COVID-19 in India: What’s in Store for the Next Two Months

COVID-19 has presented an unprecedented and complicated situation for over seven billion people in 190 countries of the world. As of today, it has affected more than a million people across the globe and more than 65,000 people have lost lives to this pandemic.

Various epidemiological models are being discussed around COVID-19 scenario in India and the media houses and online portals are publishing different models of how lockdown can help us evade or minimise the impact of this pandemic.

ICMR (Indian Council of Medical Research) model, Johns Hopkins University model, Cambridge University model & Michigan University model, all are based on popular SIR/SEIR (Susceptible, Infected, Recovered, Exposed) concept in epidemiology. This concept divides the population into four compartments viz; Susceptible, Exposed, Infected, & Recovered. It uses various computational tools to arrive at numbers around the people who would get infected, get hospitalised, get recovered or succumb to COVID-19 across India and how the disease would pan out over next few months before it fades down as we develop population immunity against it. All these models have some differences in terms of the number of people who would be affected and how the scenario would pan out over the next two or three months. One interesting thing we see in the Cambridge university model is that they have suggested that a continuous 49-day complete lockdown would help us prevent the resurgence of the number of affected cases as compared to other options with intermittent spells of freeholds between lockdowns.

There are three things very evident from all the models named above:

• We would see a resurgence in the number of affected cases once the lockdown is lifted and these models give graphical representations of the trends we will see when lockdowns are lifted and reimposed in different ways

• One spell of 21 days lockdown is not going to be enough to contain the impact of COVID-19 pandemic in India and in fact, all the gains would be lost in no time if the lockdown is lifted for all. We will have more lockdowns and longer durations of social distancing norms to make real gains in terms of limiting the impact of COVID-19 pandemic

• The trail of infections, hospitalisations, and fatalities would gradually come to a closure in the next three months if effective measures are implemented efficiently

We have been able to keep the spread of the virus infection under good control by timely imposition of lockdown across the country but this only means we have got some more time to prepare ourselves in terms of improvement of healthcare infrastructure, spread information about the disease and its prevention and control the flow of patients into the healthcare facilities so that the number of patients is manageable in the hospitals. The numbers are going to rise once the lockdown is lifted, even partially and we should hope that the numbers’ trajectory stays within manageable limits.

So, what does it mean for individuals and families in terms of how this is going to affect our lives and for how long? This is the most common question in the minds of common people. Many people wrongly believe we would have won the battle against COVID19 by the end of lockdown and life would be normal thereafter. We need to be aware of the risks we might face once the lockdown is lifted and take precautions against coronavirus infections as we live through the next two to three months.

We need to keep the following things in our minds before we venture out after the lockdown is lifted:

• As we do not exactly know (in spite of Government of India’s claims to the contrary) if we have community spread in India, it will be a risky move to venture out of homes. As a policy, the Indian government did not allow testing for people with symptoms, but without any traceable source listed in their guidelines. This could mean that if there were people who got infected through community spread and were not tested or proved to be COVID-19 positive, they would be freely roaming around in our offices, markets, and neighbourhoods and would be unknowingly transmitting the virus to others who would then bring those infections to their families and further to others in their vicinity. As the government is anyways going to reimplement the lockdown (if it doesn’t go with an extended 49-day lockdown) then we should be careful enough to avoid exposure to the virus.

• Even if the lockdown is lifted, it is not going to be completely free movement for all. The government might choose to allow movement of people between cities with a limited resumption of rail, road and flight services. Needless to say, social distancing norms would be stringently enforced. The government might still not allow a complete reopening of offices and schools. It will ask offices to follow a staggered approach of reopening the workspaces and ensure employees maintain social distancing protocols. Fortunately enough, the schools are going to remain closed on account of summer vacations so it won’t be a problem for anyone.

• As the COVID-19 virus is highly transmissible, once the government allows limited movement of people, we would be at immediate risk of exposure to the virus because of asymptomatic, infected individuals who would be unknowingly spreading the virus. Even symptomatic individuals without any traceable source won’t be quarantined because they were never tested for COVID-19 and hence they would play the role of wholesale transmitters of the virus in the communities. The government needs to allow community screening tests for people with symptoms irrespective of traceability of their sources to be able to identify and quarantine all the infected individuals in the country. As this does not seem to be the case, we better stay in lockdown and monitor the situation as it evolves in our cities.

• Given the high population density and poor understanding of the gravity of this disease among common people, we might see a huge number of patients getting sick and in need of assisted ventilation due to complications. As the healthcare infrastructure in India is grossly ill-equipped to be able to take care of the enormous number of patients who might need intensive care, it would be a major crisis to provide an intensive care bed and respiratory support to all the patients. The resulting social conundrum cannot be imagined.

In the end, given that we have several unknowns with respect to extent of COVID19 infection and the associated uncertainties related to the duration of lockdowns and social distancing with additional inadequacy of healthcare infrastructure in the country, it would be better to stick to personal lockdown and social distancing norms for coming few months and decide further actions as the situation evolves. Given that up to three generations live together in most of the families, it is imperative that the younger adult population ensures they do not bring the virus to their homes where the senior citizens might get infected and may lead to fatal complications of the infection. A slow treading approach with limited exposure to possible risks should be a prudent idea to keep our families safe against COVID-19 infection for the next two to three months. As the saying goes, an informed person takes better decisions than others who don’t.