private sector to sustain testing operations and shift the burden to the public sector, the report says.

Also, scientific demand projection undertaken quarterly can pre-empt both kit shortages as well as losses incurred by test makers due to idle capacity, it said.

Given that close to a billion people are likely to remain unvaccinated at most points in time over next 8 to 12 months, and the prospect of more infective and deadly mutations emerging, testing and tracing should continue to be an integrated part of systemic pandemic response and calibrated to complement the vaccination programme, the Rockefeller Foundation said.

With 2,76,110 new coronavirus infections being reported in a day, India's tally of COVID-19 cases climbed to 2,57,72,440 while the daily deaths were recorded below 4,000 after four days, taking the toll to 2,87,122, according to the Union Health Ministry data updated on Thursday.