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Is a Longer Lockdown a Good Idea? Three Public Health Experts Answer

Is a Longer Lockdown a Good Idea? Three Public Health Experts Answer

A security person stands guard at Jammu & Kashmir National Highway, on day 3 of the nationwide lockdown. Photo: PTI.

Delhi chief minister Arvind Kejriwal tweeted on April 11, shortly after Prime Minister Narendra Modi’s virtual conference with India’s chief ministers, that the former had agreed to extend the nationwide lockdown to arrest the spread of the new coronavirus until April 30. If this extension is confirmed, India’s lockdown will last for a total of five weeks.

Among other reasons, Modi’s decision is likely to have been influenced by the fact that scientists from the Indian Council of Medical Research published data on April 10 that indicated the virus’s spread had entered the community transmission phase in the country. Already, the bigger cities of Delhi and Mumbai have reported over 800 cases of infection each, with Mumbai also preparing to test 7.5 lakh people in Dharavi. As an advance measure, Odisha and Punjab had announced state-wide lockdowns until April 30 yesterday.

While the country’s political leaders seem to be united in their demand for a longer lockdown, what do scientists say? The Wire Science posed the following question to three experts, and their answers are reproduced in full below:

What happens if the lockdown is lifted on April 15 versus what happens if it is extended until April 30?

M. Sivakami, professor in the School of Health Systems Studies and chairperson of the Centre for Health and Social Sciences, Tata Institute of Social Sciences, Mumbai.

India is in a crucial stage at the moment in terms of the number of positive cases of COVID-19 as well as our health systems’ ability to deal with people who need hospitalisation and critical care. Except Nagaland and Meghalaya, all other Indian states have reported positive COVID-19 cases as of April 9.

As testing has ramped up, states like Delhi, Maharashtra and Tamil Nadu are beginning to reveal the harsh reality — of the virus making inroads into new areas, especially areas with higher population density, including some clusters that have the potential to let the virus spread rapidly to hundreds of people, if not more, and placing our health systems under enormous stress. The virus is expected to spread to villages and small towns in the coming weeks, as one expects in any pandemic situation.

Thus, the need of the hour is to ramp up testing in rural areas and equip our healthcare facilities to deal with the surge in numbers. Given the lack of reliable data to predict the transmission rate, a lockdown until May 1 might be necessary even if few among us may wish it. However, such a lockdown must be accompanied – unlike the one imposed on March 23 – by measures to ensure the poor and the needy get their essentials through the public distribution system, and to ensure community kitchens stay open and operational on a priority basis.

We must also ensure that we don’t mount our COVID-19 response at the expense of other health issues, which could create a dangerous situation for a country like India.

Abdul Ghafur, coordinator of the ‘Chennai Declaration’, Apollo Honorary Adjunct Associate Professor and consultant in infectious diseases and clinical microbiology

I am a strong advocate of a lockdown that lasts for a period of three weeks, but I am against any nationwide extension beyond April 15. A lockdown helps flatten the curve but will not make it disappear. We will have to face smaller and intermittent outbreaks in the future. After April 15, only those districts with hotspots can continue the lockdown until May 1. Other districts should lift the lockdown but at the same time continue to ban social and religious mass gatherings, and shut shopping malls and educational institutions.

A prolonged lockdown will affect the economy of the country. Daily-wage workers cannot cope with the lockdown scenario for long, even though governments may be providing basic support to the majority of the poor. If we continue the lockdown, joblessness will be a serious issue. Personally, if I am given the option of definitely losing my job and income and the second option of keeping my job with a 20% of contracting the virus and dying, I will of course choose the second option. A longer lockdown that restricts people’s mobility between districts, states and even countries will make human life meaningless.

There is always some risk in life. We must fight the virus with all possible means but not run away from it forever. Life should go on!

Jacob John, professor of community medicine at Christian Medical College, Vellore

Whether the COVID-19 tragedy morphs into a greater catastrophe depends on our response to it. The lockdown on March 24 was a no brainer. Having perennially failed to invest in health infrastructure, we needed to buy time. However, the increasing clamour for continuing the lockdown needs to be considered along with its consequences.

The pandemic, having firmly established itself, requires immunity in about 60% of the population before transmission will die down – whether this is through natural infection or immunisation. Lockdowns buy us time to implement strategies that retard epidemic progression and shore up our woefully inadequate healthcare infrastructure (including acquiring personal protective equipment for frontline workers).

The price for buying us time has disproportionately fallen on those who lack resilience – the invisible migrant labourers, daily wage earners and the like, who face existential questions such as ‘death by hunger or death by COVID-19’. Do we need more time? Absolutely, yes! But can we afford to let the vulnerable continue to pay for it?

The desperate attempts of the fearful to quash the epidemic while also dividing the people must give way to a reasoned approach – of a ‘slow burn’ with participatory community action based on transparency, collaboration and solidarity rather than control and coercion. We can slow the epidemic down by sensible distancing, providing for the vulnerable and ramping up testing and isolation. It is only in this context that an additional 15 days of restriction will be remotely justifiable.

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