COVID 19 – It’s too early to be complacent

In this article, Dr Monika Chaudhary, Associate Professor, IIHMR University, Jaipur points out that a very strong communications strategy will have to be implemented to prevent people from getting complacent as the lockdown is lifted

The count for new COVID reported cases on May 30, 2020, is 7964, and the total number of active cases is 86422. When you read this, another 14000 reported cases would have been added. The new cases reported are increasing every day. After every 10 days, the active cases will double which means by  June 20, 2020, there will be 345688 cases, and by June 30, 2020, there will be 691376 cases. Most of the hospitals by June 30, 2020, at least in metro cities will be exhausted. If the rate of new infections does not decrease, it would be a difficult situation for the hospitals. The testing labs in COVID hospitals are running 24 hours, the doctors, nurses and staff at the hospitals are already exhausted, as they have been working hard for the last two and a half months. 

The Ministry of Health and Family welfare issued a guideline on the eve of  May 30, 2020, which says that religious places, shopping malls and hotels/restaurants will be open from June 8, 2020. Interstate travel, passenger/shramik trains and air travel are allowed. Except for the containment zones, the lockdown will be lifted in the country from June 1, 2020. There is an attempt to begin the economic activity, while we are reaching the most critical stage of COVID 19 pandemic. The movement of labour from one part of the country to the other has taken the infection to the hinterland, from the cities. India is one of those countries where the infection is spreading the fastest. The doubling rate of infected cases in India is 12 days, while for the US, it is 50, and Italy 100. 

As the lockdown is lifted, we can see a rush to get back to business, even if that means taking a health risk for people. The lockdown was observed with ease by the middle and upper class. The poor faced economic hardship, hunger and malnutrition during the lockdown. They lost their jobs, couldn’t pay rent, did not have cash and looked towards their villages for food and shelter.  Lifting of lockdown amidst the chaos, of middle and upper classes, vary of leaving their homes and get back to work, and the labour in a rush to get back to a place they call ‘home’, has a rationale of reviving economy from a standstill. The government has announced a package of 260 $billion, that does not provide much immediate relief. 

One of the strictest lockdown imposed by any government could not prevent the virus from reaching the most densely populated areas in the country, where social distancing is almost impossible. But what has been done cannot be reversed. What is the best strategy to deal with it right now?

Epidemiological projection of numbers, estimate the reported cases of COVID 19 infections to 10 million by end of July. India’s health system will be put to test. In rural areas, there are not enough infrastructures to handle the emergencies. The death rate will increase if the hospitals are exhausted. 

The responsibility of personal hygiene and social distancing will be on people for the rest of the year. That is the only way the pandemic can be prevented from entering into Indian households in cities and villages. How effectively can that be done? The people will decide for themselves. An understanding of hygiene will be critical in rural areas, where there is a scarcity of water and sanitation products. Social distancing will be easier to do in the villages than in the cities. It will be impossible to do social distancing in densely populated areas of the cities.  

Complacency, on the part of government, institutions and people, will unfold another human tragedy in India. The government will have to keep efficient helplines, information systems, contact tracing alive. The hospital’s bed capacity will have to be increased looking at the conditions in the containment zones. Ambulance, medicines, PPE kits, masks, gloves and ventilators will have to be arranged. Quick actions to identify super-spreaders will have to be taken. Sanitation workers, policemen, grocery shop owners and cab drivers can become super-spreaders in the coming days. Regular training will have to be provided to them. PPE kits should be provided to sanitation workers. Mini-lockdowns will have to be enforced in the zones where that is the only option to keep the virus from spreading, particularly in densely populated clusters of the cities. Supply chains will have to be restored but help will have to be provided on the highways – for hygienic food, clean washrooms and sanitation products. 

Institutions will have to be responsible for their employees. As offices open up, the management will have to decide, what part of work can be done from home, to restrict people from infecting others at the office. All those who can work from home should work from home for the next six months. The industry will have to redesign shifts and take strict measures to maintain social distancing and hygiene. New models of work will have to be evolved. Online education should be encouraged. Irresponsible, hurried decisions to open schools and colleges could be worrisome. 

140 million people have become unemployed in the country, due to pandemic, as per ILO estimates. The government has doubled the outlay for MNREGA, to generate employment in the rural areas. The unemployed in the urban areas will have to get some relief package too. Hunger may lead to many social problems. There have been instances of fights and theft on the highways when the mass exodus of labour happened. Law and order might be a cause of concern in the days to come. 

India has millions of malnourished children who are prone to infections. Nutrition Rehabilitation Centres will have to be provided with funding to handle the cases effectively. If the schools remain closed mid-day meal will have to be served at home. Community kitchens will have to be established to combat hunger and malnutrition. All of us will have to donate food. Every Indian family should donate some money towards food, or feed people on their own every month; otherwise we will lose kids to infections. A movement needs to be generated; the sentiment of food donation should prevail for at least an year.

People will have to maintain strict self-discipline. Complacency on part of people will be fatal. COVID 19 has brought a complete change in the lifestyle. We have to learn to live with essentials for the next year. Unnecessary movement from the house will have to be stopped. The city dwellers will have to learn to maintain social distancing in densely populated clusters. Personal hygiene habits have to be maintained. Masks will have to be worn compulsorily. People will have to come forward to report infection, to save others from catching it. Family members with co-morbidities will have to be protected. The community will have to actively participate in contact tracing exercises. Disease tracked early, reduces mortality. No signs of the disease should be ignored. All this will have to be done for the next two years otherwise we will lose the battle. A very strong communications strategy will have to be implemented to prevent people from getting complacent. 

At some point of time in the next two years, each one of us will perhaps catch infection. But, not all of us will have a bed in the hospital, if we land there together. If that happens, there will be personal tragedies in our families. The virus does not distinguish between rich and poor, privileged or underprivileged. Every citizen in the country will have to understand that, while the nation tries to get back to normal activity. The only way to prevent ourselves is to be agile.

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