Dr Rajesh Parikh: ‘Brace for the next wave, we should not repeat mistakes made this time’

Narayan holds a BTech from IIT-Kanpur and a PhD degree in nuclear physics from Mississippi State University in the US. Despite getting lucrative job offers elsewhere, Narayan says he preferred to return three years ago.

Director of Medical Research at Jaslok Hospital, Dr Rajesh Parikh, who co-authored ‘The Coronavirus: What You Need To Know About The Global Pandemic’ with internal medicine specialist and healthcare entrepreneur Dr Swapneil Parikh and clinical psychologist Maherra Desai, said the book published by Penguin Random House has been received warmly by readers since its release on August 15. While a sequel is in the works, he discusses the Dharavi model, the role of Artificial Intelligence in our future and the many challenges ahead with Mayura Janwalkar.

What are still the most frequently asked questions about Coronavirus?

Between my co-authors and I, we get over a 100 questions every week. Many of them are related to what lies ahead for our country and treatment options and vaccines. Interestingly, we get many appeals for help with admissions and medicines among others. We have been able to help around 150 people in a variety of ways.

What could be the challenges in distribution of the vaccine in a densely populated country like ours?

There are over 250 vaccine candidates in various phases of trial around the world. We have devoted a chapter in the book to treatments and vaccines and discussed the monumental challenges, including political, not just with clinical trials but with manufacture, distribution and administration of 7 billion doses in a just and equitable manner. Hopefully, we should have a vaccine by the first quarter of 2021.

Do you think the containment of the virus in Dharavi was a success?

Yes. The people of Dharavi have much to teach us. They and the people involved in their programme deserve appreciation. We could have done better with earlier testing and tracing and looking after our impoverished migrant workers. Our city and state has done well despite all the challenges. Although our numbers are high, which is expected because we are testing more than other states, there never was an acute shortage of beds. The number of patients requiring beds never exceeded capacity. It may have marginally on a day or two but that’s a big accomplishment. By and large, the state and the BMC did a great job of ramping up our facilities.

What should the government and private healthcare facilities focus on in case of a future pandemic?

Our public health infrastructure is woefully inadequate to deal with a pandemic. At the best of times, it is barely able to cope with the disease burden. We need to allocate far more resources in comparison to the less than 2 per cent of our GDP for health. Of 191 countries for which data is available (in 2019), we rank 184. Bangladesh and Bhutan are ahead of us. We should spend at least as much on health as we spend on defence.

As we adapt to a culture of minimising human contact, what are the areas in healthcare in which Artificial Intelligence (AI) can immediately take over to ensure safety?

AI will play an increasingly significant role in all aspects of healthcare — from diagnostics to therapeutics. We have dealt with it at length in our book. It is possible that AI may be more human-centred than we have been this far. AI has done tremendous things in this pandemic. A lot of modeling studies about how the disease will spread have been done by AI and they have been fairly accurate. AI already has great applications in diagnostics. When decisions are left to AI, it can look at the long-term implications. Just vaccinating wealthy nations is a very short-sighted policy. AI will be able to figure out where the need for vaccine is the most regardless of politics.
How do you imagine the next one year ahead of us?

A period of enormous challenge lies ahead on all fronts — humanitarian, medical, economic, social and political. Over 25 predictions that we made in our book about the pandemic have been borne out. We have also expressed confidence that we will overcome it all. Hopefully, that too will turn out to be true.

Do you think we should brace ourselves for a second wave of the pandemic?

Yes, indeed. A second wave has already begun in Europe. As we have pointed out in our book, the influenza pandemic of 100 years ago had three waves between 1918 and 1919. The second and third waves were far worse than the first. We have to brace ourselves for the next wave and even the next pandemic. At the very least, we should not repeat the mistakes we’ve made till now.

With mental health being a parallel crisis with Covid-19, will anxiety and depression caused in current circumstances have a lasting effect on minds of patients?

WHO has predicted a mental health pandemic for the next year. There has already been a several fold increase in anxiety and depression this year. Undoubtedly, it will spill over into the following years. Since we are dealing with a new disease, we do not know the long term mental health effects. However, if we go by the sequelae of the influenza pandemic, one can anticipate long lasting neuropsychiatric sequelae. Some of these are already apparent.

Is a sequel to your first book on the cards?

I began work on the next book relating to future waves three months ago. It will take off from the last chapter of our book, which is titled ‘Beyond Covid-19’ and look at various effects of this cultural extinction event. It will attempt to predict the world after Covid-19 at home, work, health, economics, politics, social media, human relationships and beyond.

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