The pros and cons of Lockdown 2.0

The economic indicators, vocational and basic needs, with their related challenges can be far worse if the lockdown were lifted at this crucial time.

 |  4-minute read |   16-04-2020
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Prime Minister Narendra Modi’s inspirational message and the announcement of the calibrated extension of the pan-India lockdown till May 3 is a visionary strategy. Naysayers will harp on the colossal adverse impact on the economy, food and livelihoods. The economic indicators, vocational and basic needs, with their related challenges can be far worse if the lockdown were lifted at this crucial time.

main_lockdown-patrol_041620102905.jpgMembers of Rapid Action Force (RAF) patrol an empty street in Ahmedabad on April 14 after the nationwide lockdown was extended. (Photo: Reuters)

The transmission rates which have shown a vertical upslope would then have exponentially increased with alarming consequences of a severe disease burden and high mortality. With every passing week, the Indian curve continues to rise at higher rates, even though the slope and pace is not spiralling upward as rapidly as most of the disaffected countries. This suggests that we are in the relatively early phase of our disease burden. This justifies the calibrated extended lockdown with a window to review, reconfigure and realign the future course of actions. The devastating onslaught of the Covid-19 pandemic, particularly in certain developed countries, made it imperative that quantum gains from the three-week lockdown in our country could not be surrendered.

For senior citizens

The government’s focus on enshrining safeguards for the vulnerable populace is praiseworthy. Statistics indicate significantly higher mortality rates in those above 60, especially those with disease co-morbidities. Predictive patterns suggest this age group may account for more than one-third of all Covid-19 hospital admissions; and about three-fourths of ICU admissions, with major fatal outcomes. Hence, key interventions for the elderly may have to be configured with ingenuity to shield this most vulnerable subset. This stratified extended lockdown envisages a significant reduction of the numbers of the freshly infected and also minimises their contact with this vulnerable group.

The big takeaways

The isolation of infective cases and quarantine of exposed (at risk) cases focused around hotspots after April 20 should result in high intervention efficacy with a significant reduction of the Covid-19 transmission rates. This allows the governance an opportunity to reconfigure planning targets and strategies to address the economic downturn, supply chain impediments, unemployment and address basic needs of the poor, through course corrections, as also to prevent our healthcare systems from being overwhelmed.

In light of the recent rising trend, it is fair to assume that a substantial number of infected people may not have been identified, as yet. Hence, innovative tracking mechanisms of the suspect and infected cases may have to be developed to check community spread around hotspots, slums and clusters. The extended, though conditional extended, lockdown will succeed only if strengthened by aggressive early testing of larger numbers, enhanced tracing of contacts, quarantining of the vulnerable elderly and isolation of the infected. These measures will prevent rampant transmission from undetected infective cases, along with systemic investments in social distancing.

The Aarogya Setu App should enable health education of our masses. With the hope of the success of multidimensional strategies to minimise transmission, this extended stratified lockdown should be acknowledged by scientists, epidemiologists, statisticians and hopefully our citizens, as the most reliable mechanism; through effective community containment. Its impact could be the critical turning point in India’s fight against the formidable Covid-19 foe.

Combo testing with PCR and the antibody-based tests will create a robust evidence base through mass screening of the infected, vulnerable and contacts. Quantum gains can be achieved with the isolation of the infected people and quarantine of those exposed. The viable implementation and the sustainability of these measures will require a major ramp-up of our resources. The phenomenally positive takeaways of this strategically stratified but longer lockdown, targeted at the entire population at risk, should translate into a major reduction in the envisaged hospitalisations, ICU requirements and even deaths. This will necessitate innovative interventions of mass screening of the susceptible and vulnerable, aggressive testing and upscaled medical surveillance.

Hour of reckoning

The light at the end of this torturous journey is the development of herd immunity or an effective vaccine, or preferably both. As these are more than a few months if not a year away, we may see multiple surge patterns. Any populist posturing at this crucial phase would have conceded the battleground in our fight against Covid-19. Medical preparedness audits with robust assessment and monitoring mechanisms must address gaps and impediments. The lessons learnt from expanded testing, isolation of the infected and active tracing of contacts must chart the course for future strategies to minimise the spread of this ravaging disease.

The PM’s acknowledgement of the yeoman service being rendered by healthcare workers is heartening. Their global mortality rates of about 8 per cent make them highly vulnerable. The health of our nation is contingent on how well we manage this Covid-19 crisis, and also fortify the foundations of a robust healthcare system. The multidimensional investments envisaged in the PM’s strategy enable the country to envisage a healthy future for our citizens with cautious optimism.

(Courtesy of Mail Today)

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Writer

Lt General Dr Rajan S Grewal (retd) Lt General Dr Rajan S Grewal (retd)

The writer is the former Director General Medical Services, Indian Army.

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