With no short road to universal vaccination, lockdowns should be precise and painless
Several States have extended the coronavirus lockdowns beyond May 31, while fresh cases appear to show a downward trend, but India’s COVID-19 battle lacks strategic focus. Although a cessation of activity has been imposed, there is not much clarity on the future threat from virus variants, notably B.1.617 that now has three sub-types and the dominant one, B.1.617.2, is estimated to be 50% more transmissible than another variant of concern, B.1.1.7. Neither is there a road map for vaccine availability ahead, with direct imports by States hitting a roadblock and vague assurances of a domestic ramp-up from July substituting for firm commitments. Some States are unwisely taking the foot off the testing pedal, making it that much harder to map the course of transmission. A miasma of confusion has come to pervade COVID-19 policy, where the Centre no longer has an appetite for leadership, even if it means shunning responsibility for universal vaccination, and the only tool available with States is a lockdown. But as Tamil Nadu Chief Minister M.K. Stalin has pointed out, a lockdown does not provide a solution, and comes with its own economic side-effects that hit the working class poor the hardest. The time has come for a pandemic policy reset that reflects scientific insight, encourages safe public behaviour through persuasive communication, monitoring, and, importantly, incorporates medical interventions of scale.
The medium-term outlook does not point to a steep rise in vaccination by the end of the year to cover most of the population, making it imperative for States to prepare for potential future surges. Although claims have been made of a large volume of three vaccines becoming available between August-December, the road to universal immunisation is going to be long. The process is complicated by the finding in Britain that it takes two doses of Covishield for 60% protection against the dominant virus variant that is also found in India; the second dose, therefore, should be administered after eight weeks, not 12 or 16. What States can do immediately is to arrive at a good lockdown protocol, sparing people frequent shocks. Tamil Nadu’s recent move to intensify the lockdown, and, inexplicably, allow even jewellery and clothing shops to open for a day before that, led to massive crowding triggered by induced demand. Clearly, measures to shut down everyday activity lead to fear and panic, and leave less affluent sections, the disabled, migrant workers and many single individuals unable to cope. The golden mean would be to shut all non-essential shops, encourage remote transactions, open street sales and home deliveries, actively monitor compliance with COVID-19 protocols in public places and vaccinate workers in services, including domestic workers, on priority. Free food distribution must be a central feature of lockdowns.