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COVID-19, The New Normal – Precaution is the Panacea


Article by *Medical Superintendent, Government Medical College & Hospital,

Chandigarh

*Dr Ravi Gupta


So the lock down has been lifted!

This has invited mixed reactions from public with some welcoming it with a

sense of relief, while the others being apprehensiveof the risk of exponential

rise in the number of COVID-19 cases in the country as a consequence of

Unlock1.0.

During the lock down, we learnt and practiced the habits of preventing the

spread of disease including repeated hand hygiene, social distancing, covering

the nose and mouth with mask at public places, avoiding social gatherings etc.

All these preventive habits in the presence of lock down lead to a slowing

down of the increase in the number of active cases which gave us the time to

develop our SOPs of dealing with the disease as also time for developing our

health infrastructure to cope up with the active patients.

But, with the lifting of the lock down, the real acid test begins now. We cannot

lower our guard and become casual at this stage when we have active number

of cases rising exponentially. Even if we presume that each active case will

infect only one other person, the cases might start doubling very rapidly. Given

the size of population of our country (remember we are nearly 135 crore

people while the US has 35 crore), an exponential rise in cases, if not

prevented, can easily surpass the number of hospital beds and infrastructure

that we have been able to develop during the lockdown phase.


Another important medical fact we must remember is that the virus spreads

not only through the patients who are symptomatic, but asymptomatic

persons having virus in their body are of bigger concern because they appear

to be healthy and tend to skip the preventive precautions. Even the doctors

tend to meet such asymptomatic spreaders in an unprotected manner thinking

them to be clean and safe.

Thus, it is important that each one of us must presume that everybody around

us is carrying the virus irrespective of the manifestation of the symptoms of

the disease and take all the preventive measures of social distancing, masks in

public places, repeated hand hygiene, avoiding social gatherings in a more

stringent and absolute manner. In fact, our level of alertness needs to be much

higher in Unlock 1.0 as our public interaction has gone up many fold as against

the period of lockdown.

There is a lot of debate in society regarding the ideal timing of lockdown and

unlocking. Some people argue that at the stage at which many developed

countries imposed the lockdown, we are lifting the lockdown. Let us review the

sequence of events.

From the time that the first COVID-19 infection case was reported in India on

30 th January and the declaration of the disease as a global pandemic by WHO

on 11 March 2020, the Indian government took a series of steps to tackle this

major public health disaster.

The first curfew named as Janata Curfew was declared by our PM on 22 nd

March 2020 in his national address when India had only 340 cases. The one-

day Janata Curfew was very smartly converted into series of nationwide

curfews/ lockdowns till 31 st May which gave us the time to spruce up the

health infrastructure in our country like creating adequate number of hospital

beds for three categories of patients i.e. mild, moderate and severe patients;

developing SOPs for the diagnosis; prophylaxis and treatment and scaling up

the production of personal protection equipments (PPEs). This proactive move

of the Indian government helped the country to avoid a panic situation as has

been seen in many of the developed countries including the US and Europe.

For instance, in our country, there has been no major hue and cry related to

shortage of PPEs for the health care workers and the hospital beds for the


patients. This was mainly due to the fact that we started the lockdown when

the requirement of this infrastructure was very low owing to low number of

cases, which gave us sufficient time for preparation. During the lockdown

period, the government, through its communication apparatus, was also able

to inform and educate the country’s hugely diverse population about the

practice of preventive habits required to contain the spread of the pandemic.

To bring about a behavioural change in a short span of time in such a diverse

population is not an easy task. As we know that execution of the law in India

can be a difficult task due to variant educational, social, religious and political

factors, but with the advantage of an early lockdown and the proactive role of

our media which helped engrave the preventive measures in the minds of our

population during the lockdown period of just about 2 months, we succeeded

in creating a level of awareness amongst the masses.

Another good point of our country was the fact that in spite of the fact that the

production of essential commodities of daily use including food items and

general goods, came to a standstill during the lockdown period, the country

was able to survive without any major news of black-marketing or a general

panic among the people. To avoid the shortage of such commodities of daily

use, the government again very smartly opened the industrial and other units

dealing with such products in a phased manner so that there was no shortage

of essential commodities.

As on 9 th June 2020, we stand at the mark of total no of cases being 2,67, 749

approximately with active cases being roughly 1,30,000 with almost the same

number of patients having been recovered from the disease. Our death rate of

approximately between 2-3 % and recovery rate of about 50% is a proof to the

fact that the competency of our health administrators/ health care workers

and the quality of our infrastructure is no less than any other country in the

world and we stand fully prepared to face any situation.

But we all should be aware of the fact that the end of the disease is still not

visible. In the absence of any effective drug treatment or vaccine against the

virus, the present Unlock period is critically crucial to prevent the exponential

spread of the disease in the country, so that we never reach a situation where

the symptomatic cases surpass the medial infrastructure of our country. Rather


we need to be so absolute in practicing the preventive measures so that we

can successfully break the chain of spread of virus altogether.

Since the virus cannot survive outside the living body for more than a few days

and survives in a human body for approximately 4 weeks, if we become

absolute by breaking the chain of spread of virus where everybody, every time

and everywhere (the 3 Es)takes all precautions, our country can be free from

the virus in 5-6 weeks. Recently, New Zealand has set the example of being

free from the virus by breaking this chain of transmission in an absolute

manner.

Thus let us all take a pledge that from now onwards we will not allow any new

case to emerge due to spread of the virus from active/ asymptomatic cases by

taking all the stringent measures of prevention learnt by us and by

implementing the 3 Es of precaution - Everybody, Every time and Everywhere.

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