No lockdown, categorise India into zones to contain Covid: Lancet India Task Force

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Can India afford another coronavirus lockdown? (Photo: Rahul Kumar)

The Lancet India Task Force has recommended that a complete lockdown, as suggested by many, is not a solution to curb Covid-19 in India. It has instead advocated a complete ban on gatherings of more than 10 persons and closure of venues where such gatherings might happen.

In detailed recommendations, the Lancet India Task Force on Covid-19 says that measures to be undertaken to battle coronavirus have to go "beyond the current binary discussion on a lockdown". Highlighting the unpredictability of the virus, it says: "India's second wave is proof that it can take countries by surprise, despite preparedness over previous months. Real-time, reliable, credible data is an essential element of a comprehensive toolkit to defeat the pandemic."

Keep vulnerable sections in mind
The panel has said that steps have to be taken keeping in mind economic consequences which the most vulnerable sections of the society will face. It suggested that the government should hold in-depth consultations with all stakeholders in society and provide safety nets for the vulnerable people as they will face the economic costs of closures.

It says that instead of a lockdown, "a series of actions are needed", which include targeted containment. The Business Today magazine quoted the panel as saying: "The exact steps taken may differ based on local contexts. In areas where infections are spreading rapidly, short, severe closures may be required; where case counts are low, containment measures may be appropriate".

Improve medical facilities
The panel said that the healthcare system in the country is under strain due to the rising number of Covid-19 cases. "With over 2.7 million active cases, the healthcare system is under severe strain. It is imperative, therefore, to reduce the continuous rise in new cases", the panel recommended.

The report is optimistic that India can still improve its medical facilities. Some of the suggestions for better medical services include training more medical personnel as a back-up; setting up oxygen generating plants within hospital premises and establishing fire safety protocols.

Divide the country into zones
It added that India should be categorised into low risk zones, medium risk zones as well as hotspots to be able to tackle the rise in the number of people falling prey to the infection. It defined these categories also.

The Lancet India Task Force suggests that places with increase in new cases is less than two per cent and the percentage of available ICU beds is more than 80 per cent can be made low risk zones. Similarly, where the rate of increase in new cases is between 2-5 per cent, the positivity ratio is 5-10 per cent and availability of ICU beds is 40-80 per cent, such areas can be categorised as medium risk zones. Areas where new cases are more than 5 per cent, positivity ratio is over 10 per cent, tests per million less than 140 and the availability of ICU beds is less than 40 per cent, these should be designated as hot spots.

The task force says that in low risk zones, there can be unrestricted movement of people. Educational centres, offices, factories and restaurants, places of worship can be open but with distancing and 50 per cent occupancy. Essential services like food, the medical sector, local transportation and administrative services can also work. However, the report cautions that the low risk zones will get a rise in cases, therefore, have to increase vaccinations.

For the medium risk zones, the report says these can have unrestricted movement with advisories. Schools can be opened up but indoor confined spaces should be closed keeping local scenarios in mind. It also says that essential services like food, the medical sector, transportation, administrative services and public works can be kept open. However, the report says says that authorities should provide social safety nets, food banks and other support that the poor might need.

Regarding the hotspots, the report says educational institutions should remain closed along with shops and restaurants, offices and factories as well as places of worship for at least 6-10 weeks. It adds that essential services should function as also social safety nets, food banks, cash transfers, and similar support for the vulnerable people. For the hotspots, the Lancet India Task Force has also recommended RT-PCR testing for symptomatic patients, families and close contacts.

Ban gatherings, make masks mandatory
The report emphasises on a total ban on gatherings of 10 people, closing down all venues where gatherings can take place, closure of all indoor spaces except those providing essential services and making masks mandatory. It adds that there has to be better cross-ventilation of indoor spaces.

Regarding transport, the report says that domestic travel, particularly rail and road should be kept open. It suggests testing facilities to be created at bus stations, railway stations and airports.

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