COVID-19: another lock down may not be the best choice for Kerala

Corona virus

The rising numbers of COVID-19 cases in Thiruvananthapuram district, extension of lock down and increasing restrictions show that the government is failing contain the disease in the district.

The benefit from several of the restrictions is marginal while the impact on livelihoods is serious. Measures like holidays for banks on Saturdays have little benefit. The restricted working hours for shops selling provisions and groceries— where no demand-drop could be expected from fewer working hours, only serves to add to crowding, especially when home deliveries are banned.

The fast spread of the disease in the coastal areas was unanticipated especially in the absence of proper surveillance among the poor fishers. But the spread of the disease at Ramachandra textiles, Pothys and other showrooms, shops and markets and infections in hospitals could have been anticipated. The first cases at the hyper market, which also makes home deliveries, were known as back as in May.  About a month later, government stops home deliveries hitting every agency making home deliveries. As pointed out in an earlier post, home deliveries are safer than going around shopping, especially for the older people. On one hand, the government talks about reverse-quarantine, and on the other hand, makes it almost impractical for aged couples living alone to stay at home.

The government should apply Gandhiji’s talisman while imposing restrictions over COVID-19. It is fairly comfortable for the large population of government servants, teachers and their families and others drawing regular salaries in Trivandrum to be under lock-down. However, that is not the case with daily wage earners. The government has done nothing to provide financial assistance to them, other than releasing pension arrears for older persons.

Food assistance in the coastal region (mostly to fishers) is limited to five kg of rice and one kg of pulses. The population is denied protein-rich fish for consumption as they cannot go out to fish. If one goes without good food, one’s immunity may be compromised.

The lock-down in coastal villages may be beneficial to the urban centres (though that deprives them also of fish); but for fishers, it does not reduce crowding significantly. Interactions among neighbours are inevitable when there is hardly any home to ‘stay at home’. On a normal day, a significant portion of the population will be dispersed—fishing at sea or selling fish. Now, they are all packed together. It would have helped if widespread testing was undertaken and patients isolated and lock-down lifted in a week or two. However, testing is proceeding at a slow pace.

While the overall performance of Kerala is very good compared to most other States in managing the pandemic, the following deficiencies should be flagged.

Testing is inadequate and progressing at a slow pace. The fact that some COVID-19 cases are confirmed after the patient is dead goes to prove this. Now, the government has decided to replace PCR tests for discharge of patients with antigen tests. Antigen tests are less reliable than PCR tests and World Health Organisation (WHO) does not recommend it for clinical purposes owing to uncertainties regarding results. Apparently, the government is compelled to do so— there is already a daily backlog in respect of PCR test results.

In fact, the government has failed to set up adequate testing and treatment facilities to deal with a spike in COVID-19 cases during the past six months. Hence, the hospitals are now full and first line treatment centres with bare facilities are being set up speedily. There is shortage of personal to man the hospitals and facilities.  This is compounded by many doctors and health workers testing positive for COVID-19.

Now, government is thinking of a State-wide lock down. It is notable that the lock down at the national level as well as the triple lock down in Trivandrum failed to bring down cases. Activities in the agriculture and fisheries sectors and much of the service sector cannot just be stopped for long periods. It can even lead to food shortages and much misery.  Wider and effective enforcement of social distancing at work places, markets and functions and events may yield better results. Business should not be allowed in congested and crowded places and norms should be specified for online deliveries. Use of masks should become a habit when one steps out of homes.

Kerala already has a low case fatality rate from COVID-19. Facilities should be set up on a war-footing to deal with increasing number of cases and keep the fatality rate low.

Kerala slipping in containing Covid-19

Kerala is slipping in containing the COVID contagion. The extension of lock down in Trivandrum and elsewhere is indication of this.

What went wrong was the failure to enforce social distancing norms including wearing of masks and adoption of precautions relating to opening of malls and markets. The Trivandrum Medical College Hospital was showing signs of fatigue and weaknesses and even contributed marginally to local spread of the disease.

We already know that lock down only help to delay spread of the pandemic. The Kerala government is only repeating the failed model of Modi government by announcing lock down on the previous night. The government even moved an armed battalion to Poonthura to enforce the “triple lock down”. The results were immediately visible with a protest by fishers that threw all the social distancing to winds. Another round of protests could be expected if the government prevents fishers from going to sea for long to earn their livelihood, without giving them any monetary assistance. There will also be shortage of fish in the market.

The most laughable aspect of triple lock down in Trivandrum was the Collector’s order which said that people could call the police for grocery supplies to homes. She could not imagine that the police are ill-equipped for such a job without any system for receiving orders, billing and delivery. Moreover, as force that comes into close contact with people on an everyday basis, they are the riskiest group to undertake home deliveries.

To add to this drama, this week the administration had announced ban on home deliveries. After the COVID-19 crisis arose, many agencies were supplying milk products, provisions and groceries to homes efficiently. This was the safest method for supply of provisions and groceries, especially to senior citizens living alone. The administration stopped this overnight, forcing vulnerable groups to go to stores, groceries and sellers of meat and fish.

It is true that people working with a hypermarket making home deliveries from East Fort and getting their supplies from Tamil Nadu had tested positive for COVID-19. However, people were not widely informed of this. No restrictions were imposed on godowns, markets and hotels functioning in congested areas. It was notable that transmission occurred at a congested shop in Saphalyam complex which itself lack proper air circulation. The Palayam and parts of Chala markets are places where people will have to move in close proximity. Token system at the entrance and one way movements may reduce the problems to some extent, but that has not been tried.

Home deliveries are safer than people visiting large markets and stores. There is scope for godowns to operate from different locations. The only thing is that the government should stipulate minimum space for operations and other protocols for them. Similar is the case with hotels supplying parcels. They should have sufficient space for the kitchen and packing. Space left empty in the absence of diners could be used to expand the space available for cooking and delivery.

Recently, food delivery boys in Trivandrum had contacted COVID-19. Instead of banning deliveries in the light of developments like that, the administration should go for regular health check-up of such vulnerable groups, avoiding the easy way of shutting everything down. The economic impact and human tragedies resulting from shut downs could be large. Lock downs are not something you can use off and on.

Despite claims to the contrary, Kerala’s preparedness for dealing with the spreading diseases seems to be inadequate. This is at the root of current restrictions which destroys the livelihood thousands of people and possibly creates more victims than the toll from COVID-19. As days go by, Opposition to lock downs are bound to increase, besides number of those circumventing or breaking the restrictions.