Covid-apt practices, not lockdown, the way ahead

The Covid-19 pandemic has impacted mankind as a whole — physically, financially and mentally. The decline in the number of cases towards the end of 2020 was a positive development, and brought hope. Dire predictions of gloom in the winter had been proven wrong. Reports about the availability of vaccines added to the sense of optimism, and people had begun to expect that the pandemic would soon be behind us and some semblance of normalcy would soon return to our lives.

Alas, that was not to be. The reversal of the declining trend in the last few weeks, the rapidly increasing numbers and reports of mutated virus variants have created disquiet. The problem has assumed disturbing proportions in states like Maharashtra, and big cities like Delhi and Chennai. Uncertainty has gripped us, and people are wondering whether 2021 will be another year of stress and waste. Going by recent signs and trends, the Covid-19 virus isn’t likely to go away any time soon, and it may take a few years for life to return to normal. What, then, is the way forward?

An often under-appreciated fact is the vital importance of what can be termed as Covid-appropriate or Covid-protective behaviour. Simple, yet effective daily practices such as effective use of mask, keeping desired physical distance and hand sanitation will go a long way in helping contain this virulent virus. It is hardly a happenstance that the return to increased Covid numbers coincided with a general laxity in enforcing and practicing these precautions. The appearance of other variants, such as the UK one in Punjab, which is highly contagious, aggravated the surge in the absence of precautions. Further, this UK variant affects younger age-groups much more than the original virus. In March, 35-40% of Covid-positive cases detected in Punjab were below the age of 30. In Punjab, it seems the schools and colleges became ‘super-spreaders’ as the necessary behavioural precautions were not rigorously insisted on. Recent data also shows that the UK variant is more virulent and thus results in increased mortality even in younger people.

The effectiveness and feasibility of ‘lockdowns’ are again the subject of public debate. Experience has perhaps taught us that a full-fledged lockdown can have serious unintended consequences and cause unpalatable collateral damage on the poorer sections. Yet, some science-based (and perhaps common sense-based) restrictions are the order of the day and can effectively prevent and control the surge. Non-essential activities need to be regulated, albeit in a manner that minimises the negative impact on resources and livelihoods and the economy as a whole. As far as possible, work should be carried out to ensure livelihood of the underprivileged sections while ensuring steps which control its spread.

It is imperative that large gatherings — social, religious and political — the main stimulus to spread, be prevented and avoided. Both indoor (more harmful) and outdoor gatherings are bad during this surge. Any limited gatherings that are allowed, in exceptional circumstances, must take place only with all necessary safeguards, including the wearing of masks. Restaurants, cinema halls and malls should restrict their numbers to ensure the desired physical distance and ensure proper ventilation, including the required precautions while using air-conditioning. This will ensure that the desired objective is achieved without resorting to harsher measures like a complete lockdown. Of course, a good measure of political and administrative will is necessary, and I wonder whether the intervention by the courts would also be helpful in order to achieve this end. One way or the other, the significance and importance of these restrictions cannot be overstated if we wish to control the surge without affecting much the economic activities.

We must, at the same time, avoid a sense of panic, and make every attempt to generate a sense of confidence. While people must be educated about and sensitised to the contagious nature of this virus, it is important that no sense of stigma be permitted to arise against those who test positive. Contact-tracing procedures as well as quarantine guidelines must be rationalised, so as not to discourage testing. Any hesitation in regard to testing must be removed to enable early detection.

To this end, the Government of India could reconsider its suggestion that 25-30 contacts traced be isolated and tested. Perhaps, the CDC recommendation for testing 10 close contacts could be adopted, and testing should be carried out within the first four days or so. These measures will go a long way in removing anxiety or fear about the fallout of a positive test. Even family members of those who test positive must have the confidence that by maintaining the desired distance, using masks and following other hygienic practices like hand-washing, they could avoid a further spread of the virus within the household.

Of course, an aggressive and comprehensive rollout of the vaccination programme is now a must. Vaccination must be undertaken on a war-footing across the country. We must make every attempt to cover as much of our population as we can, in the shortest possible time, given the obvious time constraints arising from a two-shot vaccine. Fortunately, the atmosphere of indecision or vacillation about the vaccination, which we witnessed in the early days of the rollout, now appears to have been replaced with a sense of urgency and enthusiasm regarding the vaccination. Full information in regard to the vaccines should be made available in the public domain, and doubts/queries should be addressed by the authorities, in order to instill further confidence. We need to innovate ways to ensure easy and safe access to the vaccine for every needy person.

In the final analysis, it is only a concerted and coordinated effort by all segments of society that can defeat this virus. We are going through a difficult phase, and some course correction is needed. The political and technocratic class must lead by example in adopting Covid-appropriate behaviour and encouraging others to do so as well. Medical professionals, who have played a stellar role so far, must not allow their efforts to slacken and make use of the best evidence-based practices learned since the beginning of the pandemic. Generating confidence in the common man is necessary, so that we are not overwhelmed by the crisis.