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HomeLatestCovid lockdowns: Band-aid solution or effective in breaking chain of transmission?

Covid lockdowns: Band-aid solution or effective in breaking chain of transmission?

Confinement. The word itself brings back horrific memories of how COVID-19 completely invaded our lives. Despite the difficulties, authorities in India and abroad are using this measure to control the increase in COVID-19 cases.

Maharashtra, the worst-hit state in India, sees migrant workers from Nashik returning to their villages in Madhya Pradesh and West Bengal as the government announced a weekend lockdown and night-time curfew throughout the country. ‘State.

The question is: if with a second wave of infection and with India reporting more than a lakh case for the first time since the outbreak of the pandemic, will there be a nationwide lockdown? And will that help?

INTERLOCKS WORK TO AN EXTENT, ESSENTIAL EVEN NOW

Experts say if we were so worried about COVID-19 a few months ago, we might not have had to worry about a lockdown today. “Unfortunately, prevention is not always considered better than cure by the powers that be,” says Dr Swapneil Parikh, author of The Coronavirus.

“Lockdowns are a temporary intensive physical distancing strategy in which individuals are required to stay where they are to reduce risk to themselves and to others,” he explains.

Locks work in certain scenarios, experts say. “A lockdown cannot be justified if ‘the population is very prepared for a pandemic, follows masking and physical distancing requirements, indoor congregations are limited, non-essential businesses and non-essential activities have already been restricted,” says Parikh.

For this, non-pharmaceutical interventions must be ready.

“But if the population is absolutely not prepared for a pandemic and does not comply with the less strict NPI. Businesses are open and mass congregations are allowed. In this context, a lockdown would be very effective in stopping the spread, ”says Parikh.

But there is now a real possibility that the infrastructure in India is overwhelmed to a large extent. This is true for metropolitan cities as well as for level 2 and 3 cities where the infection has spread.

“In the current dynamics of transmission, and given the possibility of hospitals being overwhelmed, a brief lockdown may be inevitable to control the surge,” says Oommen C Kurian, senior researcher at the Observer Research Foundation.

Speaking about the situation in Maharashtra, Kurian says the state now faces a double bind. “The costs of a lockdown will be huge, but if the virus spreads in this way, the costs of not locking could be huge as well,” he adds.

BENEFITS AND COSTS OF A LOCKOUT

Experts say there is uncertainty about the benefits and costs of lockdowns in a country like India. “It’s hard to say how well lockdowns will work in different populations. The fact that different countries have different locks adds to the complexity. Some are very restrictive, others less. Some locks are actually applied while others are ineffective because they are not applied. To say that interlocks don’t work is a simplistic take on a very complex subject and permeates certainty in an area of ​​great uncertainty, ”says Dr Parikh.

There is a strong socio-economic argument against lockdowns in a country like India where social safety nets are non-existent and most people depend on daily wages to survive. “Lockdowns have drawbacks, but an uncontrolled spread of COVID-19 is worse and can eventually lead to a longer and harder lockdown anyway,” he says.

LOCKOUT NOT REQUIRED NOW, THIS IS A “LAZY APPROACH”

Epidemiologists have argued for some time that we need to learn to “live with the virus”. In India, a strict lockdown that saw millions of people locked in their homes was warranted because the government needed to improve its game in terms of preparedness to deal with COVID 19. With just 555 cases on March 24 of last year, India has imposed a harsh and strict policy. confinement.

“Last year, the main thing was to make sure that the health care system was well prepared to respond to the sudden increase in cases and to prevent the rate of spread. We now have better treatment options and better protocols to deal with the outbreak, ”says Professor Giridhar Babu, a well-known epidemiologist.

What we are seeing in the country is an artificial crisis, experts say and add that it is preventable. “The need of the hour is to ensure real-time coordination of the admission and provision of intensive care to people with serious illness,” says Babu.

“Allowing cases to increase to such levels and enforcing a lockdown is a lazy political approach. It is economically devastating and a public health failure because the opportunity to save many lives is lost, ”he said.

Experts say a complete foreclosure of all economic activity is neither necessary nor sustainable. “Strict enforcement of nighttime curfews, isolating people in hot spots (containment areas), banning all congregations larger than 10-20 people and that too with physical distance is a must absolute, ”says Dr Arvinder Soin, President of Medanta, Liver Institute and Principal Investigator, Indian RCT on tocilizumab in COVID.

He says, however, that it cannot be business as usual. “I am concerned that schools and colleges will have to remain closed for routine classes. We all need to be responsible citizens, preach and practice appropriate behavior about COVID. “

Professor Srinath Reddy, Chairman of the Public Health Foundation of India, agrees. “The interlocks were meant to prepare the systems for the initial response. If it is repeated later, it will be seen by people as a quick fix and there will be a breach of appropriate sustainable behavior at Covid after the lockdown is released, ”he said.

“What is needed now is a strong and sustained public health response, while maintaining the essential elements of economic and social life on an ongoing basis. Otherwise, there will be both suffering and preventable negative reactions. We need to think of it as long-term outpatient therapy rather than repeat admissions to USC. By operating with care and prudence, we can overcome the challenge while retaining functionality, ”he says.

Instead of a lockdown, other infection control options available to us should have been better used, experts say. “We could have stepped up the manufacture and distribution of vaccines on a war footing months ago. We could have stepped up the tests. Instead, the tests have been reduced. We could have detected and contained worrisome variants. We could have continued to behave appropriately in COVID-19. We should not have allowed mass gatherings. We could have prevented a lockdown by acting in January. We didn’t do it, ”says Dr Parikh.

RESCUE, NOT LOCKING VACCINES

When we announced a lockdown in 2020, we had no idea what we were up against. The situation is different now, say experts. A year later, we have two vaccines and the advantage of having an enviable capacity to manufacture vaccines. This should be the big gun in our arsenal, experts say.

“The approval of more vaccines should be accelerated and the vaccination campaign has been on the war footing by opening it to all adults. They should be administered in all health facilities / industrial premises / community centers / housing companies, and the process should ideally be decentralized and managed by state / district authorities, ”says Dr Soin.

“We could have vaccinated fast enough to avoid the second wave, but we can’t vaccinate fast enough to stop the second wave without intense restrictions. Even if we immunized all eligible people in the country today, protection would not take effect until a few weeks later. We can barely deliver 2-3 million doses a day and we don’t make enough vaccines to rise substantially, ”says Dr Parikh.

“We are debating the effect of lockdowns too late. The fact that we are here despite hundreds of millions of vaccine doses and vastly expanded testing capacity is the real tragedy, ”he says.

“We need to carefully lift the restrictions so that the vaccines have time to take effect. We need to ensure high coverage of those who are most likely to have serious consequences. We should speed up high-potency vaccines like COVOVAX because higher potency vaccines will have the same impact on reducing the peak wave two, even with lower coverage. We desperately need more doses of vaccines and different types of vaccines. “

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