By Gyan Pathak
The Delhi serological survey results have astonished all, exposed mishandling and failure of COVID-19 containment measures, and provided a proof that our Government agencies have been groping in the dark. We did not have realtime figures of actual number of patients even in the National Capital city. As against the official figure of the incidence of infection hitherto maintained, the actual infection level had been at least as high as 36 times.
The study conducted between June 27 to July 10 by the National Center for Disease Control (NCDC) in collaboration with the Delhi government revealed that about 23 per cent of the people in Delhi were infected by the disease, which translates into about 46 lakh individuals as against another official figure of only 1.25 lakh incidence of infections in the city. It means the actual number of infected persons in the country could be much more than the official figure of around 11.5 lakh cases.
The situation has posed two major questions – How should this data be interpreted, and what the country should do? Experts are divided both in interpretation and the steps to be taken. However, almost all are of the opinion that precautionary measures should continue to avoid the impending second wave of crisis, with a shift in focus from blocking people’s activities on presumption of their being ‘potential carrier’ of the disease to actual ‘patient’s safety’. Tracing of the source of infection lost its meaning in the new scenario and therefore we should not waste our time, effort, and scarce human and medical resources from now onward.
It may be pointed out that the present COVID-19 containment strategy has been focusing on prevention of the disease in absence of any vaccine or medicine. For this we had resorted first to general lockdown on March 24 that continued until May 31. It completely stopped people’s movements in a bid to prevent physical contact with other people. Social gathering were restricted with the misplaced slogan of ‘social distancing’. Tablighi Jamat incident was exploited for even social stigmatization and social isolation. People in general were treated strictly as ‘potential carriers’ of the disease, and hence social distancing measure were enforced. It had its own benefits but had created a great panic among the people, including among the administrative officials, medical practitioners, and health workers. Patients were treated with stigma. They had to suffer more from neglect from their home to the hospitals where they were kept in the name of medical care but actually providing only a little. Moreover, the scarce medical facilities created were filled by even non-serious patients while no beds were left for more serious ones to be admitted thereafter. It resulted into death of many serious corona and non-corona patients. Number of patients went on increasing sharply day after day.
The strategy has also created an unprecedented economic crisis. About 80 crore people are now struggling for survival. Crores of MSMEs have lost even their viability. All sectors of the economy, barring a few, have been severely affected creating an unprecedented job crisis. To mitigate the crisis, India started unlocking the economy from June 1. Stringent containment measures were made applicable only for the areas with infection. It was best ever strategy, however, it too suffered from mishandling by the government machinery. Focus is still on people as ‘potential carrier’ and therefore checking their movement is general trend. Actual patients’ safety is still being subject of neglect and apathy while it should have been the main focus.
The Delhi serological survey results should be interpreted in this backdrop. A very large number of patients were unaware that they had been infected and recovered on their own without doing anything. This fact should teach us all that there is no need of panicking, and we should not unnecessarily overcrowd our scarce hospital resources including hospital beds. We must keep hospital beds vacant for more serious or elderly patients who are most vulnerable. Other less serious patients should be quarantined at their homes.
Government must strengthen the hospital administration and focus on treatment of patients because the survey result shows that the threat of second wave of infection is real. We are already in the stage of community spread as the sero-survey indicates. There is no point in the claim of the Union Health ministry that we are yet to enter into community outbreak. However, we must take note of the fact that India may be heading towards larger scale of infection, far less than the level required for herd immunity. Experts differ also on this point. Some say that 50 per cent population needed to be infected for developing herd immunity while some others say 70 per cent. Delhi survey shows the present level at only 23 per cent. It should be a warning for us about the next wave, and therefore, we must focus on patients. At the same time we must ensure that the people moving around in the society follow the precautionary measures, such as wearing masks, physical distancing, sanitization etc.
It’s a good news that mortality rate in India is falling day by day which has now become around only 2.5 per cent. Additionally, recovery rate has been rising which has now become well above 63 per cent. Had there not been lapses in our hospital administration, these would have been far better. Testing and treatment have now become more important than tracking the route of infection. Access to hospital facilities therefore must be ensured rather than stigmatization of patients and communities. Treating all as ‘potential carrier’ and creating psychological havoc is detrimental. False positive and false negative reports should also be taken cautiously by the people along with the so called immunity of the recovered patients. We still don’t know the time for which immunity will remain effective. In brief, it’s time for great precaution and caution, but without panic. (IPA Service)