(opinion)
(Dr Raghava Gundavarapu)
Quarantine: The basic definition of quarantine is to isolate a person for 40 days, coming from foreign lands. This was extensively practiced in the olden days when ships from foreign lands docked at a port.
Going by the available scientific data, the average incubation period for COVID 19, stretches from 1 to 14 days, with a maximum of 28 days.
Supposing a person becomes symptomatic on the 28th day and he has infected a new person (primary contact). And the newly infected person would take on an average of 14 days to become symptomatic. At any rate, during the lockdown, 28+14=42 days should be enough time to fight the corona for these patients.
Purpose of lockdown:
- Contain the spread of the disease
- Test
- Trace
- Track
- Treatment
Contain the spread of the disease: As the whole population is locked down in India, the spread of the disease should have been minimal. The lockdown is supposed to provide a golden opportunity to freeze the timeline of the spread of the disease. Social distancing, wearing the mask and hand-hygiene are the key weapons in the fight against the virus.
Very unfortunately, the lockdown strategy enforced in India did not go well as it was not meticulously planned. The first problem was, a short period of time was given for the people to buy essential commodities, which led to overcrowding at the marketplaces. This had defeated the very purpose of social distancing. Instead, all the shops could have been let open for 12 hrs with a strict vigil on social distancing. This could have effectively eliminated the overcrowding.
The idea of the Red and the containment zones are not scientifically backed. The virus does not travel more than a meter in air and it is unlikely to be carried long-distance by the mosquitoes or flies. Just sanitization of the area should solve the issue scientifically. But, this did not happen.
What this has resulted in is a social stigma, with underlying mental agony and depression among the patients, family members, relatives, and neighbors.
This also took a huge toll on the local authorities, police personnel, and healthcare personnel. Overworked for nothing, their efforts at many places have degenerated into mechanical work, lacking care and compassion.
- Test: The most potent weapon in this war against the virus, is testing for the presence of the virus. The only test recognized by the WHO is RT-PCR (Real Time-polymerase Chain Reaction). Once the lockdown is in place, conducting the tests at the community level should not become a complicated task. The tests should have been done on a war-footing and on a massive scale. For a population of India’s dimension, the number of tests to be done per day should not be lesser than 4 to 5 lakhs. India, however, is no way nearer these magic numbers. As on May 18, 2020, in a span of 50 days, India could do just 20 lakh tests. In 50 days, a nation like India should have done 2.5 crore tests.
Doing the tests is like throwing a fishnet in the waters, the larger the net-spread, the more the fish you catch. Similarly the more the tests you conduct the more the cases you identify. The sooner you identify the case, the sooner it is possible to isolate and treat, thereby reducing the further spread of COVID-19 in the community.
The tests should be targeted at those people who returned from the places where the virus was prevalent, say countries like China, Middle East, European Union, UK, and the US.
Though the data of the people returning from foreign corona hotspots was readily available, as many as 15 lakh people were reportedly let loose, without any test, into the country, with the potential to spread the virus. Had these people been tested at the earliest the war would have been half won.
There was no attempt to find these people. The technology has advanced so much so that these days, people are warned of an imminent lightning strike when they come under a particular cell tower area through text messages. So that they could move to a safer place.
Similarly, with the available data with the airlines and the Airports Authority of India, the travel history of all those passengers, who arrived from abroad could have been mapped, enabling the authorities to conduct COVID-19 tests.
- Trace: With extensive testing, infected persons can be traced, isolated, and given treatment. By isolating, we are preventing further spread of the virus in the community.
- Track: Once you trace the case, it is important to track the primary contacts and test them. If primary contacts are not tracked, they become the potential causes for spread within the community, taking the pandemic to stage 4.
- Treatment: once the tests are done and the cases have been identified, depending upon the severity of the disease various treatment option are there.
(Dr Raghava Gundavarapu is a noted physician from Ongole, Andhra Pradesh)