Save lives with Social Distancing: How to protect your family from coronavirus, primed to hit India like a bomb
March 16, 2020, 2:00 AM IST Devi Shetty in TOI Edit Page | Edit Page, India | TOI
Biogen, a Boston-based biotech company, held a conference in the last week of February. 175 senior managers from around the world attended this meeting, including two from Italy. Within a week, 70 of them were infected with Covid-19, making it the single largest outbreak in Massachusetts. My son is studying in MIT and stays five minutes away from Biogen’s head office. He is now stuck at home because Massachusetts has declared a state of emergency and all educational institutions are closed.
It’s important to remember lessons from past pandemics. When America experienced the 1918 Spanish Flu, St Louis had half the death rate of Philadelphia, because Philadelphia held massive rallies to support World War 1 while St Louis closed all schools, churches, factories and banned public gatherings. Early actions have proven to save thousands of lives.
My other son went to Stanford and his data scientist classmate compared the spread of coronavirus outside China (www.bit.ly/2TG9fsi). Singapore, Taiwan, Hong Kong, Thailand and Japan were the most exposed to China but none of them experienced exponential growth in infections. This is because all of them were hit by SARS in 2003, so they learnt how quickly viral infections can spread, and they took pre-emptive containment measures called ‘Social Distancing’.
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Countries like Iran, France, Germany and Spain took too long to contain the infection and their numbers have exceeded East Asia. Fortunately, India clamped down on overseas visitors very early, even if it was against the wishes of partner countries.
Most people will look at a mortality rate of 3% and think that’s a very low number. However, India is a huge country and Covid-19 is the most transmissible disease we have ever encountered. Every coronavirus patient infects three other people and they are contagious for two weeks. India has 107 confirmed cases. Around 5% of those cases will need admission into an ICU and 1% of cases will be serious enough to require ventilator support for breathing.
People with pre-existing conditions like high blood pressure, immune suppression, cancer or age beyond 70 are vulnerable. Most hospital ICUs are already full with medical emergencies and H1N1. We’re already in a pandemic, and the only thing we can do now is reduce infections as much as possible so that our hospitals have breathing room to manage severe cases.
Let us not assume that India’s heat will save us, or that Indians have a special immunity to viral diseases. What if we are like anybody else? Every country had a trickle of positive patients followed by a flood. The exponential spread of coronavirus in India will hit like a bomb because of the density of population. Noted epidemiologists as well as world leaders like Angela Merkel have said that 20-60% of us will be hit by coronavirus.
We’ve a small window of opportunity to adopt Social Distancing and limit the spread of the virus. We may not be able to enact complete lockdowns like China but there are many common-sense measures that we should take:
• Avoid all travel, international or domestic, air, bus or train. Long-distance travel is the biggest contributor to the spread of disease.
• Avoid all places that concentrate large numbers of people in a small area. This means schools, gyms, malls, open-air markets, pubs, theatres, temples, other places of worship, swimming pools, etc.
• Work from home. Whether you work in an office or a factory, you are at risk of infecting or getting infected by your colleagues.
• If you must show up for work, keep 6 feet distance from your colleagues, avoid the canteen and postpone all meetings with outsiders. Don’t meet in groups of more than ten.
• Avoid all conferences, sports events, melas, rallies, cricket matches as that risks the highest chance of an outbreak occurring.
I congratulate the Karnataka government for already announcing these measures and I encourage other states to follow the same. State governments must assume that 10% of the population could get infected with Covid-19. A city like Bengaluru will require over 5,000 critical care beds with oxygen.
Since Covid-19 patients can infect other patients, they should not be treated in a general hospital. Every state government needs to convert a non-commissioned hospital or defunct medical college hospital as Covid hospital for inpatient and outpatient service. In Karnataka, private hospitals have offered their doctors, nurses’ services and equipment to these speciality hospitals.
Italy went from 300 cases to 10,000 cases in two weeks. Because infected patients with mild symptoms didn’t know they had infection and kept on spreading it. Since the purpose of testing is mainly for isolation, all NABL accredited laboratories should conduct the test free. The epidemic started in South Korea and Italy at the same time. South Korea tested virtually everyone and chased the carriers with dramatic results, whereas Italy restricted testing with disastrous results.
A serious concern is the global shortage of protective gear for medical personnel. Most countries imposed export restrictions. Indian manufacturers must be incentivised to make N95 masks. If medical personnel start falling sick, the situation can get worse.
There are over 50,000 young Indian doctors trained from overseas medical colleges waiting for licence to practice in India. All of them should be given temporary licence to work under a senior doctor in critical care units of public and private hospitals. In two weeks, they will be an important asset to overcome the crisis, if it happens.