Two main weapons to combat COVID-19 and the preventive measures to follow during this crisis!
Instead of implementing a strict complete lockdown for short time, a long term nationwide partial lockdown on some sectors with a shorter complete lockdown in hot spots with minimal socio-economic interventions and strict implementation of safe practices is better.
Social distancing and personal hygiene seem to be the two main weapons to combat COVID - 19. “Life over Livelihood” is slowly getting replaced with “Livelihood over Life” given the nature of our country where 70% of people live by that day’s work for that day’s survival. The authors suggest that instead of implementing a strict complete lockdown for short time, a long term nationwide partial lockdown on some sectors with a shorter complete lockdown in hot spots with minimal socio-economic interventions and strict implementation of safe practices is better. On a positive note, the lockdown would facilitate the central and regional governments to fine-tune the framing of its policy guidelines by bringing all registered specialists, including Epidemiologists, Strategists, and Scientists spread across the nation on a common web portal. While releasing lockdown in phases, it is very important to clearly define the criteria for every phase, as there is a possibility of a second wave which can be more severe than the first wave.
High Risk Population
Instead of screening, testing the general population, the priority testing should be given to the high-risk population, like contacts of people working in COVID hospitals, Quarantine centers, COVID-testing labs, cemeteries, and graveyards, as well as the attendees involved with COVID positive case and people who are allowed to travel with passes and handling essential services, as well as the general population in identified red zones. Isolating and quarantining suspected COVID -19 cases should be in community/marriage halls and hotels. Asymptomatic COVID positive cases should be managed in dedicated COVID hospitals.
Handling Infected Dead Bodies
During pandemics of this magnitude, all the deaths, unless tested negative, should be considered as COVID positive cases. The staff should be well trained to handle such infected dead bodies with complete PPE. The family members should be counseled not to handle the body directly, and they should be allowed to see the body only after placing the body in a transparent sealed leak-proof plastic cover, which has been sprayed with disinfectants. The body should be handed over to the Corporation Office, for cremation. It should not be kept in the mortuary. Some crematoriums should operate round the clock, to avoid storing the body for long. There should be restrictions to allow only 10 members during the funeral process, with all social distancing and disinfection protocols being followed.
The governments should mandate that their staff should not travel beyond their containment zones, and if necessary, manpower across all levels should be deputed on a long term basis from their existing government offices to those within their containment zone. The same applies to employees of the semi-government, quasi-government, public limited, and private limited units.
Educational institutions across the country should not be re-opened until all restrictions are lifted and can avail online services. The entertainment industry, tourism industry, and public gathering should be the last to reopen. Under inevitable circumstances, essential services like railway and airline services should be able to function with stringent COVID measures.
Factory owners should be able to run their units in total isolation, if within city limits or otherwise. Temporary tents or if necessary vacant flats near the industries and factories should be made available to accommodate the workers during the entire lockdown period. Labour should only be allowed from Green zones areas. Thermal Screening and health profiling should be done daily.
Courier, Postal (includes letters, domestic parcels & industrial parcels) and Cargo Services involve multiple handling of parcels across various travel zones. The items should be covered with a strong leak-proof plastic cover, and sprayed with disinfectant, at each transit point. All persons in contact with the parcels from pick up point till delivery should use proper PPE and disinfection measures in handling the parcel, including using digital zero contact methods for getting acknowledgments. The courier pickup and delivery person should not travel across containment zones.
The authors sincerely thank Profaid consultancy, Chennai and Dr.A.R.Gayathri, consultant Pulmonologist, Apollo Hospitals, Chennai for their contributions.
Dr.R.Ramakrishnan, (Retd. Scientist G and Deputy Director, National Institute of Epidemiology, Chennai).
Dr Gandham Nagarjuna (Physician & Epidemiologist, Chennai).