India has been fighting its own unique battle against the Wuhan Corona Virus, which has brought the entire world down on its knees. Under PM Modi’s leadership, India implemented a comprehensive lockdown from 24th March and averted a major blowout of the pandemic. Some in the western world have been warning us, pointing out our ‘inadequate testing’. They expected nothing short of a major catastrophe here. It has not happened. It is obvious that our situation is unique.
The Wuhan Corona Virus pandemic is a serious health and economic threat for the entire world. There is no clinically proven vaccine nor there is a proven cure for this highly contagious infection.
I argue in this article that, to save both lives and livelihoods, we need to reorient our thinking based on the experience of the 30 days of lockdown.
Our experience so far: many gains and a huge collateral damage
As of 24th April, Indians have spent exactly a month in the nation-wide lockdown. The lockdown was supposed to be for 3 weeks but it has been extended until May 3.
We have started to flatten the curve. See the charts below.
Though India has done better than the US , it has done worse than Sweden which went for herd immunity. It kept even the schools open. China figures are always suspect. So let’s leave them. South Korea went for aggressive testing and isolation.
A Similar picture emerges if we consider deaths.
It is said that the deaths present a more reliable picture, albeit with a lag. We are now well over a month after the first 5 deaths.
India has used the lockdown period really well to ramp up the healthcare infrastructure like hospitals and ICUs, testing capacity, isolation centres etc, systems, and personnel.
India’s testing has grown 33 times in 30 days as per Centre’s press briefing on April 23rd. Despite this increased testing, death rate and infection rate hasn’t risen. This shows that our testing strategy (overseas visitors, contacts, contacts of infected, and those in hospitals with respiratory symptoms) has been on the mark. More testing is needed to quickly identify more vulnerable people.
The beginning of flattening of infection chart and death charts and their low numbers in absolute terms means that in addition to the lockdown, higher immunity of Indians is at work. Our recovery rate is also picking up. The above chart showing daily deaths illustrates this point more clearly.
While we have made some very crucial gains from the lockdown, there has been substantial collateral damage. Millions of Indians have been pushed out of work and now depend on state and social organisations for food and shelter. Many others, who are better off, are staring at job cuts or pay cuts. Our economy has gone into a deep freeze. It is going to need a long time to come out of the deep trough.
Impractical guidelines for relaxation of lockdown
Social distancing or ‘do gaj ki doori’ was key to our progress so far, it can not continue universally for long. The relaxation guidelines announced by the Centre are simply not practical. Here are some examples:
How many establishments can provide transportation \ or accommodation to their employees?
How many factories or service industries can work at 50% staff capacities?
A large number of people use mass transport to reach places of work. Can we really operate our buses, trains and airlines at 30 % or 50% capacities?
The guidelines state that in order to get into a green zone a district should have no fresh case for 28 days. How much time will be needed for say, 80% districts to come into the green zone? A month, two months, or 3 months?
The distinction between essential and non-essential is possible during a total lockdown. It is rendered impractical when we start ‘phased’ relaxation. Value chains jump across industries and geographies. It is impossible to segregate them if we want to restart the economy. So far we have not been able to keep essential supply chains moving properly. E.g. an apparel manufacturer told me that he was willing to produce masks etc but the conditions placed for starting its production were too onerous. Also consider the innumerable number of barricades put up by police in containment zones have caused collapse of supply of commodities like milk and vegetables in containment zones.
Let’s face the fact that the State lacks capacity and capability for execution of lockdown or partial relaxations.
Let’s also face the fact that we can not withstand more lockdown even for one more month. Social distancing is not socially, economically, and culturally sustainable any more.
Social distancing is the only vaccine now. But the ‘patient’ will simply refuse to be injected by this ‘vaccine’ for 24x7x several months. We are risking serious consequences if it is forced for too long.
Time to shift gears
Fortunately, we have gained a lot in the last 30 days. We also have a clearer idea of progression of the disease.
We can expect to achieve flattening of curves and even their downward trajectory in the coming one or two weeks. Taking advantage of this, we should re-orient our strategies and prepare as follows.
We should take advantage of our higher immunity. The death rate among the infected is low and the recovery rate is improving even when number tests are being scaled up substantially. The death rate can be lowered further. We should focus on those who might need ICU treatment or hospital care. To prevent more people from needing such care, we should identify medically high-risk individuals and protect them through frequent monitoring of symptoms, periodic testing and helping them minimise contact with others. We can cover small clusters like buildings in this category if needed. High risk individuals and occupations can be identified using well established criteria. All our testing capacities should be directed here.
We have missed immunity building
Infections alone shouldn’t override our strategy going forward. Healthy people get infected less and can ward off infections better even if they do. We should help people to improve their immunity and to care of themselves. We should develop and produce immunity enhancing tablets etc. based on existing knowledge – e.g. Vitamins, also Ayush advisory. We should subsidise or freely distribute these to all those who need to use mass transport and go to busy workplaces. Social distancing and hygiene should remain an advisory, but people should be empowered to take responsibility for their own health.
It is counter productive to haul up morning walkers, cyclists, and runners. Outdoor exercises and exposure to sunlight improve immunity. It is even absurd to shame them.
Infected low risk individuals can be treated without hospitalisation. We should encourage and facilitate home treatment and home delivery of goods for such people.
We should reduce load on healthcare professionals through above.
It is irrational to limit shopping hours because it leads to crowding. This should be evident to public authorities.
We should not allow public or private meetings, religious, cultural, or social gatherings for some time. We should develop and put in place sanitisation programs for all large public spaces like mass transport facilities and work places which are necessary for economic activity.
We should continue to encourage and facilitate practices like work from home and web based meetings. These should become the new norms along with safe distance practices wherever practical.
The job of police should shift away from blocking movements to preventing crowds through smart techniques.
Technology is available to implement all above effectively. We should encourage further development of technology for the same.
After some weeks into the above implementation, we should open up international travel with 100% infection screening at entry points.
Time to shift gears and crank up the engine of economy is now.