China faces a dilemma in stopping Covid
China appears to be in a precarious situation today in handling its Covid crisis. Though China may not listen to any suggestions from outside, even from governments or International Service Organisations/ NGOs, and there’s no way my article can find its way to the Chinese decision-makers in China, I’m writing this article more as an academic exercise for 2 reasons:
- I want the rest of the world to make an effort to solve the problem at least on paper, so we realize the problem is solvable, though at some cost, as the cost of the alternative could be far more.
- I fervently hope the rest of the world doesn’t suffer another large-scale export of Covid from China.
Much of the information we have about China is based on unconfirmed sources and speculations, as China is a closed society. However, my assumptions are the guesstimate of what the rest of the world believes.
I had written a 2 part article in PGurus titled, “COVID-19 Lockdown Exit Strategy: Suggestions to State & Central Governments” on April 9 and April 10, 2020[1][2].
This outlined 3 possible strategies, viz., (i) preserve lives from Covid and sacrifice livelihoods, (ii) preserve livelihoods and sacrifice lives to Covid and (iii) strike a good balance between the first two strategies.
I had explained that the purpose of lockdowns and flattening of the curve should be to get infected but at a manageable rate such that hospital and other resources were stretched to the extent these were available, not to avoid getting infected totally as that would have been an unachievable goal anyway, nor to open up indiscriminately as that would have cost us a lot more of lives.
Strategy 3 was the one I had recommended, which is what India and many governments that tackled Covid reasonably successfully followed. This choice was based on common sense, not rocket science.
As it has turned out, China appears to have followed the option along the lines of strategy 1, trying to preserve lives over livelihoods. While it may have delayed the loss of lives, it may not have saved the lives altogether.
China may have flattened the curve so much that they may be in the situation we (and most of the rest of the world) were in the earlier stages of the pandemic. So, all that China has to do now is to follow strategy 3 from now on, as it is based on the reasonably successful experience of many countries of the world, whereas when we all adopted it, we were speculating.
Another major reason for China’s problems today, as the world speculates (reasonably confidently) is that its 2 vaccines, Sinovac and Sinopharm, were not effective. It avoided buying any other vaccines from outside.
Covishield and Covaxin from India have proven to be not only effective but also very cost-effective. India has now the capacity to produce these in volumes and supply them to China in quickly. China can buy these and vaccinate its people.
For those who have already been vaccinated with Sinovac or Sinopharm, these can still be administered as the third or booster dose. There are lots of people who have taken Covishield and Covaxin as booster doses after Sinovac and Sinopharm, for example, Indians living in countries like Sri Lanka, and have not suffered any adverse consequences.
For the sake of completeness, let me reproduce some details of Option 3 from my old article:
Option 3. Lift the lockdown selectively, judiciously, and progressively:
Containing spread of the CV (Covid) consists of 2 parts: (i) testing suspects, quarantining them, and treating CV-positives either as OP (out-patients)/ IP (in-patients)/ ICU in hospitals and (ii) ensuring that the others who are unaffected don’t contract it from the former group. The availability of lower-cost rapid test kits is likely to help us in this.
Where there are clusters of deaths, CV positives, or even large-scale suspects, such areas could be cordoned off as CV High-Risk Areas; these could be at the City/ Town level, District Level, or even Taluk or Block Level.
Minimizing the number of CV deaths consists of 2 parts: (i) protecting the asymptomatic, and/ or CV-negative, but vulnerable (old and immunity compromised like patients of cancer, autoimmune disorders, lung diseases, high BP, AIDS, diabetes, etc.) by home quarantining, and (ii) ensuring that the others who may or may not be CV-affected don’t contract it from possible carriers in the former group.
We can’t be 100% successful in our efforts because most people will, willy-nilly, contract CV. We’re only trying to stretch the timeline it takes for CV spread so that our hospital resources are not stretched beyond the availability of resources at any point in time.
Schools and colleges can continue to be locked down. The agricultural sector can be relaxed from lockdown subject to observing social distancing norms, to enable them to harvest and market their produce. Hospitals can be allowed to function, separated into CV, CV-suspect, and non-CV blocks, subject to handling at least critical/ urgent cases, avoiding routine cases.
Businesses & industries could be given limited chances to restart subject to observing social distancing, and mandating work-from-home where possible. Priority for business & industry to operate and permission for people to move should be on the basis of public good and national economy.
Only non-vulnerable people could be permitted to move, only for essential work, including commuting to the workplace where homework is not possible. The lockdown could be relaxed slowly and progressively, subject to improvement in the situation.
Transport of goods can be permitted with controls and observing social distancing policy. International travel can be opened up only when we’re sure the world and India have overcome CV.
All those who are permitted to commute in the above processes may be subjected to close observation for symptoms and CV test, and where suspected of CV, isolated, quarantined/ treated in hospitals.
The risks in such an approach are minimal, but the returns are enormous.
Note:
1. Text in Blue points to additional data on the topic.
2. The views expressed here are those of the author and do not necessarily represent or reflect the views of PGurus.
References:
[1] Covid-19 Lockdown Exit Strategy: Suggestions to State & Central Governments: Part-1 – Apr 09, 2020, PGurus.com
[2] Covid-19 Lockdown Exit Strategy: Suggestions to State & Central Governments: Part-2 – Apr 10, 2020, PGurus.com
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