Improving lifestyle conditions to combat Covid-19

Sandro Galea's book, The Contagion Next Time, sounds a warning. Galea's central argument is that vulnerability to Covid-19 lies with a societal failure to recognise that the foundation of health rests on a healthy everyday life and not simply in the provision of health care. He ponders why this key lesson is not at the centre of pandemic discourse, which instead focuses on vaccination and treatment.

Although situated in a global context, the book's focus is the USA. Galea considers especially the enduring impacts of racism on health and the centrality of structural racism to understanding the USA. If it is all about the USA, why bother about it here? Let us not forget that the issues dealt with are not about the USA alone. It is what the world societies are facing. The flaws of the USA get highlighted because the author is from that country and the governments' there did not hide the deaths like many countries globally have done.

As mentioned earlier, Covid-19 spread is not about lack of health care facilities or vaccinations. It is more about healthy lifestyles. We shall discuss it later. Globally, there were more than 6 million Covid-19 deaths by early April, 2022. Amid this carnage, few have asked why, if this novel virus was the spark, there was so much dry grass, the book points out. The Contagion Next Time is suffused with Galea's anguish that failure to grapple with this question will cost more lives.

Worse, the world may fare even more poorly when the next contagion arrives. (It seems it is already at our doorstep going by the rising cases every day). The Lancet wasted no time in highlighting the crux of the matter as the book writes. After the Omicron (B.1.1.529) surge, which occurred after this book was written, the USA is now approaching a staggering one million Covid-19 deaths.

An analysis in 2021 by the Lancet Commission on public policy and health in the Trump era, found that about 40 per cent of US Covid-19 deaths "could have been averted had the US death rate mirrored the weighted average of the other G7 nations". Galea does not shrink from naming an aversion to complexity in some quarters that made policy making difficult in the pandemic. Covid-19 demanded high-impact decisions that rested on imperfect, incomplete information.

A lack of humility may also have contributed to at times contradictory public pronouncements. And there is a failure to confront racism, marginalisation, and socioeconomic inequality. As Galea observes choosing health will mean "reorienting our social, economic and political priorities" to support our collective wellbeing. Here is where we all must learn. We may have our systems, but these systems alone will not help us overcome the pandemic whenever it hits us.

The assessment made by the book should not be shrugged off but understood in depth and suggestions put in place in every country, including India. But there are questions that go unasked and unanswered. Just why would a belief that medical care creates health, persist in the world. The existing medical care facilities in the world are certainly not accessible to everyone. By all means improve upon them. Yet, improve the lifestyle conditions. Give all people the means to lead a healthy life which should be the priority.