Rising Trend of Covid and Border Opening

Editorial

The rising numbers of Covid cases and deaths is causing general concern in the country, and seems to have gained a renewed focus over the weekend following the information that Dr Nuvin Ramgoolam, leader of the Labour Party, has been tested positive for the virus and is admitted in a private hospital for treatment. The probability of his being transferred to the All India Institute of Medical Sciences in New Delhi for further management has been flagged, and may take place this week if all arrangements for transfer are finalized.

In all countries, the lifting of restrictions imposed to control Covid spread, even partially or in phases, has been followed by an increase in the number of cases and of deaths as people gave vent to their pent-up feelings and started to mix again – but not always taking the precautions that have been recommended from the very beginning of the pandemic. It was therefore to be expected that we also could not escape this pattern, and although in absolute terms the numbers are comparatively less, this is no cause for complacency. Nor is the fact that we have already reached 65% of first dose vaccination coverage and 60% of second dose, perhaps the one positive statistic that is reassuring amidst the gloom which the increase in cases and deaths is causing.

The vaccination programme is no doubt progressing satisfactorily, but with the notion of herd immunity having been put in doubt even among the experts, we have to maintain if not speed up this pace so as to attain at least 90% of the population at the earliest possible, for this is what is likely to lead to a slowing down of the rising trend. We may also have to start thinking in terms of a booster dose for those above 60 with comorbidities, as certain countries (e.g. Israel) have already started to do, so as to reduce mortality in that age group, which is higher than among those who are younger and contributes significantly in the total mortality figure. Besides, this makes it difficult to decide which of comorbidities or Covid is the main factor that has led to death in a given individual.

Tied to the problem of this rising trend of Covid is the issue of whether the authorities will maintain their plan to open up borders on October 1^st, a question which is now also causing a buzz. All governments have faced the same dilemma, and at the end of the day each one has to take the call according to its specific country context and its overall strategy of coping with the economic and social impacts of the pandemic. As we contemplate opening up, and have to face the reality that there may be an acceleration of the rate of increase of cases (and possibly deaths as well) as a result, it goes without saying that the strategy will have to be updated to cope with this scenario.

Among others in doing so are points that we have flagged a number of times before: one is the conditions in quarantine centres, which are not uniformly to the satisfaction of those who have to be isolated there, despite the heavy charges being borne by the authorities. There must also be some degree of flexibility as regards movement out of the rooms in their close vicinity, as it is impossible for people to remain boxed in 24/7 especially when there is no provision for TV. Besides, these people do need to do some exercise to keep maintain fitness which helps to fight Covid. Blanket prohibition may therefore be counterproductive.

Must also be looked into: the conditions at the ENT Hospital, from non-functioning toilet/bathroom doors to some of the basic amenities which any normal person expects in terms of hygiene and cleanliness. More importantly, the medical process must be regularly reviewed and updated to make sure that the recommended treatment protocol is being implemented so as to give the best chance of survival to patients. An important factor to reckon with – and dealt with – is burnout and the morale of health personnel who are after all also human, and under great duress.

Unfortunately, there will be deaths too, and here as we have had occasion to point out earlier, both the dead and their family and relatives deserve utmost consideration on humanitarian grounds in this period of suffering and loss. Here too the Public Health Division should be able to give guidance as it concerns the disposal of an infected body.

All told, therefore, we have no option than to continue the struggle to gain control over the spread of the virus, which depends on how many people are not infected or are protected from infection – which means pushing on with vaccination –, and whether people are helping transmission, which is less likely to happen if they systematically apply Covid-appropriate behaviour.

This is the only way in which we will be able to open borders safely.

* Published in print edition on 7 September 2021