On 25 March, when the government imposed the lockdown, we had only 618 confirmed cases and 13 deaths. It took 110 days for India to reach the 1 lakh mark and just 39 days more to go past the 5 lakh mark. India crossed a million coronavirus cases on Friday, 17 July, third only to the US and Brazil. This raises the question: how effective has the lockdown strategy been to contain the spread of the virus? Have we set up the necessary infrastructure during the lockdown to tackle the inevitable surge that might rupture our healthcare system?
The lockdown gave the government the appropriate time to prepare healthcare infrastructure and resources. Still, we are seeing that States like Maharashtra, Uttar Pradesh and Bihar among others are struggling as cases surge. The governments, be it the Center or the State, could not or rather did not utilise the lockdown to prepare a strategy to contain the spread of the virus. Low testing rate, along with deteriorating health care and poor social protection, has emerged as our national weakness.
A recent study done jointly by Duke University’s Center for Policy Impact in Global Health and the Public Health Foundation of India shows India’s pandemic preparedness and its policy response varied across States.
Though testing capacity has increased in recent weeks to 3,00,000 samples per day, according to Rakesh Mishra, the director of the Centre for Cellular and Molecular Biology (CCMB) India needs to ramp up Covid-19 testing by roughly 10 times — at least one million samples daily — to fight the Covid-19 pandemic. On 19 July, the government said that tests per million people were close to 10,000 which is still far from the global average of 29,000 tests per million.
Early testing and isolation should have been implemented along with contact tracing to mitigate the spread of the virus, but that didn’t happen. The governments could have checked the readiness and preparedness of the hospitals to tackle this disease. This would have given them a chance to fix the leakages in our health care system.
When the government decided to lift the lockdown, there was a sudden surge in cases; hospitals were overwhelmed with a rush of patients coming in. This resulted in a lack of equipment like oxygen cylinder and beds. The situation is even worse in rural areas where hospitals lack basic facilities like cleanliness and senior expert doctors.
The fatality ratio seems to be lower in India as compared to many western countries. However, younger people getting arrested by infection is higher as opposed to many other countries. To give a contrast between India and Italy, people in age group 20–59, diabetes is three times more prevalent in Delhi than in Italy. In the age group 40-49, hypertension is 40% more prevalent in Delhi compared to 10.7% in Italy. This would require a comprehensive and robust healthcare system along with a determined environmental action plan to bring these figures down.
There need to be public health measures put in place to avoid a resurgence of the virus later on. Dr Mike Ryan, Executive Director of the World Health Organisation (WHO), said that countries could not simply lockdown their societies to defeat coronavirus. If strong public health measures are not undertaken at this point, there is a danger of outbreak or a second wave when the restrictions and lockdowns are lifted. What we need to do is focus on finding those who are infected and isolate them and also find their contacts and isolate them.
Testing and social distancing is our only support to stay away from this virus until a vaccine is developed. The government needs to acknowledge the ground reality and work towards improving the basic health care infrastructure and ramp up the testings as well. People need to be aware of social distancing to curb the spread. Then only we can defeat this virus.