After over a month, Telangana completely lifted the coronavirus-induced lockdown on June 20, reasoning that the test positivity rate (the percentage of test samples that turn positive for the virus) in the state has gone down significantly. It is possibly the only state that has removed all restrictions, instead of a phased move. Neighbouring states such as Andhra Pradesh and Karnataka have extended the lockdown while retaining restrictions such as night curfew and limited movement, and relaxing a few restrictions.
While lockdown was always a stop-gap measure to bring down COVID-19 cases and give the healthcare system time and relief, some experts argue that completely lifting the lockdown could send a misleading message to people, if it is not followed by emphasis on following and encouraging COVID-appropriate behaviour.
According to Dr M Jayaram, senior academic registrar at Hyderabad-based Indian Institute of Public Health (IIPH) under the Public Health Foundation on India (PHFI), lifting the lockdown completely would make people believe that everything is back to normal. “In my opinion, the government should have kept a partial curfew, like from 9 pm to 5 am. With no restrictions, people will think coronavirus is gone. Earlier, one would think he should go home before 5 pm (due to curfew), now he will feel more at ease, dropping his guard, going to a hotel or a bar. Without proper precautions, these can lead to a resurgence in COVID-19 cases,” says Dr Jayaram.
He adds, “Even if the government is making arrangements to prepare for a possible third wave, getting SOPs ready for hospitals, ASHA workers and Anganwadi workers, it will have little effect if the community doesn’t participate in practising caution.”
It should be remembered that a lockdown is not a cure-all solution to ending the pandemic. “The purpose of the lockdown is to prevent crowding in the hospitals. However, the same impact can be achieved if people are encouraged to wear masks properly. The mask is essential when you are getting into a crowd or a closed room. If that is done, we won’t have to resort to a lockdown,” explains epidemiologist Dr Jayaprakash Muliyil.
According to Dr Muliyil, a complete lockdown is an overkill. He is not keen on the night or weekend curfews either. “The coronavirus does not differentiate between a Saturday or Sunday or the day or night.”
That being said, it is important to remember the devastation of the second wave of COVID-19, which, some experts estimate, was four times larger than the first wave. Amid fears about the third wave, Dr Muliyil explains, “In my understanding, the virulence has not increased, neither has the age-specific vulnerability. We saw more deaths because more people were infected. The population that now remains susceptible to the virus will bring in the third wave, though I don’t estimate it will be as big. A serosurvey will reveal the results soon. However, if the momentum of vaccinations is kept up, we may be able to thwart some possibility of a deadly third wave too.”
He adds that the lockdown hurts the vulnerable the most – daily wage workers, those who do not have the option of earning a living from the safety of their homes. However, he also asserts that any time a lockdown is lifted, the messaging to continue practising COVID-appropriate behaviour needs to be repetitive. “A strong lockdown will bring a wave of infections down. However, repetition is the best way to change behaviour,” Dr Muliyil says.
Though the Telangana government mentioned the need to follow COVID-19 precautions in the absence of the lockdown while making the announcement, there is so far no sign of a sustained campaign to ensure that this happens, yet. An ideal example perhaps is Kerala government's ‘Break The Chain’ campaign to encourage COVID-appropriate behaviour and decrease the spread of the disease.
The Telangana government also announced the reopening of schools across the state from July 1. However, the population of students below 18 years are yet to be vaccinated, and are vulnerable to contracting the infection. Anxious parents have strongly opposed the state government’s decision. “Unless there is a strong mechanism to tackle the health crisis, the move to open schools is dangerous. It seems like the intention here is only to generate revenue,” a parent had told TNM.
Meanwhile, Dr Srinath Reddy, President of the PHFI, concurred that it is always advisable for governments to have a phased lifting of the lockdown, keeping in mind the possibility of a rebound in COVID-19 cases. “Till vaccination rates rise to over 60%, state-wide at least, if not nationwide, we need to observe considerable caution,” he says.
“While reopening several vital sectors, it is important that this be accompanied by disciplined adherence among the people to follow advisories on masking and avoiding crowding. Public administration should vigilantly prevent super spreader events. This will enable resumption of activities while still controlling the risk of transmission,” he adds.
Dr Reddy, too, believes that lifting a lockdown needs to be accompanied by the right messaging. “The message should be we are resuming activities, prioritising them for economic reasons and to ensure that livelihoods are protected. However, it is incumbent on people and governments to also ensure that transmission is curtailed and we do not give the virus an opportunity to rebound.”
As the state government lifted the lockdown completely, the Telangana Chief Minister appealed to people to adopt COVID-19 appropriate behaviour, including wearing masks, maintaining physical distance, using sanitisers and other self-regulatory methods. The Chief Minister’s Office touched upon these points in its tweets; however, there are instances where the message is not driven across strongly or the officials have made light of the seriousness of the pandemic. For instance, at a recent tour in Warangal district, Telangana CM K Chandrashekhar Rao spoke of his experience of having COVID-19. He said that his doctors asked to just take two tablets, which worked for him. It must be noted that treatment works differently for different people, based on their existing health conditions and the level of exposure to the virus. There is no one-size-fits-all treatment for COVID-19.
“For just this, so much publicity, sensationalism and fear-mongering is happening,” the Telangana CM said. Accusing the media of “health sensationalism,” he added that media should stick to publicising COVID-19 related precautions like wearing masks. “Some people have even died simply from watching television news,” he said with hyperbole, accusing the media of causing panic.
Incidentally, governments often also antagonise the need to follow safety protocols, which can send a wrong message. A month ago, the Telangana government received several complaints of highhandedness by the police, where some resort to lathis on those violating the lockdown norms. In a tweet in May, Information Technology Minister KT Rama Rao had said that he received many complaints of the police stopping food delivery executives and others during the lockdown. However, governments resorting to measures like policing, imposing fines and wielding the stick all the time, is not the best option, experts say.
“The state government should spread awareness, distribute masks to each low-income family, and involve local bodies and community networks to do so. Assure people that home-care is possible in case someone is infected, and win their confidence. And then caution them that if people behave with laxity, another lockdown would have to be imposed. Confidence-building requires local voices and networks – to overcome stigma, fear, accessing masks and encouraging vaccinations. We need to make it a popular movement rather than a top-down diktat,” says Dr Reddy.
(With input from Jahnavi reddy)