Was lockdown a knee-jerk reaction?

Was the lockdown necessary or we could have done without it? Was it imposed at the right time or was it too early? ChaT cover story this fortnight explores these issues

India has been locked out for 70 days to fight the coronavirus disease (Covid-19) pandemic that has claimed more than 400,000 deaths worldwide. The World Health Organization (WHO) declared Covid-19 a pandemic on March 11 but until March 13, India’s official position was that it “wasn’t a health emergency and there was no need to panic”. But by March 15, it became evident to health experts and epidemiologists that the virus, SARS-CoV-2, has properties that distinguishes itself from other coronaviruses and even influenza viruses’; that is highly transmittable and can evade the immune system for longer and therefore spreads quickly even without the infected being visibly sick; that the virus is able to penetrate deeper into the lower airways. They said the elderly and those with pre-existing conditions such as diabetes and cardiovascular disease had heightened risk of acute pneumonia.

On March 24, Prime Minister Narendra Modi, in a televised address to the nation, said: “I fold my hands to say — please stay where you are.” He said, “All leading experts say 21 days is the minimum we require to break the coronavirus transmission cycle. If we are not able to handle these 21 days, the country and your family will go back 21 years and many families will be destroyed. I am saying this not as the Prime Minister but as your family member.”

On the night of this address, India had around 500 cases and 10 deaths. The country got into a lockdown for 21 days – until April 17. The government felt a complete lockdown and restrictions on travel will keep the infected isolated and restrict infections to contained clusters. Hospitals in Italy, Spain, Iran and the United States were overwhelmed with cases. Health experts said if there were too many cases, it will be catastrophic for India, the country that has among the lowest capita availability of hospital beds and health care workers.

Was the lockdown necessary? Was it a knee-jerk reaction? Was it imposed correctly? Wasn’t it abrupt, disrupting lives and livelihoods? The lockdown was announced at 8pm and became effective from midnight. Unlike in South Africa, which gave its people one month to prepare for it, or Bangladesh, which allowed four days before the restrictions set in. In India, it was declared when the number of infections was low. It was most probably not an epidemiological decision but a political one. The government sought to buy time to prepare for the pandemic. The lockdown was expected to flatten the coronavirus curve; that didn’t happen. People and the economy became collateral damage.

On June 1, when the country announced Unlock 1.0 guidelines for phased opening, there were around 200,000 cases, 400 times since the lockdown was announced. The number of deaths also totaled around 5,000 now.

Whether the lockdown was necessary or not is a matter of opinion.

“Of course, the epidemiologists got it wrong. Some had predicted that there would be no new cases after May 16. Then there were others who predicted a million cases by mid-May. Even now, opinion seems to be divided and various models show disparate forecasts,” said Amirullah Khan, professor of health economics at Indian School of Public Policy. He said that some experts say that the cases will keep increasing till mid-July and only then will the curve slope downwards.

“In fact, it was primarily because of these dire projections made in February this year that most countries went in for a lockdown. India, with others like Rwanda and Syria, imposed the most stringent curfew, stopping almost all economic activity,” added the professor.

Former health secretary Keshav Desiraju said the lockdown was also clearly necessary. “Without lockdown, travel restrictions and ban on public gatherings, there would have been havoc. The lockdown was imposed late. With India’s first Covid-19 case on January 30, much quicker action was warranted,” he said. Desiraju said when it was imposed, it was done without warning, leading to unbelievable misery for large numbers of people who found themselves without jobs, income, food, or shelter — a situation that many governments seem unwilling to acknowledge.

“Lockdown should have been used to identify, test and isolate, and treat the most vulnerable — the elderly, those with co-morbid conditions, etc. This was not done,” he said.

Former head of Virology at Indian Council of Medical Research (ICMR) Dr T. Jacob John said India initiated an early and prolonged lockdown. “Lockdown was neither imposed well (abrupt, disrupting lives and livelihoods) nor implemented well (numbers grew 20 times to 12,000 in 21 days, by April 15),” he said. The extension beyond April 15 was unnecessary, ill-advised and counterproductive, he said. By May 3, the end of the second phase, the Covid-positive numbers had grown nearly 370% in 19 days.

Experts said the closure of all activities was indeed important. Health infrastructure had to be ramped up, equipped with testing and rehab facilities, oxygen capabilities enhanced and isolation centres readied. People also needed to be educated; a little panic had to set in for everyone to adopt acute measures like maintaining distance, wearing masks and incessantly washing hands.

The ICMR kept changing testing guidelines. Earlier, only those with a travel history and displaying symptoms were being tested. Then even those who showed flu-like illnesses and are in a hotspot were tested and quarantined. Some states increased their testing capacity several times. For instance, Rajasthan can now test 25,000 samples a day. It has already tested more than 500,000 samples. When the first case was reported on March 3, Rajasthan didn’t have any testing facility.

India’s lockdown, experts said, has been among the harshest in the world. But there have been several instances of people gathering in large numbers. In fact, in the makeshift relief camps that states set up for migrant labour, the high average density of population was an aggravating factor for the spread of clusters.

Most of the positive cases have been asymptomatic and the mortality rate is low. This gave people false sense of confidence that even if they get infected, they won’t die. The changed guidelines for isolation fuelled this confidence. The government said only people with severe symptoms needed to be put in isolation wards in hospitals; others could stay at home in quarantine.

The massive reverse migration of workers to their home states triggered by fear that they may all die has caused a major economic slowdown. People walked several hundred kilometres to their homes, swearing never to return. Hundreds of others have lost jobs. They said the government overreacted to the crisis and could have managed without locking out the country. That is a matter of debate. The health experts, policymakers and common man think differently about government decisions. And so is the case with the lockdown.

India is unlocking since June 1 but there’s no fall in number of cases. The heartening development is that the number of recovered cases is more than the infected cases. But as restrictions were lifted, the cases began rising rapidly, forcing some states to impose restrictions again.

Covid-19 pandemic has changed our lives completely. The schools are conducting online classes, office meetings happen over video conference facilities and work from home is the new normal. Hand sanitisers and disinfectants are the most important accessories in all homes. People took up cooking to beat the lockdown boredom, some got back to gardening. Lack of domestic helps made people do the household chores themselves. Yoga sessions and exercise became regular.

We leave it to you, the readers, to decide if the lockdown was necessary or we could have done without it? Or, was it imposed at the right time or was it too early to lock out the country?

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