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Amid the confusion generated by the sudden announcement of 21 days nationwide lockdown Nobel laureates Esther Duflo and Abhijit Banerjee have penned down nine-step guidelines to what government should do post lockdown.
Analysing a recent quick survey they did in Karnataka they concluded that while there is broad awareness of the disease, there is, however, a wide variation in people's understanding of what not to do.
They go on to mention that the current policy is not necessarily wrong, but the citizens should expect the implementation to be imperfect or worse.
If the lockdown is successful and the curve (Number of confirmed cases of COVID-19 vs Time) gets flattened, subsequently the overall spread of the disease remains contained, the disease will, however, continue to reach out in the form of unaware carriers spreading it to new populations. Given that the disease is usually dormant for around two weeks, and only those directly connected to a case are tested, it is not easy to identify these invisible agents, therefore, the number of such apparently silent carriers can be large, he wrote in The Indian Express.
Secondly, in urban slums maintaining proper social distancing and observing a complete lockdown is no easy feat. In these, containing the disease is difficult if someone has it.
Thirdly, since the lockdown started before the disease reached very many people, no one got a chance to build an immunity against it. This means that if the disease is not fully eliminated in the next three weeks (very unlikely), the disease will start to spread at a massive rate as soon as the curfew is lifted. The curfew probably bought us some time to put a plan in place and limit the number of infections however the problem will arrive in 21 days.
(1) It must be ensured that every household has at least one person who knows the main symptoms of the disease.
(2) The citizens should be aware of the fact that some people will get infected despite their best efforts; ostracism and concealment must be avoided, honest reporting is key in this situation.
(3) There should be multiple ways to report; a hotline, the ANM, the Asha, etc.
(4) Training the rural health practitioners (including the unqualified) in the detection of those symptoms and reporting them to the relevant authorities, must be considered at this point.
(5) It must be ensured that those reports are collated quickly so that the authorities manning the situation know where the new hotspots might be and are able to focus on coordination of the evidence from across the country so that broad trends can be identified.
(6) A large mobile team of health professionals, doctors and nurses, with testing kits and, ideally, ventilators and other equipment, should be created in each state. A part of this team will be quickly deployed wherever the number of reports seems to be growing fast (including in nearby areas in other states).
If the current lockdown is successful, there will still be many mini upsurges at different points of time (as against a single catastrophic burst, which would be much worse) and this allows the possibility of using the same team in multiple locations.
(7) It must be ensured that this team has access to the necessary equipment, require all health professionals (and not just those who work for the government) to be available for call up where needed and give the teams the right to make use of all hospitals, private and public, as needed.
(8) Social transfers schemes have to be bolder. Without that, the demand crisis will snowball into an economic avalanche, and people will have no choice but to defy orders. What the government is offering is now is not enough — at most a couple of thousands for a population that is used to spending that much every few days. If the point is to stop them from going out to find work and thereby spreading the disease, the amounts probably need to be much larger.
(9) There should be preparations in place to continue this "war effort" until the vaccine becomes available. Then vaccinate as many people as possible. The current healthcare system must be upgraded in order to be better prepared for the next time.
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