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Doctors advice: How to cope with Covid-19 after lockdown

Sanjeet Bagcchi | Updated on May 08, 2020 Published on May 08, 2020

With the gradual easing of stringent nationwide restrictions, how do we brace ourselves against the novel coronavirus? Hear it from medical experts

Hope goes hand in hand with despair in India these days. The number of Covid-19 cases continues to rise, and a nationwide lockdown is still in place. But people are stepping out of their homes, and have more access to services and shops in large parts of the country. But will people out on the streets lead to a rise in the spread of the new coronavirus?

The World Health Organization has praised the extended lockdown measures enforced by India, calling them “tough and timely”. In an April 25 editorial, the reputed medical journal Lancet said India had seen a pandemic of relatively less severity than was feared. “The lockdown is already having the desired effect of flattening the epidemic curve,” it said. The “immediate challenge” would be to keep infections at manageable levels and “ensure the ability to test, trace contacts, isolate patients, implement... care plans, and disseminate timely information,” it said.

Doctors contacted by BLink also stressed the need for strict measures to ensure that the virus did not spread. Excerpts from their interviews:

Diptendra Sarkar

Member of a Covid-19 strategic control team and professor of surgery, Institute of Postgraduate Medical Education and Research, Kolkata

 

The success of a complete lockdown in India is obvious in terms of a reduction in the height of the epidemic curve and population mortality. India has to now identify its “high risk” population. Thus, a slow and staggered triage-based [assigning the order of treatment based on the degree of illness] lifting of the lockdown with concurrent community surveillance seems most appropriate. It is time that we develop a new health strategy focusing on appropriate physical distancing policies in patient care, optimum personal protection equipment for professionals, promotion of tele-medicine services in appropriate cases, priority-based health services and healthcare innovations and research.

Rahuldeb Sarkar

Consultant of respiratory medicine and critical care, Medway Hospital, Kent, UK

 

In the last two decades, India has witnessed more deaths from non-communicable than from infectious diseases. It is therefore important that chronic cardiovascular conditions, cancers and acute non-infectious diseases are cared for, which is not possible optimally with a complete lockdown. A Harvard University research paper recently showed that the peak transmission for other coronaviruses will start from October, and that some social distancing may need to continue until 2022. One has to be prepared for a potential second larger peak after November, and ensure that the population does not suffer from “lockdown fatigue” too early.

Apurba Ghosh

Director, Institute of Child Health, Kolkata

Once the lockdown is lifted there is bound to be an upsurge in Covid-19 cases. So, we have to be very cautious about the whole process. Until we are very sure that we can control the aftermath of lifting the lockdown, we have to prolong it. Then gradually we will have to lift it, first in the green zones [where there have been no new cases for three weeks], then in the orange zone [no fresh upsurges] and lastly, in the red zones [areas which have seen major coronavirus outbreaks]. Interstate as well as international boundaries should be closed till the end.

Rajamahendran Rajendran

Consultant surgical gastroenterologist, RRM Gastro Surgical and Research Centre, Villupuram, Tamil Nadu

 

A complete lockdown is not going to help over a long period. As doctors working in Covid-19 wards, we feel that there will be a continuous inflow of cases in spite of such lockdowns. We must have only partial lockdowns. Mass gatherings must be avoided. After the lockdown is lifted, people aged above 60 years must not be allowed to mix with the community and they must be supported by volunteers. This can definitely reduce the mortality rates. Health workers should be tested regularly and quarantined for 14-21 days after seven days of duty.

Bhaskar Narayan Chaudhuri

Consultant clinical microbiologist and infection control officer, Peerless Hospitex Hospital & Research Centre, Kolkata

 

The virus is gradually losing its initial virulence as per the nature of all such novel viruses, which gradually adapt themselves to their host [i.e. humans] — for their own survival and propagation. Continuous mass education is needed. [People may use] face cover for additional protection. Wearing eye protectors such as specs or goggles is a must, as the virus may enter through the conjunctiva. People should consult doctors if they have any influenza-like illnesses and should not conceal any history. Testing capability should be augmented further and widespread rapid testing should also be allowed to isolate and treat positive patients. Mild cases may be quarantined and treated at home.

Suresh Kumar Angurana

Paediatric critical care specialist, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh

 

Had there been no lockdown, the number of Covid-19 cases in India would have been in lakhs. Following the lifting of the restrictions, there will be a great surge in the number of cases in the next couple of weeks, which can cripple the capacity of the healthcare system to handle such cases. The situation may worsen, which is what happened in countries such as the US, UK, Spain, Italy, France and Germany. There is a grave need to extend the lockdown to curb the surge in the number of cases and keep the curve flattened so that it doesn’t overcome the capacity of the healthcare system. The lockdown should be lifted in a staged manner with continuous monitoring of the situation in areas where it has been lifted.

Sanjeet Bagcchi is a physician and an independent writer based in Kolkata

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Published on May 08, 2020
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