A path-breaking researcher, a scholar extraordinary, Dr Sanghamitra Pati is a precursor in innumerable medical science areas like multi-morbidity, infectious diseases, chronic disease prevention, cancer. Currently, she heads the Regional Medical Research Centre (RMRC), Bhubaneswar. She had her MBBS and MD from he MKCG Medical College, Brahmapur. In 2000, she received the Joint Japan/World Bank Graduate Scholarship to pursue Master of Public Health at the University of Maastricht, Netherland. Subsequently, she got the coveted American Association of University Women International Fellowship in 2002 for a research into bio-social correlated of maternal mortality. After her stint as a faculty in different medical colleges of Odisha, she joined the Public Health Foundation of India in 2010. She became RMRC, Bhubaneswar Director and subsequently steered clear Odisha during the ominous spell of Covid-19. She was selected for the prestigious Samanta Chandra Sekhar Award, 2018 in Life Sciences by the Odisha Bigyan Academy. She has 175+ scientific publications to her credit in peer reviewed journals. She has coauthored two books and a few book chapters. She is a reviewer of reputed journals, namely, The Lancet Oncology, PloS One and BMC Family Practice and is an editorial board member of European Journal of Cancer Care. She is leading the sero prevalence studies on Covid in Odisha, Chhattisgarh and Jharkhand. In an interview to The Pioneer, Dr Pati spoke to Sugyan Choudhury on the many issues concerning the post-Covid scenario.
What are the strategies to manage the long-term risks of Covid-19?
Now that Covid-19 is under control, we have to be extremely careful in taking into account the past history of patients. This needs an inculcation of high awareness among physicians as well as patients. Periodic monitoring of those patients who were in ICU, oxygen or in ventilators is needed. They are the high-risk Covid patients who might develop some symptoms persisting of breathlessness, neurological problems, physical deformity, loss of memory or physical frailty. Nowadays in the post-Covid scenario, doctors are conducting periodic monitoring, observing symptoms and providing necessary treatment to patients. This scenario calls for both patient’s and physician’s awareness.
What are the plans to monitor the evolving virus and how to upgrade the tool kits dynamically?
As you rightly told, this arena virus is highly evolving and liable to change. We must be thankful that a majority of our people are vaccinated and do not matter if this virus evolves. It is not going to have any catastrophic effect as it had during the 1st and 2nd waves. If this virus is evolving then there is a system in country called INSACOG, which is monitoring the virus through genome sequencing and virus variation of circulating strains of Covid-19 in India. In the RMRC, Bhubaneswar, we are also monitoring through sequencing. When we find positive cases, we go for testing and tracking and studying whether there is any mutation or change in the virus. Hence, genomic surveillance is the key to understanding whether the virus had gone through any mutation or change. Only two days back, the CM of Odisha made a Make in Odisha programme wherein the RMRC was also a participant. So, whenever we see that there is any mutation that might affect the performance of kit, we go for dynamically changing the tool kits.
How can we take a unified risk mitigation approach to future infectious diseases threat even beyond Covid?
Covid-19 has given us an insight and an impetus to strengthen our laboratory and surveillance system. In India, we have an IDSP (Integrated Disease Surveillance Programme) by which any new outbreak or mutants are being constantly monitored. Now, we have a strong laboratory network and every district has artificial lab with BSL facilities. There is always a routine and robust surveillance system maintained followed by outbreak investigation and finally sequencing or molecular testing is being conducted systematically whenever we find unusual symptoms and the like.
How would you advise the State Government to strengthen the health system in order to fight diseases having pandemic potential?
Now, Odisha is one of the most exemplary States in the country for managing the disasters. Pandemic is one such health disaster and Odisha has now got a robust pandemic preparedness plan to fight against any such outbreaks. All the districts of Odisha have now high bio-safety laboratory-II with all instruments that can detect any emerging or reemerging pathogens. Secondly, the grassroots workers like Asha and ANM are making door surveillance and have made rapid antigen testing during Covid. Thirdly, information education for community awareness has also been strengthened at the grassroots level. Hence, the public health system has already been strengthened and we have to sustain the tempo.
Is there any imminent threat to our health system by invasion of monkey pox and tomato flu?
First of all, I would like to say that there is no tomato flu in our State. It is HFMD (Hand Foot Mouth Disease). It is usually seen in paediatric age group. Now that the system is very much strong, people are sensitised, we are picking up cases. Monkey pox has been prevalent in many countries and we are almost prepared for it. Our port authorities have been made aware to look for the symptoms. We have to be vigilant for our young population. Those born before 1980 have got the small pox vaccination and they are possibly immune to such outbreaks like monkey pox. But those born after 1980 are susceptible to such outbreaks. Till now, we don’t have a single case of monkey pox in India.
How does your research on multi-morbidity intone the primary health care system?
Multi-morbidity is the presence of two or more conditions in a patient. It could be hypertension and arthritis; it could be hypertension and asthma. If two or more conditions coexist, it is called multi-morbidity. During Covid-19, patients having two or more chronic conditions were at the top priority since they were in the high-risk category and were advised to take vaccine at the earliest. Primary healthcare has dealt with Covid as well as the chronic disease with care and caution. Hence, they could link the two services with care.
Is there any possibility of a fourth wave of Covid in India, especially here in Odisha?
They call Omicron the third wave; and if at all a new wave comes, it would be the fourth. The target population of the entire country has been doubly vaccinated and most of them also have availed the precautionary dose or the booster dose. Unless the same virus is too mutant, it cannot create the same havoc that it has wrought in the past. Secondly, we have the sequencing detection system and we know the treatment modalities. We are confident enough to address any such outbreak or menace effectively. If at all it comes, it will not have the gigantic proportion of a wave; it could be a spike or small peak that could rise and fall. We have started mobility; institutions have opened up like schools; and now, we are more prepared to deal with such situations. But any wave per se now is the least probable.
