COVID-19 pandemic: a narrative review on legislative and regulatory framework in India for disaster and epidemic

Public health legislation plays an important role in the containment of any epidemic or pandemic. During a pandemic, it might be necessary to override the existing laws or (individual) human rights for the containment of the pandemic. The objective of the study is to review the legal framework pertaining to COVID-19 pandemic preparedness in India. This study has been done as an unsystematic narrative review where various legislations were assembled from electronic data base, websites from various legislative and Ministries and discussion with experts. Owing to contain the spread of the novel coronavirus Government of India announced nationwide lockdown on 24th March, 2020.  For proper implementation of lockdown measures various legislative laws belonging to different ministries is required. There are two pioneer acts namely The Epidemic disease act of 1897 and The Disaster management act of 2005. Under these two acts the government has laid down various rules and regulations that have to be followed during lockdown. This article describes the need for the law in a crisis like this and various legislations that have been implemented during lockdown.

Handwashing: a household social vaccine against COVID 19 and multiple communicable diseases

Handwashing is the most cost-effective measure for prevention of a wide spectrum of diseases from respiratory, intestinal, soil transmitted helminthiasis, health-care associated illness to infection with pandemic potential like SARS, MERS and COVID 19. Experts view that handwashing can be the greatest investment in the mankind as it reduces under nutrition, morbidity, mortality and paves way for growth, development, educational attainment of people and thereby achieving healthier communities. Though the evidence of handwashing on health is two centuries old but change in human behaviour seems critical in both developing and developed countries. Hand hygiene is rarely practiced during crucial moments and even rarely soap is used. Therefore emphasis should be given towards a societal shift in behaviour change among children, caretakers and people of all age groups. Every school, community and hospital should be provided with Safe water, Sanitation and adequate Hygiene (WASH) services. Hand hygiene to be given top priority in national health plans by which millions of unnecessary deaths and burden on health care system can be avoided. Nevertheless under the looming threat of the current COVID 19 pandemic, where the exact epidemiology is still evolving and a vaccine doesn’t seem feasible as an immediate measure to control the disease, handwashing should be considered as a ‘social vaccine’ for everyone at every household level.

Diagnostic dilemma in catching anaemia early

Anaemia is major health problem in our country and the foremost cause of disability. The non-specific clinical signs together with lack of knowledge among people are a hindrance for people seeking early care for this disease. Palmar pallor in children for diagnosing anaemia is anaemia has shown to have low sensitivity. Laboratory estimation of haemoglobin levels still are the diagnostic modality of choice in most primary care settings. There are numerous methods based on different principles to estimate haemoglobin. Each method has its own merit and demerit and has to be used appropriately based on that. Some methods like Hemoglobin colour scale have shown have good result to replace Sahli's method but more validation is required. HemoCue also can be used for secondary and tertiary care health institution. A strong political commitment and dedication is required for overcoming operational issues in early diagnosis of anaemia.