COVID-19: is it time to bunker in?

Worrying rise in number of positive cases in the state and in the country need urgent measures to stem the spread

Ever since its discovery in Wuhan, China, on December 31, 2019, the novel viral Coronavirus disease, since named Covid-19 has spread rapidly globally. So much so, that the World Health Organization was forced to declare it a pandemic on Wednesday, the first to ever be caused by a Coronavirus. As we start to see more cases in Maharashtra, it's imperative that we put in preventive measures, which can help avert the spread of infection.

India was lucky to not face the brunt of this pandemic initially, but now with rising numbers, concerns are being raised about the potential impact of a worsening situation. While the government has been working on ramping up testing, increasing the number of isolation and treatment (symptomatic) facilities and implementing prevention messaging communication, we might have reached a stage where further efforts are needed. These steps will impact all of us, and requires central and state government-level initiatives, including use of their discretionary public health powers as well as support and involvement of the public.

In Maharashtra, we would need to focus on social distancing and cancellation/postponement of events. This would require cinema halls, shopping destinations, events in stadia and other public facilities to be shut down for now. Non-essential travel should be strongly discouraged, and this will require the co-operation of companies. The government can help facilitate this by encouraging airlines, rail and bus corporations to waive off cancellation and rescheduling fees. Work from home and flexible working hours should be encouraged to reduce the number of people in public transport at rush hours. We should also be working with educational institutions to cancel classes in schools and colleges, postpone exams for junior classes, and only hold the crucial ones for now.

These measures will need to be taken for the next couple of weeks at least, ideally till the end of March and then re-assessed. While these could throw our lives into disarray and potentially cause economic losses, these might be relatively minor costs as compared to the possibility of a rapid community spread of the infection.

Disinfection campaigns need to be given priority with all possible surfaces — on public transport, at stations, bus stops etc. being regularly cleaned. Risk communication, encouraging individual responsibility of personal hygiene, the need to report to healthcare facilities if unwell and following quarantine instructions in case of recent foreign travel and potential exposure to someone infected needs to be relayed and reinforced through all available platforms.

Only through the concatenation of the efforts of the government, public and private sector, and the citizens can we prevent Covid-19 from reaching a stage where it could overwhelm our health facilities.

Precaution is necessary, but should not be at the cost of steps or behaviour, which is stigmatising or discriminatory. We need to come together as a community to provide support and help to those who might be vulnerable and not able to access basic amenities at times of travel restrictions — for example, the elderly living alone.

We should try to avert panic situations, which can make people anxious and lose trust in social order. This would require the government to keep strict tabs on the 'infodemic' around Covid-19 and its spread, especially incorrect information rapidly spreading through social media.

Fortunately, within the country we also have a beacon of hope in how to structure a state-level response – Kerala. Having had the experience of handling and responding admirably to two Nipah outbreaks, the state has shown resolve, leadership and initiative in the face of Covid-19 as well. This has been enabled by a committed ministerial leadership and health bureaucracy, involvement of health professionals and health facilities and partnership with local bodies and communities. Maharashtra and other states should imbibe the learning and implement it at the local level.

The next few days and weeks will define the potential impact of Covid-19 on our lives —how we respond collectively now could make a huge difference. When the spread of this infection finally winds down, it might be imperative for us to collectively reflect on why we need health crises like these to remind us of the importance of strengthening our health system and its preparedness.

When informed citizenry raises questions on the lack of adequate resourcing for health, both at the central and state level, and demands quality, strong health services, we might see a political response, which enables this to happen. As a state and nation, this would mean we are much better prepared to handle a future onslaught of the kind we are seeing now with Covid-19.

Dr Anant Bhan is a researcher in global health, bioethics and health policy

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