Dr NITIN PANDEY
Words fail me as I sit down to write this, when everything is in a mess, making sense out of it is a difficult thing to do. As a medical professional and as a concerned citizen, getting exasperated at the chaos that marks the Uttarakhand Government’s strategy for COVID control, is but natural. Is it that I misunderstand the dynamics of a pandemic or is it that no one in the government has been able to tell the emperor the truth about his “new clothes”?
As we all know by now, that Pandemics follow a well-defined curve, initially low-level spread, then a surge and a peak and finally it settles down once 60-70% of the population has been infected or vaccinated. The initial low-level spread coincides with Stage 1, the surge with Stage 2 and the peak with Stage 3 of the natural life of a Pandemic. Until a vaccine is found, the present Pandemic will go through these stages, no matter what we do.
When India was in Stage 1, we correctly went down into Lockdown (Lockdown 1.0). Almost everything was prohibited, people forced indoors and economy brought to a halt. Halting an explosive spread of the virus was a priority, as our health care system was not capable of dealing with it and would have collapsed if Lockdown was not enforced. An extremely high death rate would be guaranteed. Aim of the lockdown was to delay the surge and the peak till our infrastructure could handle the peak. Of course, it came at a cost. Millions were rendered jobless. Daily wage earners were left high and stranded. A vast majority of lower- and middle-class people have limited savings. Central and various state governments did ramp up their capacity to treat Covid cases but probably they could not visualize the enormous numbers they would need to handle.
The problems with lockdown are known to everyone but most of us fail to empathize with the problems. Economic crisis, rising joblessness, plunging family incomes, falling GDP are somethings we acknowledge but fail to feel the pain behind those who are affected by it. People are eating less food, spending less on health and child-care. It’s a painful state of affairs.
As we transit from Stage 1 of the disease to Stage 2, the number of cases will rise as it is a natural progression. No matter what we do, the Pandemic will go through Stages 2 & 3. We gained some time with the lockdown but as our PM said it is now a matter of “lives and livelihood”. That is why Lockdown 1 gave way to Lockdown 2 & then Lockdown 3 and finally to the last phase of Unlock 1. It involved gradual opening up of the economy with the acceptance of a rise in number of cases as the Pandemic took its natural course of cycle. Only the containment zones were to be restricted, in rest of the areas life would get back to normal, despite rising number of cases. And we were all prepared, at least, supposed to be prepared. The strategy of the Central government was both scientific and practical.
Actions of Uttarakhand government however are hard to explain scientifically. Our state has either panicked at the rise in number of cases and does not know what to do, or it is a case of someone not having the courage to explain to the political masters that the Pandemic has to live its natural cycle, no matter what you do. Pushing people indoors and restricting commercial activity now, after 2 months of lockdown, will have more negative than positive effects. It will hinder economic revival, push people further into poverty, while having minimal gain in the fight against the virus.
That is precisely why the Center has laid down the well thought out strategy of Unlock 1. This is why the decision of the administration to close down Dehradun for two days in a week is a badly thought action. Fumigation has no value in fight against the virus, and the WHO has repeatedly said that “public fumigation should not be done under any circumstances,” as it has more negative effects rather than any benefits. Either our State government seriously believes it knows more than WHO or it is using this as a means of showing people that it is trying its best to control the virus. Either way it harms the fight against COVID and hampers economic recovery.
For these very reasons, restricting commercial activities in the so called “Red Zones” (a concept with is now outdated with the Pandemic in Stages 2 or 3) has no relevance.
Also inexplicable is the decision of the Government to compulsorily admit all those who test positive for Coronavirus. World over and even according to ICMR recommendations, asymptomatic or mildly symptomatic need no treatment or monitoring and should be isolated at home. Our government in its wisdom admits everyone, which not only causes great trauma to the family, but also stresses the medical infrastructure. The rising number of infected medical staff in Doon Hospital and AIIMS Rishikesh are a testimony of this. If we continue with this policy, much before we reach the peak in Uttarakhand, our hospitals will have worn down and medical staff quarantined. We must discontinue this practice immediately if we are to be ready for the peak, when, perhaps, we can get over a 1000 cases every day. Using up our most precious resource (medical personnel) well before the war, is foolishness.
Speaking of medical preparedness, there are over 7000 samples pending for testing as of today, and unless immediate steps are taken to enhance our capacity, our testing will crumble when the peak finally arrives.
We must stop pretending that we can “cure” the Pandemic, we must not try and make people feel that by shutting down and sanitizing the city, we can prevent the spread of the virus. We must prepare everyone for the worst, which will come, probably in a month’s time from now. We must ramp up testing. We must be prepared to receive 1000 ill people every day. We should isolate areas which have Coronavirus cases and encourage people to get on with their lives and businesses in the rest of the State. We must not scare people into hiding. We have to get on with our lives. We must follow the guidelines in Unlock 1 of our Prime Minister. And most important of all, we must not have knee jerk reactions to rising cases and all our actions should be scientific. Having a COVID action group, to guide the government, comprising of epidemiologists, doctors and economists would probably be a good idea, filled with people who can give independent and honest opinion and tell the emperor about his “new clothes”.
Dr Nitin Pandey is former Air Force doctor, engaged in private practice in Dehradun since 1996. He is a Pediatrician and well known Social Activist.
