पत्र सूचना कार्यालय

*Dr Ravi Gupta

 

So the lock down has been lifted! 

This has invited mixed reactions from public with some welcoming it with a sense of relief, while the others being apprehensiveof the risk of exponential rise in the number of COVID-19 cases in the country as a consequence of Unlock1.0. 

During the lock down, we learnt and practiced the habits of preventing the spread of disease including repeated hand hygiene, social distancing, covering the nose and mouth with mask at public places, avoiding social gatherings etc. All these preventive habits in the presence of lock down lead to a slowing down of the increase in the number of active cases which gave us the time to develop our SOPs of dealing with the disease as also time for developing our health infrastructure to cope up with the active patients. 

But, with the lifting of the lock down, the real acid test begins now. We cannot lower our guard and become casual at this stage when we have active number of cases rising exponentially. Even if we presume that each active case will infect only one other person, the cases might start doubling very rapidly. Given the size of population of our country (remember we are nearly 135 crore people while the US has 35 crore), an exponential rise in cases, if not prevented, can easily surpass the number of hospital beds and infrastructure that we have been able to develop during the lockdown phase.

Another important medical fact we must remember is that the virus spreads not only through the patients who are symptomatic, but asymptomatic persons having virus in their body are of bigger concern because they appear to be healthy and tend to skip the preventive precautions. Even the doctors tend to meet such asymptomatic spreaders in an unprotected manner thinking them to be clean and safe. 

Thus, it is important that each one of us must presume that everybody around us is carrying the virus irrespective of the manifestation of the symptoms of the disease and take all the preventive measures of social distancing, masks in public places, repeated hand hygiene, avoiding social gatherings in a more stringent and absolute manner. In fact, our level of alertness needs to be much higher in Unlock 1.0 as our public interaction has gone up many fold as against the period of lockdown. 

There is a lot of debate in society regarding the ideal timing of lockdown and unlocking. Some people argue that at the stage at which many developed countries imposed the lockdown, we are lifting the lockdown. Let us review the sequence of events.

From the time that the first COVID-19 infection case was reported in India on 30th January and the declaration of the disease as a global pandemic by WHO on 11 March 2020, the Indian government took a series of steps to tackle this major public health disaster.

The first curfew named as Janata Curfew was declared by our PM on 22nd March 2020 in his national address when India had only 340 cases. The one-day Janata Curfew was very smartly converted into series of nationwide curfews/ lockdowns till 31st May which gave us the time to spruce up the health infrastructure in our country like creating adequate number of hospital beds for three categories of patients i.e. mild, moderate and severe patients; developing SOPs for the diagnosis; prophylaxis and treatment and scaling up the production of personal protection equipments (PPEs). This proactive move of the Indian government helped the country to avoid a panic situation as has been seen in many of the developed countries including the US and Europe. For instance, in our country, there has been no major hue and cry related to shortage of PPEs for the health care workers and the hospital beds for the patients. This was mainly due to the fact that we started the lockdown when the requirement of this infrastructure was very low owing to low number of cases, which gave us sufficient time for preparation. During the lockdown period, the government, through its communication apparatus, was also able to inform and educate the country’s hugely diverse population about the practice of preventive habits required to contain the spread of the pandemic.

To bring about a behavioural change in a short span of time in such a diverse population is not an easy task. As we know that execution of the law in India can be a difficult task due to variant educational, social, religious and political factors, but with the advantage of an early lockdown and the proactive role of our media which helped engrave the preventive measures in the minds of our population during the lockdown period of just about 2 months, we succeeded in creating a level of awareness amongst the masses.

Another good point of our country was the fact that in spite of the fact that the production of essential commodities of daily use including food items and general goods, came to a standstill during the lockdown period, the country was able to survive without any major news of black-marketing or a general panic among the people. To avoid the shortage of such commodities of daily use, the government again very smartly opened the industrial and other units dealing with such products in a phased manner so that there was no shortage of essential commodities.

As on 9th June 2020, we stand at the mark of total no of cases being 2,67, 749 approximately with active cases being roughly 1,30,000 with almost the same number of patients having been recovered from the disease. Our death rate of approximately between 2-3 % and recovery rate of about 50% is a proof to the fact that the competency of our health administrators/ health care workers and the quality of our infrastructure is no less than any other country in the world and we stand fully prepared to face any situation.

But we all should be aware of the fact that the end of the disease is still not visible. In the absence of any effective drug treatment or vaccine against the virus, the present Unlock period is critically crucial to prevent the exponential spread of the disease in the country, so that we never reach a situation where the symptomatic cases surpass the medial infrastructure of our country. Rather we need to be so absolute in practicing the preventive measures so that we can successfully break the chain of spread of virus altogether.

Since the virus cannot survive outside the living body for more than a few days and survives in a human body for approximately 4 weeks, if we become absolute by breaking the chain of spread of virus where everybody, every time and everywhere (the 3 Es)takes all precautions, our country can be free from the virus in 5-6 weeks. Recently, New Zealand has set the example of being free from the virus by breaking this chain of transmission in an absolute manner.

Thus let us all take a pledge that from now onwards we will not allow any new case to emerge due to spread of the virus from active/ asymptomatic cases by taking all the stringent measures of prevention learnt by us and by implementing the 3 Es of precaution - Everybody, Every time and Everywhere.

(*Medical Superintendent, Government Medical College & Hospital, Chandigarh)

 

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