Lockdown alone not enough to contain COVID-19 in Chennai, say experts

With questions about another lockdown to counter the spike in COVID-19 cases in Chennai, experts say that in isolation, the strategy has little effect.

On Friday (June 12), Tamil Nadu Chief Minister Edappadi Palaniswami refuted rumours of a complete lockdown in the state capital.

The ‘Unlock 1.0’ has been gaining momentum, with business opening and movement gathering pace, and the Madras High Court on June 11 sought a response from the government about intensifying the lockdown in Chennai alone, since it accounts for over 28,000 cases of the 40,698 total cases reported till date.

Experts say that the lockdown, which was first imposed on March 25 across the country, is not a magical remedy that can halt the spike in cases.

Examination of mitigation in Chennai

Dr T Sundararaman, former executive director, National Health Systems Resource Centre, says the options are being able to manage a better level of mitigation and containment. “Tamil Nadu should look at containment in the districts and mitigation in Chennai. Testing and treatment should be treated as a right guaranteed by the government. They seemed to have not factored in the need for expansion of treatment not just in terms of beds, but also healthcare staff like doctors, nurses, etc. There are almost 1,500 fresh cases every day and we cannot have the symptomatic ones among them outside. Home isolation is ineffective and the spread is going to be more through them,” he says.

The cases of hospital infections should also be addressed, adds Dr Sundararaman, who says the initial lockdown was for better preparedness and that this has not happened, with systems being inadequate. He says other measures like hand washing and social distancing will be beneficial only in tandem with other factors like treatment. He says, “Community engagement is vital; we should be maintaining social distancing, but we should also be taking care of the sick better,” he says.

Mapping details

A closer look at the places where the 60 years plus deaths are occurring in the city, the infection spread, the deaths among people of 50 years and plus, etc. can help relook strategies, says Dr Kugananthan P, chairman, Indian Public Health Foundation, former director, Communicable Disease Hospital.

“We can understand the mistakes being committed by the medical fraternity, who treat in the four walls of the hospital, and the missed opportunities for the public health experts treating the community,” he adds.

Dr Kugananthan also says that it will also be a good idea to adopt practices from other parts of the state.

Lockdown is one among the other strategies

Going by the Kerala example, that had a higher number of cases in the beginning of COVID-19 spread in India in February-March, one can understand better the need for contact tracing, ramped up testing, and campaigns addressing the community’s role in the fight. In fact, Kerala had the highest numbers and TN was on a par with it, and did well till about April, before it lost the plot.

Rakhal Gaitonde, faculty, Sree Chitra Tirunal Institute for Medical Sciences & Technology, says, “Kerala had all these strategies — contact tracing, testing, and campaigns — in place from March onwards. If these are effectively implemented, you can have a lockdown that brings about a travel ban and ban on mass gatherings. Now, you need to broaden the debate, as it is not about lockdown or no lockdown, but about the interventions by the government,” he adds.

Dr Gaitonde emphasises the need to identify every contact of a laboratory-confirmed positive case, as the spread of infection from one person begins a few days before they start developing symptoms. “If the processes and protocols are not followed, just following a lockdown, will only affect the economy,” he adds.