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Published on: May 15, 2020
4 minute read
By: Dr Rajan Choudhary

Living With COVID And Returning To BAU!

Hurdles to Business As Usual – Hurdles to Life as Usual – Living with COVID!

Obstacles to re-open the country

As we come to the 2-month mark of lockdown, its effect on the populous is becoming apparent. The extreme restrictions have had a significant impact on people’s physical health, mental health, and general livelihood, and many people are itching for life to get back to normal. Many countries including New Zealand, Germany, Italy, and Spain have seen the first peak of COVID infections pass, and some have already begun reopening parts of their economy. This has led to concerns from public health officials that relaxing the lockdown too early and too liberally will lead to a rapid increase in infection rates. Indeed, Germany has already seen an increase in R0 above 1 (one infected person will infect more than one person, causing the disease to propagate).

Trying to work out how to reopen a country without causing another spike in COVID deaths is probably the biggest issue faced by public health officials across the world. And trying to convey clear instructions to the public is an issue some countries are currently struggling with. In the next few blogs we will look at the issues faced, what has worked and what needs improvement, and what we as the public can do to keep ourselves safe.

THE MASKS WE WEAR

We have discussed masks at the start of the pandemic, and we have discussed masks as the pandemic has progressed. Why are we bringing it up again?

Masks have been a heated point of contention, but their role in public health has matured over the past few weeks. At the beginning of the pandemic, masks were a rare commodity, with DIY stores running dry of masks, stories of people stealing masks from clinical environments, and very confusing advice on whether the public should wear masks in public.

At that time the WHO had recommended only infected patients and those working with infected people wear masks, to save on the precious PPE for medical professionals. N95 respirators are seen as the gold standard in protective equipment, and hospitals are still struggling to provide staff with enough respirators, let alone the public. Concerns have also been raised on whether using masks will provide a false sense of security, especially if they stop washing hands or touch the infected parts of the masks.

But now we are past the first COVID peak, and advice on masks has changed. People should wear a mask if they are in public. Germany has implemented this advice, as has Austria for its public markets. In the US many stores are requesting public wear masks before entry. Rather than surgical masks or respirators, the use of homemade or purchased cotton masks has been encouraged.

LET’S LOOK AT WHY

Surgical masks and respirators aim to protect the user from inhaling microscopic aerosolized COVID particles. Cotton masks do not function this way. Instead, they prevent the wearer from spreading COVID by catching much larger droplets that is coughed/sneezed or generally breathed out.

The majority of people with COVID-19 are able to spread the infection to others up to 3 days before they show symptoms. Indeed as many as 50% of infections seem to occur from pre-symptomatic individuals. During this time they produce the greatest amount of viral particles, and these particles can stay in the air for several hours. Someone with asymptomatic COVID walking around in public or in a shop could infect lots of people.

So wearing a mask, even if you are not symptomatic or around infected patients helps prevent the spread of the infection. We know already just how infective COVID-19 is, so any measures that reduces infection even a little will end up reducing spread drastically on a population level. It has been compared to seatbelts – one person might not feel the benefits, but they save thousands of lives across the country on a yearly basis.

IS THERE ANY EVIDENCE?

In our blogs, we often talk about the importance of evidence. We look at the quality of evidence, how different types of research gives good and bad evidence, and why we should always give evidence-based advice.

So is there any evidence supporting masks? We have evidence that cloth masks can stop 99% of droplets that are coughed up, and whilst it doesn’t block aerosols or actual viral particles it still has a significant impact on transmission. We also have strong evidence from high infectivity in choir groups and at call centers that the majority of transmission is via the air, rather than from surfaces.

But what about the highest level of evidence? Comparing people who do or don’t wear masks is not a study that can be easily performed or one that has been performed adequately. But why should you wait? There is minimal to no risk associated with wearing a cloth mask, it offers some protection to you and a lot of protection to the public. In these cases, we should take a precautionary approach.

We don’t have any high-quality evidence looking at hand washing or physical distancing. But precautionary measures enforced have helped reduce infectivity. The same applies to masks. The best we can offer is an Australian study looking at mask use during influenza. They found observational data suggest that transmission of viral respiratory infection was significantly reduced during the SARS epidemic with the use of face masks as well as other infection control measures” and “in an adjusted analysis of compliant subjects, masks as a group had protective efficacy in excess of 80% against clinical influenza-like illness.”. In compliant users, masks were highly efficacious.

So that’s our advice. If you're going to go out in public, wear a mask.

If you don’t have a mask, you can order one online. Or be adventurous. Make one out of an old T-shirt or sock. Here are some ways to make one without needing to sew.

https://www.theguardian.com/us-news/2020/may/11/make-non-medical-coronavirus-face-mask-no-sewing-required masks

https://www.youtube.com/watch?v=r51YroAFPds DIY Face Mask

MORE INFORMATION

https://www.fast.ai/2020/04/20/skeptics-masks/#mightnt-people-handle-their-masks-wrong-and-make-things-worse Masks - FAQ

https://www.bmj.com/content/369/bmj.m1435 face masks for the public

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30918-1/fulltext wearing face masks in the community during the COVID-19 pandemic: altruism and solidarity

https://twitter.com/trishgreenhalgh/status/1253244613927874560 twitter trisha

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

Read Blog

Lower Premiums for Health Score Achievers: How Preventive Wellness Rewards Healthy Choices

Healthcare costs are rising steadily across India, driven largely by lifestyle-related diseases and late-stage diagnosis. In response, organisations and insurers are shifting focus from reactive treatment to prevention. One of the most effective approaches emerging from this shift is offering lower premiums for health score achievers.

