By Sada Reddi
What are we looking at post-lockdown? This will depend on our strategy during lockdown.
That strategy has to begin not only in isolating and treating patients who are ill, but also those who only display mild symptoms requiring no medical attention, and those who are asymptomatic.
We gather that quite an important number of those infected will only display mild symptoms or no symptoms at all. And also that symptoms may be so mild that people may not seek medical attention at all, and thus remain unknown to the authorities. However, these categories of people are probably the more effective virus carriers.
It also seems that we are now to accept that there is a community spread of the coronavirus. Dr Gujadhur himself gave the example of one person having most likely contracted the virus at a supermarket.
Confinement or lockdown until 15th April will quite obviously not address this fully.
This explains the WHO’s prescription of ‘testing, testing, testing’; testing for positive cases but also testing for antibodies to determine who may have contracted the virus and recovered. The best time for this would logically be during confinement or lockdown, and not after. In fact, this may well be a condition for lifting confinement or lockdown altogether.
We are still waiting what the authorities are doing in that respect. More worryingly, there is no indication yet that anything is being done.
As things stand, we will not have the guarantee that once lockdown is lifted there won’t be anyone at large with the virus. This raises a number of issues.
First, there is a risk of a spike or surge after the lockdown is lifted that will not only bring us back to square one if not in a worse position.
Second, we need to consider the ongoing capacity of our healthcare system to deal with the virus and our general ills. Our health personnel would have been working around the clock during the lockdown, leaving themselves exposed, both with physical and mental fatigue and the dwindling (if not simple lack) of their protective gear. We cannot expect them to remain on call in a state of emergency once the lockdown is lifted.
Third, it will be difficult post-lockdown to enforce social distancing in a society like ours. Social distancing was not applied fully during lockdown, let alone during the curfew. We need to account for the fact that we are geographically small and densely populated. Things that hitherto were our strengths can become our greatest weaknesses: think of cultural, familial or religious gatherings, think simply of the way that we go about and organise life and work, valuing close and direct interactions.
Fourth, there is our specific reality that most of those in positions of power or decision-making in the country, across the public and private spheres, are likely to be themselves in the most vulnerable group apart from the senior citizens.
Fifth, there is the inevitable and significant impact on our economy, which we also no doubt need to get up and running. A lot is also premised on having open borders. Now, the world will not have moved on. Do we keep our borders shut or have everyone coming into the country quarantined and tested?
It does not look that we can even consider a partial lift of confinement. This may be what government had in mind when it called for more civil servants to return to work. The difficulty however is how contagious the virus is. It takes one infected person to go back home and hug his child, who then goes to hug a grandparent, for us to go back to square one. Out school population is vulnerable. We need also stringent measures to protect our labour force.
It seems then clear what we need to make the most of the lockdown. Use it optimally. Dr Bruce Aylward, a senior adviser to the Director General of the World Health Organisation talks of guerrilla warfare against the virus. He calls for countries to use the lockdown to find every case and to rapidly isolate. At this point, it’s difficult to see anything else that we can do, until that miracle vaccine is available.
* Published in print edition on 1 April 2020