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Relaxing of lockdown will lead to spurt in Covid-19 cases, warn health experts

When the whole world is embroiled and perplexed with the challenges entangled in combating the deadly China originated Coronavirus pandemic the country is now faced with the woes of relaxing lockdown stipulations. Interestingly these measures are being thought of when there is a gradual surge in the number of infections and fatalities connected with the Covid-19!
Thanks to multidimensional adversities as a result of the lockdown, the Government sources put forth their pathetic plight due to unseen and unheard recession, economic slowdown and shutting down of all manufacturing units paving way to total loss of regular resources while on the other hand exhausting available funds for the welfare of less privileged citizens.

image : The Economic Times
However, this desperate situation on the part of the government leading to relaxation of complete lockdown measures has also given rise to a paradoxical condition which the health experts foresee bound to culminate into a much more worsening state of affairs.

But what one is not able to understand is the reluctance of people who have a travel history of visiting places. The government doesn’t charge any alarming price while by and large it happens to be free or at a meagre rate.

Even assuming that one is symptomatic or found with infections it is again the government which is taking the entire responsibility of taking complete care of the treatment until recovery and till discharge of the said person.

Yet it continues to be a big wonder as to why people are so scared and running away from undergoing these tests and relevant examinations to confirm or nullify the pandemic. But what is worrying and cannot be easily gauzed is the tendency of people by and large least bothered about the lockdown measures and moving around freely as if nothing has happened at all? Perhaps it looks to be an interesting subject for the Psychologists to ponder about.

Dr Ganga Yenagi, Professor at the Department of Psychology, University of Agricultural Sciences (UAS) Dharwad is of the opinion that there could be several reasons for such public behaviour. People belonging to different economic strata have multiple explanations to give to the authorities but the real intentions could be something else?
To view it in a different perspective the fact can be interpreted to the overconfidence level of the countrymen. They might be under an impression or illusion that their immunity level is far better than the foreigners who are becoming an easy prey to the Covid-19, she says.

Probably, it is quite possible that the middle class people might have got bored sitting at home for days and weeks continuously which has not been heard or experienced of so far. On the contrary some of them may be moving around to buy essential commodities whereas in the case of less fortunate beings, they might be on the lookout of jobs, she feels.

Dr Anirudha R Podder, Consultant and Head of Gynaec-oncology Mahavir Cancer Sansthan, Patna has a caution on the gradual relaxation of lockdown norms as he says: The third phase of India’s lockdown began on 04 May and will last till coming 17. But already certain restrictions have been eased out during this period and unfortunately in the first six days of this period the number of people with Covid-19 has increased from 40,000 to 60,000. Talking purely from the standpoint of the containment of the disease, what are the concerns as India prepares for the removal of the lockdown in a phased manner, he ponders over.

He deals with the issue in detail: Firstly, there would be spurt in the number of cases, as indicated in the data over the last one week. Lockdown mainly serves the purpose of flattening the curve, which means that it will ensure that there is no sudden spurt, or a deluge in the number of cases being reported, which would make it impossible for the healthcare system to handle the load. One must not forget that there are many asymptomatic carriers who will quietly recover from the infection but might transmit the infection to others...

...Secondly, there are reports of policemen, paramilitary forces, and health care workers who are involved in the imposition of the lockdown and the care of patients themselves testing positive. The (temporary) loss of manpower in these sectors which are paramount in the country's fight against the pandemic is definitely a matter of great concern...

...Thirdly, for how long can do medical fraternity procrastinate the treatment of other medical conditions like cancers, heart disease, kidney disease, neurological conditions etc. One can postpone surgery for cataracts, joint replacement etc. for couple of months. But it is not possible to postpone procedures like radiation, chemotherapy, dialysis for more than a week or two without disastrous consequences. Deliveries which are due will also have to be conducted as indicated, he points out in defence of his statement.

Dr Anirudha R Podder also warns: Considering all these factors, it is not merely the number of infected persons, or the speed with which the infection is spreading within the community that is to be considered, but how severely affected are the infected persons, and how quickly are the infected persons recovering; and how effectively are the home quarantine measures being implemented. This would hold the key to India's battle against pandemic.

So should we be lifting the lockdown in the coming days, when we have actually seen the cases surge, seeing record increase in the number of new cases each passing day?
The answer may not be straightforward, not a simple yes or no. Given the unprecedented nature of the pandemic, for which we do not have any past references, any instances of successful or unsuccessful handling of the situation to guide us, the best way forward is to remove the lockdown in small instalments and autocorrect according to the response, he stresses.

We have seen countries like Singapore which had successfully contained the spread of infection now face a second surge. After bringing back stranded workers from abroad, states like Kerala are gearing up for the second wave. As mentioned before, it is not the number of infected persons which should be worrying us. There already might be lakhs of asymptomatic carriers in the community; if the majority of the infected are going to be asymptomatic or mildly symptomatic then this is reassuring. We should be able to identify the vulnerable groups and protect them. 

We should know how to protect healthcare workers, police and the paramilitary forces. They are the last people who can afford to fall sick points out Dr Anirudha R Podder.

He also says: Places where large number of people congregate- places of worship, malls, parks and gardens, Cinemas should remain closed since there is nothing emergency or 'essential for life' about them.

Speaking purely as a medical person, everything else should slowly be reopened with strict monitoring. Medical personnel also have an additional responsibility when it comes to identifying cases. Unexpected deaths are always happening to a variety of reasons ranging from pre-existing conditions like heart disease, diabetes etc. to complications arising due to surgery, he reminds.

He mixes no words in mentioning: It is very important to detect every Covid patient even retrospectively. Convincing public across all communities to overcome their fears about testing and quarantine, and providing guidelines to medical personnel regarding recording and identifying all cases is essential as we prepare to remove the lockdown in a phased manner...
...This is important since new guidelines will have to be prepared and dispatched to all the Healthcare providers depending on the changing trends. One has to balance overreaction and over cautiousness from 'sleeping over the issue'. No matter how long the lockdown is imposed, there is bound to be a surge when the lockdown is lifted.

In conclusion, strict monitoring and quick identification of any loophole and its rectification is the key as we prepare to come out of the lockdown, he concludes.
-Manohar Yadavatti

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