Containment strategy for COVID management

Rising fatalities and high COVID-19 positivity rates in Assam call for harsher containment measures before things go out of hand. Data released by the Ministry of Health and Family Welfare on Tuesday reveals that as many as 20 districts in Assam have positivity rates of more than 10 per cent, higher than the overall positivity rate of 8.04 per cent in the State. The State recorded 77 COVID deaths on Monday which speak volume about the rise in several critical cases along with the spread of infection. Health experts have attributed to delay in the hospitalization of critical patients by family members as one of the reasons behind the rise in fatalities. This reflects a lack of awareness among a section of the general public about the advisory issued by the Health Department on triage of COVID-19 infected patients depending on the asymptomatic, mild, moderate, severe, or critical infection. The state has not reported any shortage of beds with oxygen or beds in intensive care units even though occupancy is rising with the spiralling of infection. There can be no room for complacency as the number of such beds for the critical patient is limited. Fatalities will rise if the health system is overwhelmed with severe or critical patients. Wider publicity to the health advisory will help family members rush infected patients in home isolation having moderate or severe symptoms to hospitals in time so that required treatment can be provided by doctors to save lives. Checking oxygen level with a pulse oximeter and monitoring other symptoms as advised by doctors can help rush the patients to hospitals in time. The first and foremost priority, however, must be to stay protected from contracting the virus infection by wearing double masks, strictly following the hand sanitising/washing hygiene and maintain adequate physical distance in public spaces. Moving out of home must be avoided unless it is extremely essential. There is always a saturation to an optimal level of infrastructure and human resources in the health sector in any state or country. The objective for every single stakeholder including the citizens must be to break the chain of infection so that the health system is not overwhelmed beyond its capacity. The measures such as closing down shops and marketplaces at 2 pm and night curfew, ban of public gathering, restrictions on social and religious functions, closure of educational institutions have been enforced to allow daily life at a bare minimum. When such measures fail to curb the spread of infection stringent measures are required to flatten the curve and prevent fatalities. Lessons learnt from stringent measures such as nationwide lockdown cannot be forgotten. Restrictions on the movement of people, trade and commerce and other economic activities during the nationwide lockdown left a cascading effect on the lives and livelihoods of people in the first wave. Lakhs of people became jobless, lost their livelihoods, as business, industries could not absorb the economic shocks. The impact was severe for the downtrodden people who work as a daily wage earner or contract workers, migrant workers as well as other non-salaried people besides small and medium business class. If the government provides adequate financial assistance to needy people to make them free from worries of arranging meal it can make them stay indoors to help achieve the objective of stringent restrictive measures which can be either complete lockdown or akin to it. Clarity on allowing people to visit vaccine centres if their scheduled appointment falls during any such restrictive period must be there as vaccination is a crucial strategy to fight against the COVID-19 virus. In the case of the 18-44 years age group, it will be easier to check the genuineness of the claim as the walk-in appointment is not allowed in the category. The walk-in vaccination for the 45 plus category can also be streamlined by facilitating app-based online booking and by SMS-based prior appointments in response to phone or SMS-based bookings for those not having internet access to prevent people to take advantage of walk-in vaccination during the restrictive period. Easing the restrictions can fail the objectives of containment strategy but enforcement will be a hundred per cent successful if the economic worries of the people are taken care of by the government. This is easier said than done and a state like Assam will need adequate financial assistance from the Central government to declare any such relief measures to make containment strategies successful. This will also be needed to build the resilience of the state to manage the third wave of the COVID-19 pandemic. The wise saying- a stitch in time saves nine- can be the guiding strategy for COVID-19 pandemic preparedness and management for the state to withstand the third wave and better manage the current second wave. It will make any extreme measure to flatten the pandemic curve redundant and allow the return of normal life which is crucial for the state to stay on the path of progress and development.