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There is need for a calibrated approach to end the lockdown, testing will be key

The complete lockdown, while needed as a first step, is also causing huge hardships to people, especially those without jobs and food, due to lack of warning and very little planning. But lifting the lockdown fully and suddenly will lead to new outbreaks. I would suggest we go for strategic easing of the lockdown in a calibrated way.

Written by Bina Agarwal | Updated: April 3, 2020 11:09:26 am
coronavirus test, covid-19 test, coronavirus india, covid-19 india, migrant workers coronavirus, mass exodus coronavirus, Strategic testing can better protect our health carers, doctors and nurses, if those with immunity undertake the more risky end of care. (File Photo/Representational)

We know that in the coming months, this pandemic will hit an already ailing economy even harder and devastate the poor, the unemployed and the hungry. It will take a heavy toll on lives and livelihoods. But in the immediate short term, we need ways of maintaining essential production and other services, such as food supply chains (from harvesting standing rabi crops to transporting these to markets, to households and to the hungry and homeless); production supply chains for protective gear, ventilators, masks, medicines; delivery services; government employees maintaining public utilities, and so on.

We are trying to break the COVID-19 transmission chains with a total lockdown but in the process, we are also breaking essential service supply chains. We are creating an ocean of joblessness. Is there a way out? I believe so, through strategic easing of the lockdown. How?

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Scientists say that 80 per cent of the infected population will recover without hospitalisation. This includes both those who have symptoms and the asymptomatic. All of them will develop immunity — we don’t know for how long, but at least in the immediate future. And there is an antibody test (serological test) which is easy to administer and can tell us within minutes whether someone has already recovered from COVID-19. It only needs a blood sample, where the blood goes into a cartridge alongside chemicals called buffers, and produces a reading. India has hundreds of technicians who are already trained to take blood samples in labs, hospitals and from homes (unlike nasal swab tests which require training). But we do lack enough testing kits for largescale serological testing.

So here is what I suggest we do. We should identify workers in each essential service and production supply chains and test them for antibodies, each state conducting its own. (Even among essential services we need a priority list, given the scarcity of kits.) The workers who have antibodies, and hence immunity, can go back to work. This will be easiest in factory-based production units, such as those manufacturing and delivering hospital equipment, gear, medicines, etc. since they have identifiable workers who can be reached.

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Food supply chains are more of a challenge, especially for harvesting the current rabi crop. But large numbers of migrants that are at present under quarantine on the borders of states, and are being tested anyway. Instead of keeping everyone on a 14-day quarantine, those who pass the antibodies test can be identified straightaway and offered work for harvesting, loading, or other jobs in their own state, or elsewhere if they wish. Those harvesting foodgrains, vegetables or fruit can be paid in kind, if they wish, so that they have food. Transporting the produce to markets will still be difficult. Here the government needs to mobilise the trucks currently lying idle for farm-gate pickup.

In addition, strategic testing can better protect our health carers, doctors and nurses, if those with immunity undertake the more risky end of care. As our antibody test kits increase we can broaden the parameters of testing. Basically by such strategic testing we can gradually begin to open up production units and facilitate re-employment in both the formal and the informal sector workers.

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Apart from this, I suggest we convert large spaces like stadiums and conventional halls into temporary hospitals and quarantine spaces. Stadiums have multiple showers, bathrooms, and enough space for large numbers, setting up testing units, and for medical staff, food preparation, etc. At present, in Delhi, we are scattering people across guest houses, schools, etc. That is fine, but it would be more efficient and save on personnel and resources if we concentrated efforts in larger spaces. Also while creating railway make-shift hospitals is an excellent idea, we should also use these mobile hospital units to take patients from remote areas with few medical facilities to areas with facilities.

The complete lockdown, while needed as a first step, is also causing huge hardships to people, especially those without jobs and food, due to lack of warning and very little planning. But lifting the lockdown fully and suddenly will lead to new outbreaks. I would suggest we go for strategic easing of the lockdown in a calibrated way.

This article first appeared in print edition on April 3 under the title “Plotting The Way Back”. The writer is Professor of Development Economics and Environment, University of Manchester, UK.

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Here’s a quick Coronavirus guide from Express Explained to keep you updated: What can cause a COVID-19 patient to relapse after recovery? | COVID-19 lockdown has cleaned up the air, but this may not be good news. Here’s why | Can alternative medicine work against the coronavirus? | A five-minute test for COVID-19 has been readied, India may get it too | How India is building up defence during lockdown | Why only a fraction of those with coronavirus suffer acutely | How do healthcare workers protect themselves from getting infected? | What does it take to set up isolation wards?

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