Published: 29th June 2020
Why it is only people who are illiterate about viruses that will call the lockdown useless
The argument that India started the lockdown too late is not valid from a medical perspective and from a social one
With nearly 4 lakh infected persons and over 12,000 deaths in India due to COVID-19, in comparison to the 86 lakh infected persons and over 4.5 lakh deaths globally, now is the right time to review the measures taken by the government and plan ahead. We are yet to reach the peak and in addition to low mortality, fortunately, the bulk of the infections in India are limited to Mumbai, Delhi, Ahmedabad, Chennai and other cities.
To my knowledge, rural India is yet to be affected in a significant way. Whether that catastrophe will happen or not is dependent on our efforts in the near future. At this point in the fight against COVID-19, the common man will have myriad questions. I will try to answer some of them.
Is the pandemic hyped up or a real threat?
In what way is Coronavirus and the pandemic caused by it, different?
Do we have any past experiences that could have guided us?
How long will it last?
Was the lockdown effective, correct and beneficial?
Is it correct to impinge upon the freedom of an individual in the name of lockdown?
Are we justified in relaxing the lockdown now when it the cases are increasing? Why don’t we continue the lockdown?
Should we test everyone? Should we quarantine all? Should we admit everyone to the hospital to get treated?
I may not be able to answer all the questions because neither is that my aim nor will it be useful at this juncture. But I may try to explain the background for the common man, who is the backbone in the fight against COVID-19, to understand.
Dr Subbiah Shanmugam is the ABVP National President
This pandemic is a real threat, occurring once in a century. It has not been hyped up. On June 10, 2020, in Tamil Nadu, an MLA from the opposition succumbed to the disease. Some VIPs, including politicians, have been affected and many are getting themselves tested, to be proved negative later. Doctors are feeling helpless due to the non-availability of antiviral agents or vaccines. Patients are just being given supportive care in anticipation of the body limiting the infection by itself. Some doctors, healthcare personnel and others working on the frontlines have lost their lives.
Even though morbidity and mortality is more prevalent in the elderly and those with other comorbid diseases, I have seen people in their mid-thirties dying due to COVID-19. Of course, most of them received treatment much later and could only be given what was available. The doctors are so frustrated that even allopathic ones, who are a little high-handed and averse when dealing with native medicines, are not against native medicines being tried on the patients. Many allopathy drugs which are primarily active against other diseases like malaria are being tried too in treating the patients.
The number of COVID cases in India has crossed the 5 lakh mark
Unlike bacteria and parasites, viruses, in general, are obligate parasites and can’t survive outside the host cell for long, be it animal or human. COVID-19 is a betacoronavirus, with more affinity to cells of respiratory epithelium. So it is naturally a respiratory disease, spread by respiratory secretions, which are more difficult to control, particularly in crowded places. Hence the progression is more pandemic than logarithmic, in alarming proportions.
In comparison to SARS and MERS, which are older cousins of the present Coronavirus, with a higher mortality rate — 10% and 30% respectively — in comparison to 6%, which is the highest in the case of COVID-19, the spread of the current pandemic is uncontrolled and alarming. The only previous pandemic with which we can compare with the present one and try to learn some lessons from is the Spanish flu pandemic of 1918-20. Unfortunately, that pandemic happened during and after the First World War and little information was available in the public domain. It belonged to the pre-antibiotic era as well. Hence, we have to learn lessons afresh.
Documentation of each and every stage of the pandemic and the fight against it, is very essential for future generations. The virulence shown by the virus and experience from abroad shows that we will also achieve our peak with attendant morbidity and mortality. Everyone should realise that the threat is real, not a hyped-up one.
SARS and MERS are mortality rates higher than COVID
Now comes the question that several critics of the governments, both central and state, have raised. What has been the benefit of the lockdown that was observed so far, which even impinged on individual freedom sometimes, as complained by several activists. I can definitely say that the progression is slow due to the lockdown and the peak has been delayed in comparison to other countries. But we have had time to prepare ourselves and our medical facilities. If we had peaked along with other western countries, we would have been left helpless, forced to compete with the so-called ‘rich’ countries for scant resources available worldwide in the fight against COVID-19. Besides we had precious time to educate and prepare our population psychologically. Only people who are illiterate about the biological behaviour of viruses and the pandemic caused by them, can complain that the lockdown is useless if it is not going to arrest the pandemic, which is impossible scientifically.
Coming to the relaxation of said lockdown and the magnitude of testing and treatment, it is very important that the nation and society considers the cost-effectiveness of each and every act during a pandemic. Unless any particular response is going to be cost-effective, with considerations of loss and gain in the process, we can’t implement any mass-scale testing and treatment or continue the lockdown indefinitely. Understanding that the pandemic will have its own course in the absence of effective drugs to treat or vaccines to prevent, the lockdown is being relaxed worldwide at an appropriate time. Crying wolf over this will just be a political stunt and nothing else.
Now, with the society well-educated, resources to fight against the pandemic accumulated, various departments working in tandem, the future is definitely promising. We have charted out our own future in various fields, including education, and we can definitely overcome the disease. The viral genome has been sequenced locally, indigenous vaccine efforts are progressing favourably, native knowledge has been helpful, beds and ventilators are available in sufficient quantity and future looks promising to me. Society has shown its resilience, has not turned anarchic, disappointing many pundits who wanted to score political mileage. The economy has not failed midway as shown by the good agricultural harvest – more than enough food grain availability – and increasing foreign reserves in dollars at hand. We have proved that India is not a banana republic and that we have solid democratic foundations.
Rome was not built in a day, babies will be born only after 10 months unless premature. Similarly, we should also wait patiently. We don’t have any other options, even though everyone will love to take a shortcut. I appreciate the Indian society, political parties and government for their mature way of tackling the pandemic.
Dr Subbiah Shanmugam is Professor and the Head of Department for Surgical Oncology at the Kilpauk Medical College, Chennai and National President of the Akhil Bharatiya Vidyarthi Parishad
The views expressed here are the author's own