VIJAI SARDESAI
ome of our Goan seafarers allowed to disembark in Mumbai after a prolonged ordeal of 40 days, had to face the added nightmare of rejection and opposition from locals to their quarantine in their localities in Mumbai. Such local opposition is just a microscopic sign of the general fear, anxiety as well as prejudice and ignorance prevalent and seen exhibited all over the country with regard to this pandemic. It is my contention herewith that this fear, prejudice and misconceptions are fuelled to a large extent due to the prevailing official narrative concerning the government response to this pandemic. Unfortunately, this insidious narrative is fraught with disastrous socio-politico-economic health as well as public health consequences.
India has just completed a month of “lockdown” to combat the novel coronavirus tormenting the world. As of April 25 morning, we have in India 24,506 confirmed cases and 775 confirmed deaths (MoHFW website). Globally we have 2,831,785 confirmed cases and 197,306 confirmed deaths (worldometer). Goa had seven confirmed cases with no confirmed deaths till date.
If one examines the official briefings given every day since the national lockdown started on March 25, one can notice that the Health Ministry Officials seem to be doubly concerned with proving that we have managed to flatten the curve and contain the spread of the pandemic. So the impression created is that the success of the ‘lockdown’ is to be seen primarily in the dwindling numbers and by how we are faring compared to other badly affected countries. With the result that anything that leads to or has the potential to lead to a spike in numbers is an ‘anathema’, abhorrence, a curse. Is it any wonder then we have the government releasing statistics periodically (flashed with screaming headlines by a section of the media) detailing the percentage of spike in cases due to the ‘Tablighis’? Is it any surprise then that there is widespread apprehension and opposition to the return of the seafarers and other NRIs and NRGs to Goa? It is clear that the National and State governments are making extra efforts to show that the “lockdown” has worked and that they have been the “saviours” who have managed to redeem the Country and the State. This fallacious thinking can lead to serious misconceptions regarding the prevailing pandemic and have disastrous consequences for the Country and the State, both with respect to the socio-politico-economic as well as public health.
Let me highlight below some of the hard realities we have to inevitably face so as to get rid of our misconceptions and fallacious thinking with regard to this global health emergency.
Reality 1: Lockdown cannot stop a pandemic, only delay it.
Whether we like it or not, the first reality that we need to accept is the fact that “lockdowns” can never end a ‘pandemic’. In fact, it is never meant to be. It can only delay it, at best. “Lockdowns” are never meant to bring infections to zero. “Lockdown” is a social distancing measure meant to contain a pandemic with a two-fold objective: slow the infections and ramp up the critical healthcare infrastructure so as to protect the vulnerable sections of the population and minimise the loss of lives. Therefore, more than the numbers of infections going down, the government needs to inform the citizens the measures it is taking to save lives of the vulnerable sections of the society: those with low immunity and those with co-morbidities particularly those below 10 years and those above 60 years. This would mean regular update on the status of ‘testing’ to identify the infections in the early stage and save lives and the status-update of the number of ICU beds and ventilators and related therapeutics and infrastructure to treat full blown cases of the pandemic. Everything else is a spin. As I pointed out last week, in this spin the unknown ‘total cases’ of infection due to the pandemic are confused with laboratory ‘confirmed cases’ and the unknown ‘total deaths’ due to the pandemic are equated with laboratory ‘confirmed deaths’ to create the mirage that ‘we are in control’ of the pandemic. And then we have the ludicrous slogan that we are “COVID-free” unfortunately uncritically swallowed by the intelligentsia and almost all sections of media. It is one thing to say that we are “COVID-active-cases free” and totally another thing to say “COVID-free”. The simple question is: How many people have you tested in the State to come to that conclusion? 1000-odd tests for a population of about 1.5 million? The Goa government is on record that the recent house-survey revealed nearly 30,000 with respiratory diseases. How many have we tested of these and with what type of test to discount the possibility that they either ‘have’ (proved by PCR test) or ‘had’ (proved by serological test) the novel coronavirus infection? This assumes added importance in the context of the Indian government officially acknowledging that nearly 70 per cent of the confirmed cases so far have been asymptomatic that is, either with zero or mild symptoms.
