R
Raju Jotkar

Thanks Sunil. The Covid 19 came abruptly with its very high transmission potential (R0= 2.5) and moderate toll and gave little time to the states to have comprehensive and logical thinking. Moreover the trial lockdown followed by total lockdown 1.0,2.0, 3.0 and possibly now 4.0 selectively for red zone and containment areas) with closure of state and district boundaries restricted the choice while selecting the members for task force or think tank for Covid 19 from state capital only. So the states deserve benefit of doubt in this context. Having said this, here are some observations for your consideration. 1. Presence of experienced epidemiologist should have been the top priority and the PSM departments of medical college should have been on forefront in the battle. This opportunity is missed out. (I saw cardiologist leading the state strategy of Karnataka which appeared a lopsided and hardly rational. ) 2. The Kerala with fresh experience of tackling Nipah possibly helped well to prepare a comprehensive state strategy which has fetched tangible results. Their representatives should have been part of National think tank too. 3. Largely the Dominance of clinicians in pandemic think tank rather than a multidisciplinary think tank has made frequent flip flops in national and state level guidelines/ SOPs. Nevertheless the clinicians have major role in downsizing the case fatality rate and case management of individual patient specific complication rationally. 4.