Place strategy

Omicron: Rely on health protocols, do not disrupt economic activities

India is facing the third wave of the Covid-19 pandemic. Evidence indicates that the new variant, Omicron, is highly transmissible but less severe compared to previous variants. However, due to its higher transmissibility, the current wave can cause a large number of cases. Given the current state of healthcare infrastructure and low immunization coverage in many states, Omicron can place a significant burden on the healthcare system.


Fortunately, we now have more evidence on response strategies and evidence-based tools to guide us in managing the current wave. We reviewed the published literature to understand the different exit strategies adopted by countries for containments. The results illustrated the importance of expanded testing capacity, the need to continue with non-pharmaceutical interventions such as physical distancing, use of masks, hygiene measures and robust monitoring systems while designing safe exit plans from containment. Full vaccination remains the most preferred strategy for reopening companies. However, immunization inequity hampers progress in coverage in low- and middle-income countries.

India has seen severe job losses, economic upheaval, food insecurity and disruption in education, all caused by containment measures aimed at curbing the spread of Covid-19. Some states have responded to the wave by imposing partial closures and curfews. Most developed countries rely on universal immunization, including boosters, to contain the spread of Omicron without disrupting economic activity.


However, in low- and middle-income countries like India, this strategy is a challenge. By the end of December, 65% of India’s adult population had been fully vaccinated and around 90% had received their first dose. Even as the country strives to provide universal vaccination against Covid-19, other equally important public health measures are needed to avoid lockdowns.

Global reactions to contain the spread of Omicron provide useful information for India’s strategy. The UK plans to ‘ride’ the wave without further restrictions. The government plans to test essential workers daily with minimal restrictions such as working from home, wearing masks in most public places, and performing rapid tests before going to public places.

The United States plans to increase testing availability and improve immunization coverage while keeping schools open. Germany has restricted private gatherings and banned major events and is trying to improve immunization coverage.


Being aware of the effects of a lockdown, India should rely on more robust public health measures that place fewer restrictions on economic activity.

Evidence suggests adopting a multi-pronged strategy that includes the following approaches:

One, limiting restrictions on social gatherings and public events as well as compliance with masking, physical distancing and hygiene measures. Second, the collection of high quality surveillance data to identify local hot spots and decide on strategies. Epidemiological surveillance is necessary to calibrate social distancing measures appropriately and achieve a low and stable infection rate that will not overwhelm the health infrastructure. Third, strengthening of the public health system for surveillance, tracing and quarantine must continue. Fourth, achieve 100% vaccination for the eligible population (those over 15 years of age) and booster vaccination for all frontline and essential workers, the immunocompromised and elderly population. And five, effective and targeted communication on the current epidemic, possible variations of concern and the importance of adhering to public health measures.


These public health interventions will limit the load on health infrastructure with minimal disruption to livelihoods and consequences for the health and economy of the country.

Madhavi Misra is a doctoral candidate at the Johns Hopkins School of Public Health. Harsha Joshi works to strengthen health systems in India. Krishna D Rao is Associate Professor, Department of International Health, Johns Hopkins School of Public Health)

Opinions expressed are personal