Let’s learn to live with the virus

Suneet Newton

More than four months in the COVID-19 world and 54 days of the nationwide lockdown, the contours of the crisis are emerging visibly. The following facts have emerged out of the data available on the various matrixes related to the pandemic: -

• Notwithstanding the Lockdown with varying gravities undertaken by different countries of the world, the number of cases is exponentially on the rise.
• Mortality percentages out of the total detected cases are on the decline.
• Recovery percentages are fast increasing.
• Most of the mortality is in the higher age groups, primarily 65+. Correspondingly it is mostly countries with higher Median age average have been worse hit in terms of mortality (Reference to be drawn from the data table given below). The data on COVID 19 mortality rate by age groups is available for various countries on the website www.statista.com and an examination of the same broadly vindicates my claim on the subject of higher mortality in higher age groups.

Facts Specific to India

We have had a reasonably successful lockdown, with varying rates of intensities across states depending on the dynamics followed by respective state governments as the actual implementation of the Lockdown is their responsibility as a part of the maintenance of law and order.

Broadly speaking, the effect of the Lockdown has not translated into the effective control of the spread of the Virus. The Virus has grown exponentially, and the number of cases has grown steadily.  When studying data (on national and international websites) on the figures related to COVID-19 there are some takeaways :-

• Per day growth of cases has plateaued to average 7% a day for period 15 April to 16 May from 17% in the period from 14 March to 14 April. Per day trend growth of cases indicates that a doubling period of cases has gone up to 14.28 days for period 15 April to 16 May against 5.88 days in the period from 14 March to 14 April.
• The recovery percentage is steadily going up, and now it stands at 38% of the total detected cases up from 25% and 13% on 30 April and 15 April, respectively. Recovery % has gone up nearly three times within a month.
• Testing rate is now almost 1 Lakh per day from the last week of April against a daily testing rate of 14-15 thousand per day in the preceding period pointing out to the fact increase in testing rates helps in detecting more cases. To date, 22,67,642 tests have been carried out, and 91,314 +ve cases have been detected, leading to the conclusion that on an average of 24 tests, one +ve case is found.
• India’s percentage of death out of detected cases is 3.2% against 7% of the world.
• The death rate is slowly but surely coming down by the day against the number of detected cases. From 14 March to 14 April, the daily average percentage increase of death was 21%. From 15 April onwards till 16 May, the daily average percentage increase of death has come down to 6% that is a reduction by 3.5 times in the given period.
• About 75% of total deaths indicate the presence of previously existing comorbid underlying conditions in the deceased.
• Exact figures on age-wise death figures are not available for India. But broadly from various news reports, it becomes quite evident that the death rate is much higher in elderly age groups.
• On close examination of data, nearly 75% of COVID cases in India are in the 20yrs to 60yrs age group against higher age group brackets in western countries, possibly one of the reasons for higher recovery rates and lower death rates from the detected cases in India.

Deductions out of specific facts pertinent to India.

The lockdown implemented in India from March 25, 2020 has been executed with utmost dexterity. Still, sporadic violations in a country like India with its large population and dependence of people on the unorganized sector cannot be ruled out.    

Lockdown has been successful in containing the spread of the Virus but not in its entirety. It leads to the conclusion that a Lockdown can assist in containment but not a total annihilation of a silent Virus mutation.

The principal and the only fear which has struck a chord of terror in people's hearts is the fear of death. But it emerges that death is on a meagre rate when seen in the Indian paradigm.  The fear of death further deescalates when one realises that death percentage is much lower against the detected cases. If the rate of testing is doubled from 1 Lakh per day to 2 Lakhs per day, then there is a great possibility that the number of case detected may also exponentially rise from an average of 2,214 per day to nearly 4,000 per day, thereby proportionately taking up the cumulative number of cases. If the presented analogy is templated on the present positive figures roughly, they would be 1,30,000, and the death percentage will come down to 2.22 percent.

There are prominent indicators that, in the case of us Indians, there is an element of inherent inner strength and immunity and the resilience in our bodies to fight the Virus and overcome it silently. The young median age profile (27 years), tropical climatic conditions, exposure to many community-based microbes due to our high density of population and community-style living, customization to leading a comparatively uncomplicated and relatively fuss-free life can be some reasons for this.

COVID -19 is Here to Stay!

The Government has given relief to various sectors in the form of a 20 Lakh Crore package. This on the face value looks incredibly attractive and seems to draw colossal optimism. The concrete effects on the state of the economy and genuine relief to the masses will take some time for one to draw a definitive conclusion on its degree of efficacy. But one thing is certain, that realization of this relief bonanza demands the immediate resumption of economic activities in multiple dimensions and involvement of all sectors simultaneously.

Lockdown can be a temporary measure, but it cannot go into infinity. It is evident, that Lockdown can contain the spread of the viral infection to an extent, BUT it CANNOT eliminate it from the horizon. Many experts and epidemiologists are of the view that COVID 19 is here to stay for a considerable period.

The World Health Organization has recently stated that COVID 19 is likely to become an endemic from a pandemic. The definition provided by the US Centres for Disease Control and Prevention (CDC) says that whenever a disease is present always among many people, it can be called an endemic. For example, endemic diseases like malaria and chickenpox, despite the presence of vaccines, still exist, and there is some number of cases registered every year across the countries.

Many studies, like a study by researchers in the University of Connecticut or the one by the US Centre for Infectious Disease Research and Policy (CIDRAP) indicate that there will be waves of the Coronavirus pandemic. This means that a place witnessing a decline in the number of cases or a flattened COVID-19 curve can have cases likely to come back again. Therefore, it can take a long time (maybe years) before the Coronavirus is wholly eliminated.

As the migrant labour force starts to trickle into their villages, COVID-19 is likely to manifest its presence in rural areas against its present majorly urban manifestation. The Indian rural paradigm has its social dynamics wherein lack of awareness and any callousness in making a concentrated effort in destigmatizing the disease can lead to a large number of intricate socio-economic complications.

The Way Forward

The following becomes pertinent in my view: -

• Concentrated and dedicated efforts should be made towards the Lifting of the Lockdown.
• It is imperative that there be complete synergy in the functioning of the Union and all the state governments, irrespective of their party affiliations, Central and state governments have to realise that the country’s economy and growth trajectory is inter-twinned and inter-networked; no state can afford to remain in isolation and the lifting of the Lockdown has to be a coordinated exercise between both Union and State government.  
• It will not be a bad idea to look at the option of developing herd immunity in public. Keeping in view our young age profile and better immunity profile comparing to the westerners, the chances of us developing antibodies against the disease are extremely high.
• There is an urgent requirement of socio-political and behavioural changes in the society, where the responsibility of handling this crisis has to shift from government to individuals. It is the citizens who will have to take responsibility for managing risk from disease/ prevention and seeking medical attention and make some changes in their behaviour like maintaining hand hygiene and wearing masks.
• Senior citizens and people with underlying comorbid conditions to be protected.

Date Figures

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