What COVID taught me

When I did MBBS, PSM - Preventive and social medicine wasn't one of my favourite subjects. Frankly I was bored. I thought genes, molecules and receptors were way cooler. The fact that Park textbook had some chapter on count of eggs in shit (literally) and the dimensions of a septic tank didn't help either. The only saving grace was data and analytics - but it was also covered in pharmacology. The family health advisory programme, which looked lame to me and the rural posting added to the woes. Of course, you can have fun in these postings, if you don't have exam myopia- which makes you obsessed with cracking the entrance exam in the first attempt. I thought anything that stood between me and my MCQs was merely nuisance - to be tolerated for mandatory requirement, no more and no less. The final nail on the coffin was when I found during internship that TB patients were paid some incentives for completing the free medication for six months. My brain could understand the calculus - you pay them some incentives so they complete the drug course and stop infecting others. I saw it as investment to prevent one additional infection. My twenty-something heart revolted at the thought of some drunkard who utterly lacks any self responsibility and needs some incentive to even complete the medicines. Suffice it to say I wasn't a socialist.

I joined my preferred branch - and got plunged in the things I saw were cool. Where Park's textbook looked pale, Harrison's Internal Medicine seemed like the resplendent zenith of human achievement. To my chagrin, we couldn't practice even half of what was written in Harrison.

The cracks started showing up. The small picture of genes and molecules simply wasn't enough. It was , to use Dan Brown's phrase, like an atheist coming face to face with God. I had to eat humble pie and grudgingly accept that Park's made as much sense as Harrison - if not more.

Years passed.

Circa 2020, the pandemic hit. I had assumed that most doctors would have organically had the epiphany I had during MD medicine. Boy, was I wrong ! TV channels showed cardiologists and endocrinologists and gastroenterologists talking whatever they knew about pandemic control. Epidemiologists and preventive medicine guys were no where to be seen.

When vaccines became available, this lacuna took on a macabre turn - India saw a wave of antivaxx sentiment. No one knew what to do with it. It was a good time to revisit Park. Around the same time, state "models" started trending.

I had seen first hand - Tamilnadu had done a terrific job at controlling the pandemic. Amazingly, no one outside its borders had even heard of Tamilnadu model, which has perhaps the country's strongest public health system.

TN government has given incentives, conducted lucky draws and even cash prizes for volunteers who bring in people for covid vaccination. In short - it has used carrots. Where possible, in early stages, the state machinery used sticks too - literally. The private sector, meanwhile has only wielded metaphorical sticks.

One way or the other, public health principles were adapted to local realities and the goal has been largely achieved. When the history of the pandemic is written in the distant future, I don't know if the term Tamilnadu model will be immortalised in a future Park textbook. But everyone who received a vaccine here, got an oxygen bed on calling the helpline or survived the deadliest scourge in a hundred years, will be a living testament to its efficacy. The future doctors, I hope, won't be as dismissive as I was about PSM, in my youthful ignorance.