Overall relaxation of lockdown needs massive testing and support for infection clusters
As the world watches, India must plan its strategy for a calibrated exit, possibly in a week, from the most aggressive lockdown anywhere to contain the novel coronavirus. The government faces the challenge of normalising some level of daily life and oiling the wheels of the economy, without causing a surge in cases that could follow wrong steps. It is wholly welcome that Prime Minister Narendra Modi has sought the views of the States on the way forward beyond the 21-day lockdown, and mandated his Ministers to come up with a set of priority actions under a business continuity plan. The strategy will have to take into account the exodus of migrant labour from cities to their home towns or to camps set up along inter-State corridors. Given that this is harvest season, cessation of activity due to labour issues can trigger food deficits and high prices. On the medical front, States are monitoring those under isolation or in quarantine and straining to trace the contacts of those who attended the Nizamuddin congregation, many of whom are now found in distinct clusters in some districts. The States must also scale up testing, as part of the latest ICMR advisory for clusters and migration centres, and going forward, as part of the exit strategy. Against this complex background, the States are cautious, and Telangana and Chhattisgarh have voiced doubts about an exit without a clear plan.
Reducing the risk of withdrawal from lockdown will depend on prioritised actions. The experience of China, South Korea and Singapore, who are ahead of the curve thus far, provides pointers to opening up of activity after a phase of movement curbs. These countries opted for enhanced testing, isolation of the infected, tracing of patient contacts and strict quarantine. After three weeks or more of lockdown, India, where 284 districts have so far been affected, should institute a system of testing that includes not just indicative cases but surveillance samples to determine the extent of spread. This will enable targeting and containment to specific areas. With high emphasis on social distancing, universal mask use and hand washing, it should be possible to open up some activity and release the pressures building up under the lockdown. Needless to say, free and widely available testing, and support systems for those infected, will encourage universal adoption. The identification of hotspots, where a virtual lockdown could be in force even if the nationwide curbs are relaxed, would require planned, humane measures to ensure availability of food, other essentials and medicines. Mass gatherings, long-distance travel and leisure activity would have to wait. Urban mobility for workers in the absence of public transport could be made possible by encouraging bicycle use where feasible, avoiding congestion