The lockdown is 4 weeks old in Odisha and a few days shy in other states. A brief scorecard of the spread of the pandemic is in order. By end of March 24, the reported numbers of infected cases was 571, with 74 new cases (note, with minimal testing). The same on April 11 was 8454, with 864 new cases added. The corresponding numbers for March 6 were 30 cumulative cases with 1 new case. While the spread of the disease grew almost 20 times in 18 days between March 6 and March 24, the growth was about 15 times in the next 18 days.
On April 18 afternoon, in India it is touching 15,000 cases, which is less than 2X spread in the past week. The cumulative detected cases in the corresponding period for Odisha – the first case was detected on March 16, the state announced a lockdown on March 22 when there were two cases.. On April 11 there were 54 cases and a week later it stands at 60. Testing is being ramped up in the state as this post is being published.
Going by statistics and experience of other countries, containment of the spread of COVID-19 in this period has been impressive in India. For Odisha, the containment has been stellar. Considering the experience in some other countries, a 50 to 100 fold growth in this timeframe would not have surprised many.
Understandably, most of the new cases detected during the lockdown would be of people exposed to the virus before the lockdown. Subsequently, thanks to the lockdown, each of these people will have
transmitted to about 3-10 people each, depending upon their own context. Therefore, if the lockdown continues and is successfully enforced we will probably see a multi-fold growth (though less than ten-fold) in the next 2-3 weeks. This translates to about 25,000 to 75,000 cases in India, unless there is a major community transmission of densely-populated areas of Mumbai and Delhi.
Assuming the lockdown continues to be effective, the maximum number of cases by April 30 is expected to be below 1000 cases (even after factoring much higher testing). As there are few overcrowded locations in Odisha, unlike Mumbai that has Dharavi, the risk of community transmission is relatively less during the lockdown. In Odisha and Kerala, containment has been phenomenal thanks to the state governments.
Besides restricting spread of the virus, the lockdown has had multiple positives – one, we have perhaps flattened the curve; two, we have used this to ramp up health infrastructure – PPE, testing kits, COVID-19 hospitals, building a resource base – and, most importantly, getting a better hang of transmission and characteristics of the virus. In short, we brought this disease from the realm of the unknown to the relatively familiar; boosted our confidence levels to fight it; and are much better prepared with processes and infrastructure to combat it.
Where do we go from here?
Considering a vaccine is expected to take more than 12 months for mass production and that the virus can never be fully eliminated without a vaccine, do we continue with a prolonged lockdown? Were the lockdown were to continue in the current form post April 30, inevitably the active affected cases will start reducing, and the recoveries will far outnumber new cases. Maybe the country will continue to need stringent restrictions in movement and gathering (if not a total lockdown) in of May too.
However, a significantly prolonged lockdown will throttle the economy, which is now in a limbo. The supply chain and the livelihoods are in the amber zone; either of them rupturing will initiate a cyclical downward spiral for the economy – and will then need months to repair. In such a situation, more people may die of hunger and malnutrition than those saved from COVID-19. If we go back to pre-lockdown days in terms of restrictions on movement, in 2-3 weeks the virus will again raise its fangs and we will be back to square one in terms of the scare of the spread. Thus it is a Catch-22 situation we are in.
Quite clearly, neither a prolonged full lockdown nor a free for all is a practical proposition. Till the time, tested, affordable and effective vaccines are available we need to ready ourselves for a
golden middle path. Hong Kong has done it quite successfully. Japan has also been reasonably successful in not enforcing full lockdown (despite being one of the early victims of the virus). Singapore has enforced lockdown only recently, that too because of recent international travellers. We need to find a smart way out (contextualized to India, to the individual states and districts) to live with the virus in a post blanket lockdown era and keep the economy chugging, even if at a slower pace.
Currently, in Odisha we have more than 5000 beds for COVID-19 patients. The same for the country will be in excess of 30,000 beds and substantial additions to ICU and ventilator infrastructure for patients have been set up. Also, additional infrastructure in a reasonable timeframe can be created. Factoring that a patient will be in the hospital for 1 to 2 weeks, to attempt some guesstimates, Odisha can easily handle more than 100-200 patients a day, without the heath infrastructure getting overburdened and the entire country can handle 3000-4000 patients per day, without bursting at its seams. These are far higher than current numbers of daily new cases. They are useful reference points that can be leveraged when distancing restrictions are eased. They give the confidence that we can always go take help of austerity measures and go under these manageable limits through 1-2 month stringent lockdowns, if coronavirus crosses the risk zones after (cautious and calibrated) easing of the restrictions.
As many economic activities as possible need to be revived, while ensuring citizens maintain good habits related to physical distancing, PPE usage and hygiene. A string of measures will need to be explored. Schools to remain closed and operate online for months. Limiting international travel and testing all international travellers before letting them enter the country. Bans on large gatherings, especially weddings, political rallies, religious events, will need to continue. Sealing state borders and select districts and possibly plan for online courts.
The Odisha government has listed several activities which can be carried out. This list can be reviewed and expanded with experience and learning. Agriculture and allied sectors have been given necessary concessions. That will help protect rural economies and revive the food supply chain. In urban areas, construction, hospitality and entertainment industries employ a majority of the unorganized labour. The same is true for SMEs. Any job that can be conducted online must continue to with the work-from-home mode for months. Individual establishments will need to be their own arbiter and strike a judicious balance between essential and distancing; and between physical health and economic survival.
As individuals and as a society, we have adapted very quickly in the advent of an unfamiliar danger, we can pat ourselves on the back – but not claim victory or drop our guards just yet. Unless the hot summer kills the virus, as some of us are hoping – we need to be mentally ready for a long haul. We need to continue to learn and discover and take the rational steps, based on experiences and available knowledge, keeping in mind the collective good – while continuing to be sensitive to genuine individual concerns.
[The author is a Bhubaneswar-based edtech entrepreneur and start-up mentor]
