Time for India to go for selective lockdown? Country faces dual problem of increasing new cases and new variants

Dr Suresh Singh
With India witnessing more than 20,000 new cases per day consecutively for 16 days since 11/3/2021 and more than 40,000 per day for seven days since 20/3/2021(> 50,000 on March 25&26th), it is time to declare total lockdown in selected cities, towns and localities. These hot-spots include Pune, Thane, Mumbai, parts of Punjab, Kerala, and Madhya Pradesh etc. where major spikes of Covid-19 are seen.
Another disturbing trend is the increase in new variants of all forms. According to reports, 36 UK, 34 South African and 1 Brazilian variant were found as on 24/3/2021. These are the worrying scenes requiring minute monitoring.
India’s 1st lockdown was on March 25th last year with around 525 total cases. I have maintained from the very beginning that total lockdown of the country is not the solution and expressed so specially against subsequent extensions. I have advocated total shielding of Delhi, Maharashtra and Kerala borders as early as 22/03/2020 with mapping of red spots and 2 week area quarantine immediately.
Learn from past mistakes:
The country should now learn from past mistakes and take effective remedial measures and should not repeat past mistakes. I, along with many public health doctors, are still not reconciled to home isolation and treatment where facilities are not available-e.g. Dharavi with 10 lakhs population, crowded city/town slums etc. One most important factor for the massive spread of corona, in spite of country-wide lockdown, was attributable to this. Hope authorities would not repeat such mistakes.
Though the government is still not sure of the main cause of recent increase of Corona cases in selected cities, and areas, doctors like us are worried by the present increasing trend of the mad virus.
Worrying trends:
Seven worrying states-Maharashtra, Kerala, Punjab, Karnataka, J&K, Madhya Pradesh and Chhattisgarh – accounting 89% new cases in 1 day (23/3/21) ii) of 10 districts with highest active cases-9 are from Maharashtra, other one from Karnataka iii) a total of 206 double mutant variant (E484Q+L452R) have been detected in Maharashtra through the centre maintains no direct link with the ongoing surge in the state. iv) for the first time in last 4 months, the country reported more than 50,000 fresh cases
b) State-Wise :i) Maharashtra (24/3/21) had the highest 1 day hike of 31,855 new cases since the pandemic began. Last peak was on September 11, last year with 24,886 cases. Mumbai accounts for 5,185 new cases in a single day with a total of 3,74,611. Pune had 1 day new cases of 6,741, out of this -3,509 are in Pune Municipal Corporation area.
ii) Punjab-becoming the 2nd highest state with Covid case reporting 2,613 new infections. According to Chief Minister Amarinder Singh, 81 per cent of samples are +ve for UK variants. iii) Kerala-on March 25th, reported 1,989 new cases accounting for an active caseload of 24,380. It had the highest new case of 4,070 on March 22nd with 3 districts contributing more. iv) Gujarat reported the highest single day rise of 1,961 new cases since the pandemic. The active cases now stand at 9,372. These are a few examples.
In-active, timid and too much watchful Covid Task Force response:
Though the Central Covid Task force has done many good jobs and has many credits to its name, however, often it is found to be ‘In-active, timid and too much watchful’ in the time of need. When there is insufficient data, one cannot wait for it forever. We have to apply common sense and take bold decisions based on whatever is available. Present trends demand that India should have limited lockdown in places where Covid surges are eminent. We should not wait for a 2nd wave; in fact, we should prevent it. We have to go for the jugular in the beginning before the mad virus overtakes us.
Area lockdown with suggestions: One day/two day lockdown, night time curfew, limited movements etc. enforced in many states are not the solution. It will have only a marginal effect on preventing the spread.
Hence, enforce – a) total lockdown in affected red spots –cities, towns and other areas. As a thumb rule, any locality with 100 and above new cases may be declared as a quarantine zone. As it can’t be located in cities, whole cities/towns may be quarantined with total lockdown.
b) In lockdown period, enforce basic principle of infectious disease control i.e. i) case detection by house to house surveys and by testing of all households ii) case holding by appropriate treatment- home isolation and treatment for the poor is to be avoided at any cost. There is no point in doing so when 4/5 persons stay in a room with no separate bathrooms. They need to be treated at the so-called Quarantine centres/homes etc. This can and should, however, be implemented for the affordable and well to-do families where facilities are available. And of course, treatment of severe cases at hospitals. iii) health education – enforce preventive aspects i.e use of mask, 6’ physical distance and frequent hand wash as minimum. Now is time to enforce it with heavy fine as people of all categories-politicians and common men are having a casual attitude to it and neglecting the same.
c) 14 day quarantine be enforced strictly in Q Zones, with fines whenever needed.
d) All Testing now to be done by RT-PCR kits.
e) Strict testing and quarantine rule enforcement at all airports-international and domestics. Present strict rules at international airports are not enough. Minimum charge may be applied to the passengers for the tests.
It is time for Prime Minister Narendra Modi to give strict instructions to the government’s COVID Task Force as per the suggestions made above in an effort to prevent the 2nd wave of Corona spread.
The author is former Director, Health, Manipur, a public Health Specialist and WHO Fellow (Holland & UK). Email: [email protected] Views expressed are personal

Courtesy : Financial Express Online.