Glenn C. Kharkongor
Red Zone and Containment Zone
East Khasi Hills District has been declared as a Red Zone. A Red Zone has been defined and described in a variety of complicated and confusing ways, as Arijit Sen of IIM Kolkata has pointed out. Initially it meant to include the districts that together contribute 80% of the country’s cases, or has 80% of the cases in a state, but along the way also is defined as districts with a doubling rate of less than 4 days. Lists of such states have been drawn up in an inconsistent way, says Dr Sen who is a professor of economics.
So far there are 170 Red Zone districts, though these numbers move up and down. A Red Zone district may apparently also be a ‘hotspot’ (defined by the Health Ministry as districts where cases double in 4 days or less, so this means the same thing as Red Zone) or cluster (fewer than 15 local cases). A large cluster i.e. more than 15 local cases becomes an ‘outbreak’.
Anyway, suffice it to say that a Red Zone is a worrisome area and it is correct that EKH has been declared as one. So, now what? The main strategy is ‘containment’. Within a Red Zone a Containment Zone may be declared. This zone may be a building, a city, or even the whole district. A district which is not a Red Zone may still declare a Containment Zone.
The Containment Zone is the battle front. It is to be in full lock down. Easing up of restrictions allowed in other areas will not apply. There are detailed action plans to be followed. For example, no outbound travel and no private or public transport will be halted, except for essential services. A ‘buffer zone’ around the Containment Zone is also to be declared. The same restrictions will apply in the buffer zone.
Not Critical to Find the First Case
While the Meghalaya government has been reasonably upfront and efficient in information dissemination, there have been a few missteps. This is not a criticism but an opportunity for better communication management.
While the Shillong Times has kept us updated on the Covid numbers from day to day, one kernel of information doesn’t seem to be forthcoming from the government. Withholding the results of the test on the Air India pilot is not in the public health interest. It is not enough to say that results are being awaited, when test results of other individuals have been announced.
The doctor would have come in contact with hundreds of people during the course of his work and daily routine, and perhaps in his travel to Guwahati. Most noteworthy among these are patients, who could have spread the infection to him, even though they were not symptomatic or were being treated for another ailment. Besides patients, many others may have been in casual contact with him.
Finding that person is helpful but not critical. There need not be an obsessive search to find this needle in the haystack. The first case in China, supposedly from Wuhan, has not been identified and may never will. It is now only of academic interest to ascertain whether the virus came from a seafood market, or from a secret lab, as some are beginning to speculate. Whatever the case, the public health measures remain the same.
So the Meghalaya government can go ahead and clear some confusion by announcing the result of the tests done on the pilot, irrespective of whether it is an RT-PCR (for detecting the virus) or an antibody test (to detect an old infection). The cloud of suspicion over the pilot can be lifted.
Administrative composure
Even though the situation changes from day to day and there continue to be gaps in our knowledge of the pandemic, government response should appear sure-footed. This will inspire confidence and reduce the uncertainty that may lead to panic.
In almost every state, multiple notifications, press releases and statements by political leaders carry contradictions, confusing reasons, and sometimes withdrawals of earlier decisions. The momentary lapses of administrative grip happen without adequate explanation, leaving the public confused and suspicious, and creates space for rumour-mongering.
Such vacillations, though sometimes understandable, need to be minimised. A daily communique should be issued from one authority. A leading newspaper, The Hindu highlighted on its front page on April 20, the discrepancy between ICMR and Ministry of Health figures. Last Sunday ICMR reported that 17,615 persons had tested positive in the country, while the Health Ministry said the number was 14,792.
Step- down apart from the Red Zone
An editorial in the Shillong Times, April 20, rightly called for a calibrated easing of the restrictions.
This can begin immediately, since as of that date the States have been empowered to take steps in accordance with the local situation.
It is unlikely that any state in India has imposed the regime of curfews, and the restrictions of movement of people and shopping as in Meghalaya. Stern police enforcement, community-led barricades and vigilante actions have contributed to almost a siege situation. In a stringent lockdown, fear and suspicion is heightened and no amount of ‘education or awareness’ will work.
The State Government should consider whether the entire district needs to be declared as the Containment Zone, or just Shillong, or part of Shillong.
Shops for food provisions must be open every day, in every locality of every town outside the Red Zone, with sufficient hours to prevent long lines and crowds. Congestion near shops, in the frenzy for buying food, negates the objectives of distancing.
Even if vehicular transport is limited, people should be able to take walks in their localities. Being locked up in one’s house creates claustrophobia and is psychologically debilitating. Only a privileged few have comfortable homes.
The rural hinterland must be opened up to their usual activities of farming, harvesting, and markets. They should be able to bring their produce to the towns that depend on rural vegetables, fruit and meat for daily consumption. Transportation for them needs to be restored.
All offices should be permitted to re-open with minimal or rotating staff. The wheels of normal life need to start slowly turning again. “Hong Kong has demonstrated that Covid-19 transmission can be effectively contained without resorting to the highly disruptive complete lockdown adopted by mainland China, the United States, and Western European countries,” said Benjamin Cowling, a professor of epidemiology and biostatistics at HKU’s school of public health.
Continuing precautions
It is becoming increasing clear that in many areas of the country, the pandemic is waning. The time for doubling of cases has doubled to 6 days. In 19 states a downwards trend has been observed, and Goa has been declared Covid-free. So the threat to Meghalaya from other parts of the country is diminishing.
In Meghalaya we are fortunate that there is only one cluster of cases and that is being managed well. The period of quarantine and self-isolation for the early incomers have been completed. Meghalaya can rollback some restrictions while maintaining the mitigation measures of physical distancing. Focused case and contact testing will continue. The ICMR guidelines will remain in force.
Citizen compliance and cooperation will be ensured by self-discipline. The fear of the pandemic has been embedded in all of us and will remain the main motivation to be responsible. But one must not worry about getting food for the family and be assured of a timetable back to normalcy.