Hyderabad: Lifting the lockdown or introducing exemptions in hotspots that have witnessed large outbreaks of Covid-19 positive cases should be based on sound decisions from State health administrations. Experts warned authorities in particular and community in general to be prepared to face a possible spike in the cases of Covid-19 if the lockdown is removed at one go. A well-planned exit strategy is the way to go, they added.
Dr. K Srinath Reddy,
President of Public Health Foundation of India (PHFI)
Individual State governments have to decide to what extent they are comfortable to implement exemptions. In fact, the local District Collector and the health authorities must be able to take the call in easing restrictions because they will be the right officials aware of the ground realities and not officials in New Delhi.
Moreover, at this moment of time, the local State governments can’t afford to provide such exemptions in hotspots. The exemptions could be useful for unorganised workforce like plumbers, electricians etc., but State governments will not be able to implement such exemptions in areas that are recognised as hotspots. One thing what all of the States and the entire country must remember is that it is not advisable to lift the lockdown at one go. To exit the lockdown in May, there should be strategies based on general principles that are necessary to contain an epidemic.
Dr. L Narendranath
Former Director of Nizam’s Institute of Medical Sciences
The decision to lift restrictions and the lockdown during the ongoing coronavirus crisis should be left to the Chief Ministers, because individual States will have a far better idea about the ground realities than anybody else. The Telangana State health wing has been able to handle the coronavirus outbreak very well and they should be allowed to take a call on lifting the lockdown in their own time.
Moreover, a little prolongation of lockdown will give time to the State Government to put special focus on farmers. While in the first lockdown, Government fully focused on health aspects, this time around they can focus on agriculture. Exemptions or partial lockdown is very difficult to implement because people will swarm the streets.
The State governments can base their decisions to open lockdowns on the disease burden of the coronavirus and also on the death rate. Mass testing though ideal is very difficult to implement because we depend on China for the rapid testing kits. In the absence of such diagnostic kits, death monitoring with best possible testing is what we can do. Due to the stigma attached to the disease, there might be situations where deaths are not being registered.
To get a fair idea, there is a need to keep a close tab on crematoriums and burial grounds where the last rites are performed, to find the exact number of fatalities that are taking place in the State. An accurate picture of fatalities will enable authorities to take an effective decision on lockdown. There is also a need to have a fair idea on the number of acute respiratory and pneumonia patients that private hospitals in Telangana are receiving.
The Health wing can also take at least 5000 samples from a Red Zone and equal number in a Green Zone on the same day, which will also give a fair idea on prevalence of the disease. Such measures help us to know about the asymptomatic carriers. There are many States that have very less number of Covid-19 cases and such States can relax their lockdowns but continue with the inter-State ban on travel. Once such States relax the lockdown measures, then over a period of time health authorities will get a fair idea on the spread of the ailment for other States. There is a large migrant population in all the major metro cities and there is a definite sentiment among them to visit their homes once. States also should explore the possibility of providing them a safe corridor with transport facilities to reach their native places. Such measures will give more freedom to States to take a call on lockdowns.
Dr. GVS Murthy
Whenever lockdowns are lifted during pandemics, State governments, community and individuals must be prepared for a spurt in cases of Covid-19. This is a universal phenomenon and nobody can escape it. So where or how do you end the lockdown? The best possible way to end a lockdown is to identify people who are high risk in the hotspots through extensive survey from the field staff and tracking their health every other day.
Tracking the death rate due to coronavirus is also very critical to individual States. Kerala has managed to reduce the number of deaths and we must learn some lessons from them. The vast IT capacity of Telangana must be leveraged to build GPS-based mobile applications to track high-risk patients across the State. Field level health care workers and volunteers have a lot of potential that can be tapped in strengthening surveillance. We must work towards identifying cases, isolating them and tracking high risk persons, which will help State government to take an informed decision on when to lift the lockdown.
Dr. P Raghuram
President, Association of Surgeons of India and senior oncologist
The decision to continue with the lockdown till May 3 is very important because it plays a vital role in cutting down in transmission chains and also given an opportunity to health care systems to sharpen their containment response. Moreover, Chief Minister, K Chandrashekhar Rao is on point when he says that saving lives is very important.
We also must realise that compared to western population, 87 per cent of Indians are below the age of 50 years. This is an advantage because there is every chance that Indian population will be able to recover quickly from such viral infections.
Already, the government has identified certain hotspots in the State and health authorities should be aggressive in implementing containment measures. Patients should be tracked, isolated and their close contacts should be quarantine. To take-up such activities and also to prevent further spread of the infections, there is a definite need to have more time in our hands.
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