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Coronavirus: 'A 28-day lockdown would have been good'

By SYED FIRDAUS ASHRAF
Last updated on: March 27, 2020 12:32 IST
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'Don't be under the illusion that we are in a lockdown for 21 days and then we are free.'

IMAGE: A closed market in New Delhi. Photograph: Yawar Nazir/Getty Images
 

On Tuesday, March 24, Prime Minister Narendra Damodardas Modi called for a 21-day lockdown of the country in an attempt to curb the spread of the deadly coronavirus.

Will this lockdown help in the battle against the virus is a question that many are asking.

"From a science perspective a 28-day lockdown was good, but, of course, the government has other things to worry about, like the economy and logistics," Dr Shahid Jameel, virologist and chief executive officer at the Wellcome Trust/India-DBT Alliance, a research funding agency supported by the United Kingdom and the Indian government, tells Syed Firdaus Ashraf/Rediff.com.

Can India win the war against the coronavirus after 21 days?

We should not look at it in that way -- that India will win the war against coronavirus in 21 days.

The whole point is that we are fairly early on the curve of infection. If we do not control the spread of coronavirus now and the more we delay, the harder it gets to control. That's the point.

Could you please explain why this 21-day lockdown is a must so that the virus doesn't spread?

Twenty-one days is important from various perspectives. We have, at present, 500 plus confirmed infections and most of the infections is due to people who have travelled overseas.

As of now, we don't have good evidence of community transmission within India, but I believe that is a false hope because we have not tested enough in the community. And that is a separate story.

We are early in the curve and now we have the lockdown, therefore the virus does not get a chance to transmit from person to person.

One infected person on an average infects three other people. And we don't know who that infected person is because when you show symptoms of coronavirus it is already too late.

Therefore, it is important to isolate that person, but we don't know who that one person is. Therefore, the lockdown has to happen for everyone.

But...

(Interrupts) The virus has an incubation period. It means from the day you catch the virus till the day you show symptoms, that is varied from about 1 week to 3 weeks.

Let us assume that I get infected today I will not know whether I got infected because I will not show any symptoms of coronavirus. I will show symptoms only after one to three weeks; therefore I have to be in isolation for three weeks.

Therefore, it is important to have a 21-day lockdown.

Honestly, purely from a science perspective a 28-day lockdown was good, but, of course, the government has other things to worry about, like the economy and logistics.

Still, I think it is a good decision of a 21-day lockdown. It is a good balance and we should be able to take care of this problem if we all follow this lockdown religiously.

The important thing is that we have to follow and not do what we did on Tuesday night -- rushing to stores to buy things. All social distancing norms were thrown down the drain on Tuesday night.

The common man has an impression that the virus will be extinguished in 21 days.

Coronavirus will not get extinguished in 21 days, but the number of cases will be reduced. The virus has already started picking up in India and the number of cases has started doubling every five days.

Let us say if community transmission takes place, then the number of cases will start doubling every three days and then we will have a high number of cases which our healthcare system will not be able to cope with.

Our experience from China shows that if 100 people catch coronavirus, then 20 of them would require hospitalisation and another five of them would require ventilators in ICU.

The only way to reduce the number of people on ventilators in ICU is to reduce the total number of cases. Simple logic.

All these things (lockdown) are being done to ensure that we don't pile up with more cases. Cases will continue to happen.

Don't be under the illusion that we are in a lockdown for 21 days and then we are free. We are not free.

Simple idea is that the number of cases at any point should not exceed the healthcare capacity of our country. That is important for people to understand and each one of us has to contribute to this.

At what point will we know that the virus is now in a community-transmission phase?

There is no figure and you have to keep your eyes and ears open. You have to see the number of cases that is happening daily and the rate at which it is picking up.

All flights from abroad are now shut down and now if there are people who have contracted coronavirus without any travel history or that person has no contact with any person who has travelled overseas, then it means community transmission is taking place.

A case such as that has happened in Kolkata.

It will happen.

I am of the firm belief that community transmission is happening at this time. And the whole point of this lockdown is to slow it down further.

Therefore, each one of us has to consider ourselves as a potential source of infection. We should not be considering ourselves as somebody who can get infected.

Each one of us should show the behaviour that we are infected and we have to protect the community.

IMAGE: People practise social distancing as they queue up outside a supermarket to buy essential items in Faridabad. Photograph: PTI Photo

Is social distancing the only way to prevent it?

That is really the only way. Because there is no vaccine for coronavirus.

There is no confirmed therapy to treat coronavirus. Although people are talking of chloroquine and other medicines, but chloroquine again is in experimental mode. It has not proved anything in a large scale random trial. It has only been tried in France and it could be used as an experimental drug only on those people who are in a hospital setting.

Chloroquine is not a preventive medicine for coronavirus and you cannot start taking chloroquine hoping that you will not get the virus. Chloroquine is not preventive.

There are higher chances you will damage your kidneys and liver if you do that. It is associated with some neurological disease as well. You will mess up your system.

Chloroquine can only be given to people who are sick and under the supervision of a doctor. So please, no self-medication just because chloroquine is a cheap drug and readily available.

But those who tested positive for coronavirus have also turned negative, like this couple in Maharashtra. What medication do they take?

They don't take any medicines. The body's immune response takes care of it in 80 per cent of the people.

If you have the virus and tested positive, you will get fever for a few days and let us say you don't have trouble in breathing, then you don't need hospitalisation. Your immune system is perfectly capable of taking care of it.

Therefore, if you analyse those who died of coronavirus, it targets the elderly who have other health problems like heart disease, high blood pressure or diabetes.

If you are below 50 or 55 years and reasonably healthy, you don't need to worry.

Even if you get the virus there is an 80 per cent chance that you will not suffer from any serious ailment. It will be mild and you can be quarantined at home and just take fever reducing medicines like paracetamol. That is all.

Now say four people stay in one home and one person among them is infected. What are the chances that the other three may also get infected?

Chances are high for the others to get it too.

The person who gets infected must try and protect others as much as possible. They must isolate in a separate room. Any waste the patient generates in terms of clothing or tissue papers has to be properly sanitised.

They need to wear a mask and if there are people in the house, they too need to wear a mask. Regular hand washing and all other precautions need to be taken which doctors suggest.

I have read reports that people first test negative for coronavirus and then suddenly they turn positive. How does that happen?

It depends on when you are tested.

In the matter of any viral infection, it takes time for it to settle in your body and multiply. Only when its concentration reaches beyond a threshold the tests are able to detect it.

Let us say you were tested on day 1, you did not have enough of the virus in your body and you are tested negative but when you were tested on day 15 or day 20, the virus has multiplied and then you will test positive.

It depends on the concentration of the virus in your body.

When will we know that India has won the battle against coronavirus? What will be the indication?

I don't think anybody is in that position to say for sure. Let us go through this exercise of lockdown and see where we are (on April 14). And be ready for further restrictions if needed.

It's very hard to answer this question.

It's hard to answer because viral outbreaks are extremely unpredictive and they are unpredictive because the spread of virus depends on human behaviour. And human behaviour is the most unpredictable that we know.

How I will behave, you will behave and the third person will behave is very different.

Therefore, it is very important to follow guidelines and advice (by the government on social distancing).

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The War Against Coronavirus

The War Against Coronavirus