- Lockdown has slowed numbers but not transmission
- States with more cases imply they are conducting more tests
- Selective lifting of lockdown mooted with even an exit option in red zones
- States, Centre need to prepare post-lockdown plan to bridge gaps in hospital infrastructure
With just nine days left before the second phase of the lockdown ends, experts believe coronavirus is yet to reach its peak and that May could see cases touching the highest level in India. Also, both healthcare workers and economists are right now worried about the novel coronavirus' trajectory and the lockdown impact in India. Speaking to Business Today, some experts said India had certainly not reached its peak as there are just about 1,400-1,500 cases coming in every day. If the lockdown is lifted, the number is expected to rise. But even if the lockdown is extended, the increase in cases will continue because the lockdown can lower the numbers but can't contain the virus spread altogether.
Most experts -- based on speculations around what'll happen after May 3 and the government's preventive strategy -- agree the COVID-19 cases will start peaking May-end or June. Following that, everything will depend upon how rigidly states will follow the Centre's guidelines on the isolation of positive cases, quarantine measures, contact tracing and testing.
So, what should be the right post-lockdown strategy? A staggered approach that ensures selective opening in terms of regions and zones, suggest experts. They believe there should be an exit option for select localities even within the red zones, depending on the type of work (employment) and age groups of those going out to work. The government will also have to restart limited but high-frequency transportation to allow people's movement.
This way, most in the age group of 20 to 40 years, who have one of the lowest mortality rates, could go back to work provided there's the system in place to ensure physical distancing, along with other safeguards.
Considering this scenario, how well is India prepared in terms of hospital infrastructure? Dr K Srinath Reddy, President, Public Health Foundation of India and former head of the Cardiology Department at the All India Institute of Medical Science says: "Right now, we are well-prepared in terms of hospital infrastructure unless there is a huge and a sudden surge in the number of cases. Also, the lifting of the lockdown has to be in a staged and differentiated manner."
Please note that currently, you are not hearing about hospitals being flooded with cases and people dying anywhere in the country, as such a development cannot be missed. Even in 2017, when in Gorakhpur, UP children were dying because of lack of oxygen, it quickly became national news," he added.
Dr Rajib Dasgupta, Professor and a specialist in the area of epidemiology at the Centre of Social Medicine and Community Health of the Jawaharlal Nehru University, says: "At the moment, we are well-placed to handle the COVID-19 crisis and even if, post lockdown, there is a peaking of cases, it is unlikely to be uniform across the country. Within this, the bigger cities with a higher density of hospitals, including high-end facilities, maybe better placed. The challenge could only be around the ability to provide intensive care if there is a spurt in cases in rural areas or outside bigger cities."
To avoid this, states and the Centre will need to review preparedness. States will need to communicate in advance their need for financial support to arrange isolation wards, PPEs (Personal Protective Equipment), ventilators and Intensive Care Units (ICUs) in hospitals.
So is India testing enough? Wherever more cases are being reported, it directly implies a higher testing rate as the more you test, the more the cases will appear. For example, Maharashtra, Delhi, Gujarat and Tamil Nadu are ahead than others in testing, so are their number of cases.