This model aligns personal health responsibility with financial incentives, creating a win–win situation for individuals, employers and insurers.

What Is a Health Score?

A health score is a composite indicator that reflects an individual’s overall health status.

It typically considers:

preventive health checkup results
lifestyle habits such as physical activity and sleep
key biomarkers like blood sugar, cholesterol and blood pressure
body composition indicators

The focus is on risk reduction, not perfection.

Why Health Score–Based Premiums Are Gaining Importance

According to NITI Aayog and EY-FICCI reports, preventive healthcare can reduce long-term medical costs by up to 30–40 percent.

Health score–linked premiums:

reward proactive behaviour
reduce claim frequency
encourage early detection

This shifts healthcare from illness management to health preservation.

The Preventive Healthcare Gap in India

NFHS-5 and ICMR data show:

many chronic diseases remain undiagnosed until advanced stages
preventive screenings are underutilised
lifestyle risks are increasing among working adults

Health score incentives help close this gap.

How Lower Premiums Motivate Behaviour Change

Financial Incentives Drive Consistency

When healthy habits are rewarded financially, individuals are more likely to:

attend regular screenings
improve diet and activity
monitor health metrics

Behaviour change becomes sustainable.

Focus on Improvement, Not Punishment

Modern health score models emphasise:

gradual improvement
personalised targets
achievable milestones

This avoids discouragement and promotes inclusion.

Benefits for Individuals

Reduced Insurance Costs

Lower premiums directly reduce out-of-pocket insurance expenses.

Better Health Awareness

Tracking health scores increases understanding of:

personal risk factors
lifestyle impact
preventive actions

Knowledge leads to better choices.

Early Disease Detection

Regular monitoring identifies:

prediabetes
early hypertension
lipid abnormalities

Early intervention prevents complications.

Benefits for Employers

Lower Healthcare Claims

Preventive health programs reduce:

hospitalisations
long-term treatment costs

This improves corporate insurance sustainability.

Improved Productivity

Healthier employees experience:

fewer sick days
better energy levels
improved focus

Wellbeing translates to performance.

Stronger Wellness Culture

Reward-based programs signal genuine employer commitment to health.

Benefits for Insurers

Health score–based premiums help insurers:

manage risk more accurately
reduce high-cost claims
promote preventive engagement

This supports long-term viability of insurance models.

Role of Preventive Health Checkups

Preventive screenings form the backbone of health scoring.

They help track:

metabolic health
cardiovascular risk
nutritional deficiencies

NITI Aayog identifies screening as the most cost-effective health intervention.

Addressing Privacy and Fairness Concerns

Responsible programs ensure:

data confidentiality
voluntary participation
non-discriminatory design

Transparency builds trust and engagement.

Making Health Scores Inclusive

Inclusive programs:

adjust for age and baseline health
reward progress
offer support for high-risk individuals

Equity is essential for success.

Integration with Digital Health Platforms

Digital tools enable:

real-time health tracking
personalised insights
long-term trend monitoring

This improves engagement and accuracy.

Long-Term Impact on Public Health

Widespread adoption of health score incentives can:

reduce lifestyle disease burden
shift focus to prevention
improve population health outcomes

WHO supports incentive-based preventive health strategies globally.

Challenges and How to Overcome Them

Common challenges include:

low initial engagement
lack of awareness
resistance to change

Solutions involve education, simplicity and continuous support.

Why Lower Premiums Are More Effective Than Penalties

Positive reinforcement:

motivates sustained behaviour change
reduces anxiety
builds trust

Punitive models often discourage participation.

Future of Health Score–Linked Premiums in India

As digital health infrastructure expands, health score–based models are expected to:

become more personalised
integrate AI-driven insights
support nationwide preventive strategies

This marks a shift toward value-based healthcare.

Conclusion

Lower premiums for health score achievers represent a powerful shift toward preventive, value-driven healthcare. By rewarding healthy behaviours, early screening and consistent wellness practices, these programs benefit individuals, employers and insurers alike. Financial incentives aligned with health outcomes encourage long-term behaviour change, reduce disease burden and create a sustainable healthcare ecosystem. In a country facing rising lifestyle diseases, health score–linked premiums are not just an incentive—they are a strategic investment in healthier futures.

References

World Health Organization (WHO) – Preventive Healthcare and Incentive Models
Indian Council of Medical Research (ICMR) – Lifestyle Disease and Prevention
National Family Health Survey (NFHS-5) – Adult Health Indicators
NITI Aayog – Preventive Healthcare and Insurance Reform Reports
EY-FICCI – Corporate Wellness and Healthcare Cost Studies

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