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.

Lock down has failed in large parts of the country — open up now

Lock down has failed in large parts of the country. As the Central government projected, Covid-19 cases are not going to become zero by the middle of this month.  The cases are multiplying at a fast rate in several States. The exceptions are only some small States like Kerala and Chhattisgarh and the North Eastern States. Most of them, especially Kerala and Chhattisgarh achieved control, by early detection, contact tracing and proper care of the patients.

Almost all States could not shore up supplies and create infrastructure needed during then lock down. Several States could not prevent spiralling up of the cases and deaths. While the Centre claimed that curve could be flattened with the lock down and brought down to zero, Congress leader Rahul Gandhi had told the people that lock down could only be a pause. Even a pause could not be achieved in cases of several parts of the country during lock down.

State-wise list of Covid-19 cases as on 12-5-2020 morning. Death rate is highest in West Bengal followed by Gujarat. It is less than one per cent in Tamil Nadu, Kerala, Odisha and Bihar. Several States smaller States have zero death rates of which Chhattisgarh is notable.

Now, there is little option than opening up fast. The tragedy of migrant labourers is still unravelling. They as well as the rest of the population are increasingly becoming susceptible. While the lower class is facing hunger, the middle class is suffering from lack of exercise and exposure to sunlight (sunlight fortifies Vitamin D in your body). All this reduces immunity. The economy is collapsing and millions are facing unemployment.

There is confusion of policies at the government level both in dealing with the pandemic and economy. There is also a bias against the poorer and less influential sections of the society. Guidelines on dealing with the Covid-19 are changed frequently because arrangements to deal with the disease in the best way are still not in place. Now, there is only one way—to face the pandemic head on and pray for herd immunity, achievement of slower spreading by means of physical distancing and use of masks and faster development of vaccines or medicines.

The government has now resumed rail services in a limited way. But non-AC coaches may be safer than AC coaches. Similarly a few hours of travel by air will be safer than a few days travel by Rajadhani class train. So, flights should be resumed along with metro services with restrictions. All manufacturing units should be allowed to function with physical distancing norms. All services except cinemas, entertainment programmes, sports events, meetings, religious gatherings and festivals should be permitted.