By Glenn C. Kharkongor
There is no magical answer, but we must try. Scientists, economists, epidemiologists, bureaucrats and politicians all have their own particular orientation, but all must put their heads together so that a collective reasoning can emerge. No dominant viewpoint should skew the formula in a particular direction and those with powerful and influential voices must keep the interests of the voiceless at the head of the agenda.
The question is not when to unlock? The easing up of restrictions all over the world, the demand for personal rights in prosperous countries, and the abject suffering of poorer sections in developing countries from economic hardship, makes the easing of lockdown restrictions inevitable, sooner rather than later.
The science is incomplete and while we see daily reports of medical advancements, it often seems like two steps forward, then one step backward. Dealing with the current situation is difficult enough, predicting the future of Covid is fraught with uncertainty, not much better than peering into a crystal ball.
This article is divided into three parts. Firstly, the need for unlock. Secondly, a review of the current situation, and thirdly, a reasoned plan for unlock. The experiences of other countries and even other states in India is not fully helpful as each region has its own unique aspects and experiences. The available data from elsewhere needs to be melded with local data to find the best solution for the state or a district, and distinctions also made between urban and rural areas.
The Urgent Needto Unlock
The Covid pandemic is shadowed by the lurking spectres of many other pandemics, growing in severity. The looming collision of pandemics will soon overtake the casualties of Covid and the fallout will be more devastating than the virus.
Economic disaster for the poor in Meghalaya is inevitable with continued lockdown because it will affect the sectors of agriculture, construction, tourism, and transport. The shutdown of these sectors imperils farmers, daily wage workers, drivers, semi-skilled workers, and hospitality staff. The middle class salaried employee will survive over the short term till the formal sector starts faltering. The continued rise of the stock markets promises little for the poor, because it is speculated on growth and is a gambling game for those with deep pockets. Observe how the billionaires of the world became richer during the pandemic. Because of deepening poverty and mounting hunger, untold numbers will die of starvation if lockdown continues.
Children and youth have been grievously damaged by the yearlong lockdown, and tragic data is now emerging. The National Commission for Child Rights has informed the Supreme Court that more than thirty thousand children have already been orphaned, lost a parent or been abandoned because of the pandemic. A report from the US describes an epidemic of child mental illness, growing by more than 90% in the last year. Suicide has become the number one cause of death among children and adolescents, with some younger than ten years of age taking their own lives. In MLCU, 24% of students report daily feelings of stress and 80 high-risk students are receiving therapy.
There are many other threatening pandemics: the plight of women because of domestic violence, trafficking, and poor reproductive health services, the loss of learning for millions of children, the despair of jobless men. Space does not permit the elaboration of these tragedies. The continuation of lockdown will have a multiplier effect on these calamities.
Data is uncompiled, neglected or suppressed, with Covid news mainly favouring elite concerns, and the evident efforts by the government to save face. Just yesterday, the Ministry of Health asked states not to reveal data about vaccine stocks. Even the courts keep asking the government for data.
Review of Covid Situation
The unpreparedness for the second wave, super-spreader elections and religious melas, failure to educate the public, and lack of citizen responsibility compounded the rampaging onslaught of the highly infectious Delta variant.
In the interim, vaccination stayed on a slow track, only recently being stepped up. As of June 10, 2021, 238 million Indians have been vaccinated, which is about 17% of the population. In Meghalaya, 4.06 lakh persons have been vaccinated so far, which is about 12% of the population. To these protected persons we could add the nearly 40,000 confirmed cases, who might have antibody protection. Unconfirmed cases may be four to six times more than the confirmed cases. If we add two lakh unconfirmed cases, the protected population rises to about 20%.
So with these levels of cases and vaccinated persons does this mean that we are nearing herd immunity? Dr Srinath Reddy, President of the Public Health Foundation of India has dovetailed some data as follows: “A recent study from Serrana (in Brazil), revealed that deaths were reduced by 95% and infections by 86%, when 60% of the population was vaccinated. On June 1, 2021, Britain reported zero Covid-19 deaths, after 59% of the British adult population were vaccinated. If we conclude that we too must achieve 60% vaccination coverage to attain such safety, we have several months to go. We cannot remain in lockdown till then.”
The snail pace of vaccinations in Meghalaya clearly indicates that vaccine protection is not the available solution to lifting the lockdown. The other important limiting factor is the availability of hospital beds for the moderately and seriously ill, which approached saturation level a few weeks ago. So vaccination and ramping up of hospital services are not solutions beyond a point.
What are our remaining options? And what would be the criteria to implement them.
Safety Guidelines in
Easing the Lockdown
Maharashtra, Karnataka and Delhi have announced plans and guidelines for lifting the lockdown. Maharashtra seems to have a more structured plan of phases from June 7 which is district-wise, based on a positivity rate of less than 5% and occupancy of oxygen beds in hospitals of less than 25%. There are separate rules for municipal areas, rural areas and containment areas summarised in a detailed spreadsheet. Karnataka has announced a similar multiphase unlock plan starting from June 14, also using a 5% positivity rate cutoff. These guidelines could be adapted to Meghalaya.
Release from lockdown could have the following phases: In Phase 1, daily outdoor physical exercise such as cycling, jogging will be permitted, essential shops will be open for four hours every day and plumbers, electricians, carpenters and mechanics can move around for work. Offices will be allowed to function with 25% staff.
In Phase 2, all open markets and market areas will be opened, but not closed area malls and market complexes. Limited public and private transportation with passenger management will be permitted in urban areas, but unrestricted in rural areas. In Phase 3 increase in office staff to 50%, and dine-in eateries can open with restricted number of customers. Each of the above phases could last from 7-10 days.
Depending on the success of the first three phases, in Phase 4, educational institutions, poorly neglected over the last year, could be allowed to open with limited hours, distance management, and batches alternating on a weekly basis ie each student would have one week offline and then one week online.
In Phase 5, places of worship, theatres, gyms, swimming pools, entertainment halls, barber shops, beauty salons, and bars can open on a limited basis. Weddings and funerals will be permitted with small numbers. All large events will be prohibited. Through these phases, tight monitoring of state entry points should continue. Tourist spots will be open only to locals.
Third Wave?
Is a third wave coming? Almost definitely there will be a spike with the phases of lockdown release. Widespread vaccination has not been achieved and it is impossible to eliminate human to human contact. Admissions to hospitals can be minimised by improved awareness of symptoms so that timely care can be instituted, and late stage deaths avoided. If the spike is large, the next lockdown will be unavoidable and so on till vaccination of all including children is accomplished.
During the unlock phases, of paramount importance is responsible citizen behaviour. This will necessitate step-up of community messaging, and monitoring by the authorities, communities and individual citizens. Freedom from lockdown comes with the price of self-discipline and community vigilance.