Concrete plan & baby steps
The 'Containment Plan for Large Outbreaks' published by the Ministry of Health and Family Welfare is an action-oriented document to allow the administrative machinery to cope with the dynamic scenario of the Coronavirus pandemic. The objective statement of the document states that the 'plan is to stop the chain of transmission thus reducing the morbidity and mortality due to COVID-19'. With details of action plans outlined in the document, it covers five distinct stages of an outbreak for India. It states that India would follow a scenario-based approach to combat each stage with a requisite level of expertise and preparation in order to adequately contain the situation. The five stages are, namely, 'Travel related case reported in India', 'Local transmission of COVID-19', 'Large outbreaks amenable to containment', 'Wide-spread community Transmission of COVID-19 disease' and 'India becomes endemic for COVID-19'. Out of the enlisted five, India has already experienced the first two that necessitated a nationwide lockdown for 21 days to flatten the transmission curve. During the lockdown, the continuous rise in cases affirms our arrival at the third stage of large outbreaks which can still be contained through proactive administrative approach and sound medical supervision. Currently, there have been around 3,300 cases reported with more than 70 deaths and more than 200 cured. The Nizamuddin incident has raised apprehensions of a possible fourth scenario even as states have sprung into action, tracing all suspects and isolating them to prevent any instance of widespread community transmission. Countries across the globe continue to suffer under the plight of the fourth stage with the US hitting more than 3 lakh cases and nearly 9,000 deaths, Spain and Italy with more than a lakh cases each and more than 10,000 deaths each. The morbidity in the fourth stage is evident and India will have to do everything in its capacity to prevent a transition to the fourth scenario. The likes of South Korea and Germany empower hope that such an action-oriented document and proactive government machinery can together prevent an otherwise disastrous outcome.
Lockdown has ensured that we did not jump to the fourth scenario — which would have been quite easy given the poor health infrastructure and average hygiene maintained in our country — but we still require to take into account our future plan. With the lockdown approaching its end on April 14, the Containment document also entails cue for an exit strategy to be implemented across the country. As India identifies the disease clusters — some 210 districts have reported cases — it is imperative that cluster by cluster distinction and thereby associated actions are taken to combat the situation in those clusters. For instance, Maharashtra, Kerala, Delhi, UP, Telangana, Karnataka, Ladakh, etc., have reported relatively higher numbers against the rest of the country which is why these areas would have to adhere to strict regulations following the lifting of the lockdown against others. It is well established that figures will rise if a calculated step is not taken in terms of handling the outbreak. India has the experience of other countries to learn from. While we imposed a lockdown much before others in the transmission phase, it is imperative that such a lockdown yields a concrete result rather than merely delaying the proliferation of the disease in society. In the coming days, as the government draws plans for the country, state by state and district by district, strict adherence of norms from the populace will be key in winning the battle against the disease. At the same time, mobility will have to be strictly regulated and supervised because any slip would prove costly for us. While the health infrastructure has been tweaked in the wake of the outbreak, it still remains inadequate and susceptible to overburden in an event of an alarming rise in cases. A hasty lifting of lockdown would prove just as costly as a prolonged one.