Extending The Lockdown Is Not A Feasible Option; Here’s What We Must Do Next

Prime Minister Narendra Modi has called for an exit strategy to ensure the staggered reemergence of population, once the lockdown ends.

Clearly, a phased unwinding of the lockdown is on the cards.

However, when the unwinding starts, what form it will take and how long some restrictions in one form or other will exist are in the realm of speculation.

However, planning for the post-Covid-19 world depends on speculating and anticipating every possible scenario.

International Outlook

As on 6 April 2019, about 60 countries had more than 1,000 coronavirus infections and another 65 have between 100-1,000 infections.

The World had 12.7 lakh infections, 2.7 lakh cured, 9.4 lakh active cases (of which 46,000 were serious or critical) and 69,757 dead.

Global infection rate may be slowing down to more than five days for doubling (on 31 March, the global number of infections was 858,361), but you never know.

All the countries in the world are going through three stages of Covid-19, and on 15 April we would see many countries in each of these three stages.

The first stage is when the number of infections is still very few or none. As of 6 April, there are about 80 countries with two-figure infections, but most of them are countries with small economies or small populations.

The second stage would be countries that are actively managing the crisis, practising social distancing, and are under national lockdown or regional lockdown(s) with only essential economic activities permitted.

Most of the world is in this stage and would perhaps remain in this stage until 15 April.

The third stage would be countries that have managed to keep daily infections low without shutting down their economy (eg, Taiwan), or survived a Covid-19 scare and have reopened their economies (eg, China).

International travel is currently near zero now, and will probably stay there for some time, until there is visible success globally against the pandemic.

Almost all countries have either cancelled all visas, allow only citizens or residents or diplomats to travel or have cancelled all international travel.

Until a vaccine is developed, international travel may only be possible between countries in third stage, and that also only if countries trust each other’s data on Covid-19 infections.

Some kind of international travel where people are quarantined for 14 days (only recovered patients with immunity may be exempt) may be possible during the summer or later this year, though unlikely to be in big volumes.

The number of planes in the air at any time during a day has reduced from 8,000-20,000 before the pandemic to 2,500-5,000 currently. The world had about 24,000 commercial aircraft (only 1,800 cargo planes, excluding military aircraft) in active service during 2019.

We don’t know whether the disease will be accelerating or slowing down elsewhere in the world on 15 April. We will of course be more concerned on whether the disease is decelerating in India or not. There are several possible scenarios and we would have to be prepared for all eventualities.

However, in all eventualities, we are unlikely to be attending large sporting events or political rallies or religious congregations for the rest of 2020.

Depending on whether or not a second coronavirus wave occurs in the winter of 2020, we may be avoiding large crowds in 2021 as well.

Until a vaccine is developed, approved and is manufactured in sufficient volume, the mantra is going to be “emotionally connected but physically distant!” Goodbye shaking hands! Welcome namaste!

Lifting The National Lockdown

Most of us are realising that an extended national lockdown is not a feasible option for India.

Our government neither has the means, nor does it have the method to feed 500 million unemployed (migrant and farm) workers for an extended period.

The government will have to lift the lockdown even if the national-level data looks bad, provided the spread is restricted to some pockets of pandemic hotspots.

Number Of Cases Per Day Across India

Unfortunately, this is the number that is reported by the press, which everybody is tracking. Clearly, the week starting 5 April is the crunch week. The dream scenario would be that the number of new cases per day sees a dramatic decline and goes back to two figures per day.

The worst scenario would be an increase in new cases per day touching four figures or worse by the end of the crunch week.

Of course, the third scenario would be that the number of cases per day remains in three figures. Whatever it may be, the government will most likely ignore the number of cases per day at the national level, and base its decision only on the following two factors:

Ramping Up Healthcare Capacity: We get sporadic news about railway coaches being converted into hospital beds but despite the non-availability of details, we can be sure that efforts are on a war footing to expand (temporary) hospital capacity and ensure all our hospitals are well-stocked with masks and other personal protective equipment (PPE), ventilators and intensive care unit beds to a much larger number of patients.

Hopefully, by end of April/May, the Prime Minister would be able to assure the country that we are geared to handle a spike. Progress on this will be a key factor on deciding the date to lift the lockdown.

District-Wide Spread Of The Virus: Data about the number of districts that Covid-19 has spread to and the intensity of infections in the district will be a key factor to decide whether the challenge can be managed district-wide, or a national lockdown is still necessary.

As on 6 April, the Ministry of Health website, reported that 211 districts had Covid-19 cases (India has over 720 districts) and only three (Delhi – shown as multiple districts –, Mumbai and Kasaragod) had three-figure infections. Also, only 50 districts had double figure infections.

However, this is older data as it only considers 1,965 infections, whereas the all-India figure is currently twice that.

On 15 April, the government will have to assess the growth in each district to decide whether the new cases per day are climbing rapidly or are manageable. Districts will be classified as zero-growth districts (with no Covid-19 infections), districts where doubling is taking 10 days or more, districts where doubling is between five and 10 days, districts where doubling is five days or less.

The government will most likely lift the national lockdown on 15 April, and opt for statewide, district-wide or city-wide lockdowns, depending on what the above district-wide and state-wide growth factors. It is highly likely that the government may continue the lockdown in Mumbai, Delhi, Kasaragod and a few other hotspots for a couple of weeks more.

The Health Ministry will actively monitor district-wide data and opt for new lockdowns whenever required, hopefully only for a state/district/city and no national lockdowns will be required after the current lockdown.

Travel

The key factor that will determine new lockdowns would be the policy on travel. What will the policy on travel be for road, rail and air transport?

It is highly likely that no travel will be permitted to/from hotspots.

However, travel in other parts of the country may also be curtailed; train tickets in a 72-seater compartment may be restricted to 36. Buses and planes may also be told to sell only half the seating capacity or less.

Obviously, ticket prices will be higher – people will travel only if absolutely necessary. Everybody will be wearing ‘face cover’ (the authorities don’t like the use of word ‘mask’ as it is understood to mean surgical masks that are still reserved for health workers only) and be practising social distancing.

Permitting travel increases the likelihood of new hotspots and new lockdowns but the country will have to take that risk.

Hopefully, people will practise social distancing, and new hotspots should become rare. Lockdowns in hotspots may be lifted when the district growth rates fall to doubling in 10 days or more and/or when the number of Covid-19 infections is below 100.

Airlines and train services will struggle as a lot of trains/planes originate and terminate in places like Delhi/Mumbai, use service stations/parking bays in Delhi/Mumbai that are likely to experience longer lockdowns.

They will have to reorganise and improvise. Trains that originate in the hotspots may have to originate elsewhere and trains may have to travel non-stop when they go through hotspots. Employees working in airline/railways may also have to be temporarily relocated outside hotspots.

Hopefully soon, all districts in India will see Covid-19 infections of less than 100, growth rates reduced to doubling in more than 10 days and all lockdowns lifted. Hopefully, that should happen, without overloading of the hospitals, without pressure on availability of ventilators and without too much loss of life.