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Is lockdown the only way out of this pandemic?

lockdown
Image credit: economic times

The nationwide lockdown would continue in some form or the other even after May 17. This post attempts to analyze if lockdowns were effective to fight the COVID 19 pandemic.

To be sure, when the Government decided to lock down on 24th March, it had no other acceptable alternative. The response was based on an overwhelming consensus of experts, the initial trajectory of infections in developed countries, and how other countries were tackling the pandemic.

Most countries with the exception of Sweden decided in favour of complete or partial lockdown to control the spread of the epidemic. And, there was widespread public support regarding the decision.

With the benefit of hindsight, we can now analyze the trajectory of the coronavirus outbreak in India and the efficacy of lockdown.

  1. First things first, India decided to go the lockdown way because of the consensus amongst epidemiologists and public health experts that if we don’t impose lockdowns, India will have around 30 crore infections by the end of July. Their models did not take into account variations across geography, demographics, etc. We have a precedent for this inaccurate modeling. This had happened in the AIDs/ HIV epidemic. It was predicted to overwhelm India in the late 1990s. But, the model did not incorporate the difference in sexual behavior in countries. The panic created had the unintended effect of the diversion of limited resources from building a stronger health system for all diseases.
  2. We cannot ascertain the actual number of people infected with coronavirus, due to several constraints in testing abilities, but what we do know with certainty is the number of deaths (although it can be suppressed too as believed in the case of West Bengal). As of 10th May 2020, the total number of deaths in India due to coronavirus is 2,212. This is a small number.
  3. As noted, the ability to test people is severely constrained in India. Moreover, there have been doubts about the effectiveness of the tests. Therefore, the number of coronavirus cases is not a reliable parameter to track. Let us take the example of Dharavi. As of 10th May, the number of positive cases in the largest slum in Asia is 808 (with 21 deaths). This is logically an underestimate considering, it is almost impossible to follow social distancing norms in a congested settlement like Dharavi. But, as deaths are not possible to hide in a small densely populated slum, it makes the mortality rate of COVID-19 similar to the normal flu. The same is true for the slums of Khayelitsha (20 deaths) in South Africa.
  4. It is clear that initial predictions were made on experiences of developed nations. And, the developing countries blindly emulated them. The developing countries are not in a position to do ‘whatever it takes’ to prevent the economic fall-out of the lockdown. We have to be wary of fiscal constraints while taking any decision. [You may read: What is debt monetisation? Should India do it?]
  5. Further, there are only two ways to get rid of this pandemic. First, a vaccine is developed and it becomes available to all people. Companies are working to develop a vaccine, but it will take at least a year before it goes through several phases to finally reach the masses (Read this post by weforum). The second is developing herd immunity. This will happen when over 60 -80 % will get infected and become immune to the disease. There’s no other way. Lockdowns will only delay what’s inevitable.
  6. The lockdown was not entirely without benefits. It is possible that it prevented our health system from getting overwhelmed. More importantly, it bought us some time to plan and also procure necessary PPE kits, testing kits, ventilators, etc, and ramp-up our medical infrastructure so that we are better prepared. Further, some people were callous in their attitude to the pandemic. The lockdown drove home the seriousness of the pandemic and helped in spreading awareness about hygiene and social distancing. It made citizens a participant in the fight against coronavirus.
  7. That said, the lockdown was ostensibly prescribed to flatten the curve. As this post by conversation points out we don’t the answers to the following questions yet- will the flattened curve rise again? Or is the suppression strategy possibly an intermediate solution?
  8. We are in a better position now to conduct a proper cost-benefit analysis of imposing a lockdown and plan accordingly. It seems that economic costs and human suffering of the lockdown exceeded health benefits. Consider the plight of migrants who were forced by circumstances to walk for hundreds of kilometers without food and water. The lockdown has disrupted economic activity and denied people their livelihoods. For a poor migrant, fear of dying of starvation is far worse than contracting the flu.

[You may read: Mass Exodus of Migrant from cities to villages]

While the privileged can opt for working from home and can maintain social distancing, it is the poor and vulnerable who suffer the most. They don’t have the means of quarantining themselves. Neither are they so inclined in the absence of basic necessities.

You may read: Impact of COVID-19 on MSMEs]

Therefore, the Government has taken the right step to restart the economy in a phased manner. We need to find localised solutions to this global pandemic. We have to get the economy back to pre-COVID levels with appropriate hygiene and social-distancing measures as outlined below.

The use of masks will perhaps become mandatory, at least in work and public places. Two, protecting the old-aged and immuno-compromised will have to be somehow managed within each household. Three, workplace safeguards, with elements of social distancing, etc, will have to be adopted. Four, periodic screening and testing of frontline medical staff will be critical. Finally, mass gatherings will have to become avoidable, at least for the foreseeable.

That’s all. What do you think is the way forward for India? Should we work towards normalising the economy with adequate social distancing measures? Do let us know in the comment below 🙂

[On a different but not unrelated note, we’ll talk about a paper by Imperial College-London (ICL) that prompted various Governments to lock down.

The Trump administration specifically cited ICL’s 2.2 million death projection on March 16th when it shifted course toward a stringent set of “social distancing” policies, which many states then used as a basis for shelter-in-place orders. In the United Kingdom, where the same model’s “do nothing” scenario projected over 500,000 deaths, the ICL team was directly credited for inducing Prime Minister Boris Johnson to shift course from a strategy of gradually building up “herd immunity” through a lighter touch policy approach to the lockdowns now in place. 

Source: www.aier.org

The paper was authored by Neil Ferguson. He had overplayed the death projections 3 times in the last 20 years- mad-cow disease in 2001 (50-150000 human deaths predicted, actual human deaths less than 200), bird-flu in 2005 (up to 200 million deaths, a few hundred actually died), swine-flu in 2009 (65,000 deaths in the UK, actual was 457). (1)

It’s extremely ironic that he had to resign from his Government advisory position in the UK as he broke lockdown rules to meet with his lover. Prof Ferguson allowed the woman to visit him at home during the lockdown while lecturing the public on the need for strict social distancing.]

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