The lockdown and controlling of COVID -19

By HH Mohrmen

We are not even half way to the end of the 21- day lockdown and the majority of the population are already anxiously waiting for it to end. There are others who doubt if it is really going to be over? Be that as it may, the lockdown has to be completed. At the same time one needs to hope for the best and prepare for the worst.  The question in the mind of some who try to understand the problem is, if India has at least been able to get over the worst part of its fight against the Virus? Or can we go into business as usual mode immediately after the end of the lockdown?

Literature available are of the opinion that out of the hundred people affected by the Virus, about 80% will be fine and only about 10% will need hospitalisation and of these 5% will need ICU and only 2 % (WHO estimate is 3.4%) will not survive the disease. So one may ask why worry? It is also true that there is a high mortality rate of elderly patient of those above 60 years of age, so why this seriousness and urgency in the fight against this dreaded disease?

We are in a warlike situation and in fact it is a world war but of a different kind in its sheer scale and size. The only difference is that in this war the fight is not between one country against the other or the alliance of few countries fighting against another coalition. In this particular war all the countries of the world are fighting against the one unseen enemy which is very infectious. This enemy is not only invisible but could also be invincible.

Expert opinion says that COVID – 19 will remain even if we are able to control it and it will also take a long time till a vaccine is available, for human use. It was estimated that it will take at least twelve months for the research and the trial to be completed, so the first vaccine is expected to be available only after a year or more from now. What we need to understand is that the end of the lockdown is not the end of the fight against the virus; rather it will be just one stage of the war. Like the saying goes, it is not over until it is finally over. The fight now is to contain the virus and prevent its spread; the technical terminology used is to flatten the curve.

In countries like India the entire effort of the government and its people is to flatten the curve but what exactly does that mean? Perhaps this story of a certain woman in South Korea doing the rounds in the media will help us understand what that means. The story of what is known as patient 31 in South Korea is the kind of tale which best describes how the curve peaks and the need to flatten it. The story has it that a 35 year old woman came from China and met with an accident on February 6. She went to the hospital although she did not have any fracture but it was detected that she had a mild temperature. She went home and then attended church twice on February 9 and 16. After 16 symptoms started to appear she was taken to the hospital, tested and she was found to be Covid positive.  It was estimated that from this one patient had infected 60 percent of the cases in the country. From the two services she had attended, she infected 1200 people only in the church and out of the 8897 people infected, 5382 are from those whom she had contacted.

This is how contagious the virus is, and if it is not controlled then it can reach its apex and that is when the problem becomes difficult to handle. If one person can do so much damage, one can imagine what this virus can do especially to a country like India. One can only imagine the consequences of ignoring this reality. The question is how prepared the country and the state is to tackle this outbreak if God forbid it hits the state. We may have sufficient numbers of beds in the hospitals across the state, but do we have enough ICUs, ventilators, (PPE) Personnel Protective Equipments or even simple protective gear like N95 masks? It is a breathing problem so the most important thing is to not only have ventilators but enough supply of oxygen too. So are we prepared for the eventuality? The problem is that almost all the countries are running short of these important equipments and the ventilators, oxygen, the PPE and even the N95 masks are in high demand all over the world. This is also because the most important duty of the state and its people is not only to cure the patients but its paramount duty is also to protect the doctors the nurses and the entire team who are in the frontline of fighting this enemy.

The WHO has emphasised on the need to test as many people as possible to prevent the spread of this virus. In this regard the good thing is that not only government laboratories but even the private sector is on board now and are allowed to test a suspected COVID – 19 patient. It also heartening to know that it will only takes six to eight hours to get the results, but do we have enough testing facilities in the state and even in the country? The need for testing is because if we want to ensure that this virus does not spread then we need to have these facilities accessible to the common man and more importantly available at every nook and corner of the country.

Because of the high infectivity of the virus which experts suggest spreads at the rate of one to three or four, or one person can infect three to four persons in a day or in geometric progressions, the key is to break the chain. That is to not allow this disease to spread by controlling its progressions. It is also true that no country in the world not even the United States of America can say that it has all the necessary equipments to fight the virus or claim that it is hundred percent geared to fight the decease.  Because of not having enough manpower and adequate machines to fight this virus at once, the effort therefore is to flatten the curve by controlling its spread.

No country can afford to allow its curve to reach the apex and perhaps Italy is one example where it has reached its apex. Its medical system is overstretched and overwhelmed and hence the high fatality rate in the country. So in order to reduce hospitalisation and ensure that its medical system is not overstretched, the only alternative is to see that fewer patients need hospitalisation.

The objective of the lockdown in India is to ensure that transmission goes down and hopefully stops the spread of the virus altogether which will in turn help flatten the curve. It is heart-rending that is has only been three months since the virus came to light but it has done more damage that any war or both the wars put together. It has damaged much of the medical system of the affected countries, and its impact on the economy of the country and the world is yet to be studied. But there are also the positive outcomes of the catastrophe.

The country has only experienced one week of lockdown and the resilience of the people of this country has already come to the fore. The story of migrant workers walking hundreds of miles to reach home is an illustration of that spirit. In fact it has helped us realise that there are more things to appreciate than to despise in life. In many instances we see that it has helped bring out the best in humans and more importantly helped us realise how interconnected we are and that we live in a world where we are interdependent on one another.

If the lockdown succeeds it is like winning the battle only because the war is not over yet. But hopefully the after the lockdown we can say that the worst is behind us.

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