Reality 2: Flattening of the curve is not flattening of the virus
Secondly, we need to be conscious of the reality that ‘flattening of the curve’, which is the goal of a ‘lockdown’ as a ‘social distancing’ measure even if achieved cannot lead to the ‘flattening of the virus’ or ‘eradication of the virus’. In fact, global medical experts that I have read and heard are unanimous that a pandemic can end, meaning cease to be a pandemic and continue existing as a normal everyday virus, only when at least 60-70 per cent of the total population become immune to it either through ‘injection’ (vaccination) or ‘infection’. So if not today, days, weeks or months down the line I am susceptible to get it. How long can we remain in our ‘cocoons’ locked down? Therefore, we don’t need the ‘Tablighis’ or the ‘NRIs’ or the ‘seafarers’ to get it to Goa or India. The narrative needs to change. The focus needs to be shifted from “avoiding infections” to “avoiding deaths”, if infected. This assumes importance given the disclosure of the National Health Officials that just about 5 per cent of the infected get critical. In fact, 80 per cent don’t even need hospitalization. And therefore, the “lockdown” is supposed to give us time by “delaying the infections” (not so much avoiding) to upgrade our critical healthcare system and ramp up testing so as to save lives. In this context, we applaud the Goa Health Ministry with its dedicated team of doctors and staff for putting their best foot forward and healing all the seven confirmed cases in Goa.
Reality 3: Need to protect ‘public health’ as well as ‘public sustenance’
Given the above reality it is not surprising therefore, that WHO has warned that the worst is still to come. Experts are warning of a ‘second’ wave in the coming months particularly as the temperatures go down. The much awaited ‘vaccine’, the ‘real saviour’ is by most estimates 12-18 months away. Whether we like it or not, till we get an effective vaccine we will have to learn to ‘live with this virus’.
According to Dr Richard Horton, the Editor-in-Chief of Lancet, in a recent interview to a National Channel, any ‘lockdown’ to be really effective in ‘flattening the curve’ has to be of duration of at least 11 weeks as it was done so in Wuhan. India, by May 3, the present end-date of ‘Lockdown 2.0’ will have completed just over five weeks. ‘To extend or not to extend’ the ‘lockdown’ will be a conundrum for India. Some experts have suggested that ‘lockdowns’ for a country like India can be disastrous given the millions who survive on daily earnings. Given the greater proportion of younger population they suggest that India should go for the other option of containing a pandemic, namely, “herd immunity” whereby a Nation consciously allows a significant percentage of the non-vulnerable population to get ‘infected’ so as to build ‘natural immunity’. Others argue that this can be disastrous given the fact that even the 5 per cent of vulnerable population can be a huge number in India putting the ill-prepared healthcare system at stress and leading to undue loss of lives. In this context, one is tempted to wonder whether Goa government is secretly promoting ‘herd immunity’ given its apparent lack of enthusiasm to do aggressive testing and triumphant declaration of Goa as “COVID-free” giving people a false sense of security.
Given that we are in for a long haul and that we will have to ‘learn to live with this virus’, the trillion-dollar question is how to ensure “public health” as well as “public sustenance”? How can we prevent deaths from ‘disease’ (COVID-19) and also deaths from ‘deprivation’ (hunger)? Reviving the economy from the collateral damage of the pandemic is a colossal challenge facing the Nation and the State. Goa is in a much more precarious condition given its dismal state of economic and fiscal health. Given the hit earlier to the mining and now the tourism sectors, reviving and incentivising the traditional economic activities at the micro level and supporting the MSMEs with effective and timely mitigation measures will be the real challenge for the Goa government besides addressing the unemployment caused by this pandemic and those vulnerable populations left without ‘roti or makaan’. How well the government faces this challenge will be determined both by its statesmanship and inclusive approach of taking along all the stakeholders as well as its ability to sincerely tackle the ‘public health’ emergency as well as the ‘socio-economic health’ emergency. Goa is watching!
(The writer is a MLA and the
president of Goa Forward Party)
