COVID-19 – The Past, The Present and The Future

Dr. Pradeep Kumar^*

*Corresponding Author: Dr. Pradeep Kumar, Senior Medical Officer at Sagar Polyclinic, Oman.

Received Date:  October 14, 2020

Publication Date: November 01, 2020

Abstract

Independent India did not face any ravaging pandemic after the Spanish flu in 1918. COVID-19 which is affecting almost all the countries in the world similarly has also hit India, owing to its international participation in trade, travel and economy. Each country has designed its way to handle the pandemic. India has chosen lockdown as a first and foremost measure to combat the rapid human to human transmission of the newer virus. Though it appears a very harsh measure to a majority of Indians, it indeed is a necessary and essential step to avert massive mortality due to COVID-19.

Lockdown is  being criticized for affecting the poorest and postponing the inevitable.  However,  even the harshest proponents  for herd immunity do not claim that lockdown is never to be used.  Be reminded  that  India declared locked down on  24th  March when the cases barely crossed 500 all over the country. And look at the countries which locked down after the case numbers reached  tens  of thousands.  The  US locked  down  on the  same day at the count of 50,000 cases and paid the price of crossing 370,000 cases by World Health Day! India had barely 5000 cases by then. Yes, lockdown slows down the influx of up to 500,000 expatriate workers from the GCC countries, a lot of them obviously carrying the virus.

No one denies  the fact  that  the lockdown  cannot  continue for one or two years. No one ever claims that community transmission will never happen either. The anxiety which was caused  by  a large  number  of projected  deaths  was supposed to be bad for inflation and hence to poverty as per  experts in  social  media. The  same  social media  gave  negative colors to the Tablighi Jamaat incident which was mentioned in an editorial in The Lancet and also possibly triggered  a  mass exodus  of  migrant laborers  against  the lockdown rules. India has the largest network of digitally connected   health   force.  The   malignant   campaigns  in  social  media  have  not been  successful  in creating  sustained setbacks to the control strategy that has worked satisfactorily so far. Any amount of planning for such a mass outbreak would be deemed  insufficient. 

In a  country  as big  as  India, even one lakh tests per day would take years to cover the population  completely.  While complaining  about  the meagre  number  of tests  done  in India,  we  must accept  the fact that we are doing much better than many of the so-called developed  nations.  Why would  one  claim that testing  alone will  control  the march  of  the pandemic?  A  large number  of  cases will  be  missed by  a  test that  has  only about 50%  sensitivity. Even  the  best of  the  tests has  been  shown to cause  intermittent negativity  with  its lucid intervals. We are still experimenting with treatment protocols and the vaccine trials are yet to move into phase III.

The fact is that SARS CoV-2 seems to be mimicking (and accelerating) the age-specific death rates of yesteryears when there were no automobiles to kill the young and the active.  But  the old  people  are not  dying  alone ...  some  young people also are dying (even infants).The violence against health personnel has been on the rise before the pandemic started and has abated a bit following the  helpless situation  where  modern medicine  was  the only  option  left to people  who were  suffering  from  the  new virus.

The states have been dealing with the control of  the  spread of  illness  with federal  control.  Attempts at  loosening the lockdown have shown reappearance of cases and the central government has stepped in to support the state governments to clamp down again. Without federal support,  it  will be  difficult  for  the  state governments  to  implement strict curfews  such as  is  warranted by the  pandemic. The young population of India is not a boon as has been painted by the proponents of herd immunity. The  younger individuals  will  bring the  infection  back to  the old people living in overcrowded joint families of rural India.

The  opening  of schools  will  bring asymptomatic  carriers  to such  homes  in the  form  of children. The acceleration of age-specific death rates will essentially wipe virus considerably. A country with a population of about 1.3 billion beat the exponential growth of cases which was witnessed in countries with populations much lesser than that. The critics point out that the lockdown should have been announced before the clampdown. Congregations which  happened despite the  rapid  lockdown created  a  couple of  the  bigger spikes  in  number of  cases  since the start of the pandemic in India and spoilt the control status of at least two of the states in the country.

Kerala  had been  shown as  a  better example  as  per the  editorial2  and that  is  one state  which  is waiting  for  the out the  old  generation without  support  systems in  place for critical care. The government in  the  UK, which  proposed  ‘herd-immunity-line’,  later recanted  it  in the  face  of rising mortality. Without a lockdown, a large gathering of people can never be curtailed. The majority of old people in India never retire since they lack social security  in  real sense.  They keep working  until  they can do  so.   Locking them down alone would prove to be disastrous in the short term too. 

That, India had a  strong federal  government  which took a bold decision which was supported by the majority of the states, talked volumes of the kind of democracy she has.  ‘Social acceptability’ of  an equal  number  of deaths  due to other causes such as road traffic accidents pales in the face  of  catastrophic overload  of  health systems  even  in the  best  of countries.  Taking  lessons from  an  equally young  and  big country  like  China, we  know  that only  harsh lockdowns work well.

Volume 1 Issue 5 November 2020

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