The road ahead from the lockdown

While it is too early to say but the indicators are that the southern region of the equator is relatively better-placed.

 |  4-minute read |   04-04-2020
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India’s first Covid-19 case was detected on January 30 and as of today that number has increased to 2,547. The country has been put under lock-down for more than a week now and will be so till April 14 at least.

It could potentially go on for longer if the Prime Minister so wishes. Of course, measures around social distancing have generally paid dividends as seen in China and other South-East Asian countries. Keeping that in mind, it is worth asking two questions. One, if the government was well-equipped to implement enforce a lockdown and two, what are the strategic options once the lockdown ends?

Missing a trick

When the threat of the virus spreading in the country increased in February, the government began to screen incoming passengers at the airport through thermal scanners. This was undoubtedly important but the authorities may have missed a trick as more than half of the passengers may have been asymptomatic or just simple carriers of the disease. They were allowed to enter India’s borders without ‘proper’ testing or compulsory quarantine.

Further, the guidelines by the World Health Organization were unclear on the use of masks and the bureaucracy lost precious time ramping up production of protective gear not just for doctors but also citizens at large. Finally, the government has partnered with private labs to increase testing but it is still far behind than the stated capacity. India has conducted about 3,500-4,000 tests and in comparison, the state of New York itself is now testing about 20,000 patients a day.

It is clear therefore that initially the government was inadequately prepared. It subsequently went ahead with a national lockdown last week considering the gravity of the situation. It is to be noted that the first state do so was Rajasthan under the thoughtful leadership of Ashok Gehlot.

These strict measures will need to be in place till the transmission is slowed down and the health infrastructure scaled up to safely manage the outbreak and care of the sick. Scientists across the world believe that the pandemic across the world will have to be fought with the development of the Herd immunity. Professor Matthew Baylis from the University of Liverpool believes that the strategy could bring us to a ‘sweet spot’, where one corona could infect less than one person so as to allow the herd immunity to develop with minimum human and economic loss.

The Indian edge

When one looks across the world it appears that the incidence, rate of progression and mortality have been variable. While it is too early to say but the indicators are that the southern region of the equator is relatively better-placed. Indians in particular have been reportedly having high heterologous immunity as reported by a well-known immunopathologist, professor NK Mehra, formerly with AIIMS, New Delhi, in his recent write up.

The human leukocyte antigen (HLA), frequent infections, the commensals and vaccinations such as BCG contribute to this immunity. Either the vaccination can do that, or 70 per cent of population takes the hit of the virus.

It is clear therefore that a phased, state wide partial lockdown is the way forward: meaning thereby that the high-risk group remains isolated, work from home stays in place and closure of public transport continues. Avoidance of public gatherings and significantly reducing socialising and regularly maintaining personal hygiene and wearing masks are equally essential. Let me also clearly state that there are several studies available which prove that wearing of masks has proven very effective in the past in limiting infection rate in influenza-like illness. Simple surgical masks may not be N95 but they are in no way worse and can be an acceptable alternative. They not only double the protection — with you and those around you wearing one — wearing a mask also add to social distancing automatically. Korea, Taiwan, Japan and Germany have done it successfully.

What lies ahead?

Better late than never, we must push for large-scale production of masks. It is the right time for ‘Make in India’ to take off. Proper cleaning of shared spaces and extensive repeated testing to identify contacts and isolate them. Germany has taken a unique initiative of doing antibody testing against Coronavirus and certifying their citizens as immune to enter into the country’s workforce to rebuild the nation economically. The lockdown can’t be infinite, so a strategy needs to be prepared and the roadmap of navigating through the current COVID crisis kept ready.

(Courtesy of Mail Today)

Also read: DailyOh! Why Imran Khan is a Covidiot, to when Daniel Pearl's killer said he was Pranab Mukherjee


Ashok Panagariya Ashok Panagariya

The author is Professor Emeritus Neurology and former vice chancellor, Rajasthan Health University. The views expressed are personal.

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