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We’ll have to extend the lockdown

The government has made no official announcement about the end of the lockdown but I don’t know a single person who believes that it will end on schedule.

The most we can expect are staggered and perhaps region-based withdrawals of the restrictions.

 

Sensing that there might be a backlash, the Centre has chosen to involve the states in the process of consultation. And leaks to the media have made it appear that the extended lockdown will be the Centre’s response to requests from the states.

 

   I don’t think any sensible person can advocate a total withdrawal of all restrictions on the 15th April. It is too soon to gauge how much progress we are making in the battle against Covid. And one mistake is all it takes to lose momentum in this effort. And once the toothpaste is out of the tube it won’t go back inside.

 

   On the other hand, there are the demands of the economy. Daily wagers are going hungry. Entire sectors are struggling to survive: retail, hospitality, manufacturing etc. And not enough people are talking about the agricultural sector. How can farmers harvest their crops at a time of lockdown? How do they transport them to the mandis?

 

   Just as we wonder about the lockdown, we worry about nearly everything that has to do with the Corona Virus. One reason why we are all so tense is because we know so little. And so, it seems do the scientists.

 

   This is a new virus. Nobody has much experience of it. And scientists don’t fully understand its behaviour. So nearly everything that you are told is the truth one day tends to be contradicted a week later.

 

   Worse still, politicians have now got involved. We had India’s junior Health Minister telling us that 15 minutes of sunlight would kill viruses. In Britain, Boris Johnson listened to bad advice, believed in a herd immunity approach and wasted valuable time. Worst of all has been the behaviour of Donald Trump, the world’s most powerful man, who spent weeks acting as though Covid was no big deal, going so far as to call it a Democratic hoax.

 

   Another of Trump’s positions shows us how little we really know about the virus. Some weeks ago Trump announced that a drug called Hydroxy Chloroquine (HCR) was a miracle cure for the illness.

 

   HCR is not a new drug. It has been used for decades to treat malaria. But nobody of any consequence in the US had touted it as a cure for Covid till Trump made his claim. Anthony Fauci, the US’s top infectious diseases expert, tried to distance himself from Trump’s claim but by then it was too late because the President boasted that the US had stockpiled 29 million doses of the drug.

 

   When he was questioned closely about his discovery of a miracle cure, Trump said, “In France, they had a very good test.” Trump was referring to a single, flawed French study of 36 patients that had already been rubbished by the scientific community as being poorly conducted.

 

   Soon after Trump issued his endorsement, many doctors (including those who appeared on Indian TV) seemed to agree with him. A shortage of HCR in the US (and unusually high demand in India and other countries, for instance) made it difficult for patients who were already taking it (for other ailments) to obtain supplies.

 

   Now, the cycle has turned. US doctors are openly countering the President’s claims and even in India, doctors have been appearing on TV and other media to advise people not to take HCR without medical supervision and warning of dangerous consequences to healthy patients who take it.

 

   Trump continues to tout HCR --- his recent threat of ‘retaliation’ to India was about supplies of HCR. But it will take time to find out if HCR can ‘cure’ Covid, though, the odds of it turning out to be a ‘miracle cure’ or a ‘prophylactic’ are low to zero.

 

   Take another instance. The World Health Organisation (WHO) and the US surgeon general declared that masks would not help avoid Corona infection. Then, around a fortnight ago, the conventional wisdom on masks began to change. Even the government of India which followed WHO’s lead, has now changed its tune on masks to the extent that now there is even talk of making masks compulsory for anyone who leaves his or her house.

 

   Where does all this leave the average person?

 

   Should we have stocked up on HCR? Should we have bought masks before many shops ran out of them?

 

   We don’t know.

 

   Because scientists didn’t either.

 

   As with all such pandemics where scientists have too little experience, the non-scientists have sometimes seemed as wise. Nassim Nicholas Taleb, the statistician and probability expert (best known for his bestseller The Black Swan) launched a statistical exercise comparing Covid rates in countries where there was a tradition of using masks to those that did not use them. He found that the mask countries were way better off. Though Taleb’s work was derided by scientists, it contributed to a change in thinking and to the eventual turnaround on the mask issue.

 

"Because ultimately, scientists are still groping for answers. They know very little about Covid and what little they know seem to change almost on a weekly basis."

    The original US and UK government recommendation had been for health workers to use masks. The general population was told they were unnecessary. This made no sense to many people. How could the same mask which was unnecessary for us suddenly become vital when a health worker put it on? (Presumably the authorities meant that health workers were more exposed to the virus and had greater need but this was not always clear.)

 

   The mask controversy relates to another issue: how does the infection spread?

 

   So far, scientists have said that it spreads through contact. You touch something that has the virus (a surface, for instance) and sometime later you touch a part of your face (mouth, nose, eyes, etc.) from where the virus can enter your system. Hence the need to keep washing your hands.

 

   The second way is through droplet infection. Somebody, sneezes and releases droplets of saliva, packed with the virus, into the air.

 

   You inhale the virus and it enters your system.

 

   But, scientists say, the droplets are large and will soon drop to the ground so, if you maintain a distance from an infected person, you are okay. Hence the policy of social distancing.

 

   Now, some scientists say that yes, droplets do fall to earth but there are other micro-droplets that are smaller and lighter can float in the air for hours. These may be released even through the breath of an infected person.

 

   The problem will all of this that a) nobody knows how much of the virus needs to enter your system to infect you so is a single micro droplet dangerous? b) just because you can detect a virus in a lab test hours after it left the body does not mean that it is still infectious  c) Scientists have paid too little attention to the ‘viral load’. As the author and doctor Siddharth Mukherjee recently pointed out, just because two separate individuals are both infected by Corona, it does not follow that they both have similar loads of the virus. Studies suggest that people with higher loads of viruses have a bigger chance of dying than those with lighter loads.

 

   Is that true of Covid? Probably: there just isn’t enough work on the subject.

 

   Then, there is the fluctuation in rates of infection. In some countries, Corona seems much deadlier than in others. In India, for instance, the virus has been less deadly than we feared. In the UK and America, on the other hand, there have been thousands of infections and many more deaths than in India.

 

   Various theories have been advanced for the disparity: Indians have a natural immunity, we are a hot country, we are afflicted with less virulent strain of Corona, etc.

 

   Last week, an intriguing new theory (statistical, like Taleb’s work on masks) made the headlines.

 

   In countries where there is a tradition of vaccinating people with BCG against TB, there appears to be a much lower mortality rate. Could it be that BCG gives us a higher level of antibody resistance?

 

   The numbers support this view. Most Asian countries vaccinate their children with BCG but only a few Western countries do this as a matter of course. In Spain, where there is no BCG, mortality rates are high. In Portugal, where children are vaccinated, mortality rates are lower.

 

   The outlier is China, which has a BCG tradition and still has lost thousands to the pandemic. One answer is that the deaths come from Wuhan, which is the epicentre of the epidemic. In the rest of China, mortality rates have been substantially lower than Wuhan and perhaps, such European countries as Italy.

 

   So, should we all take BCG again? Don’t most of us already have antibodies for TB anyway? Can we compare responses to Corona (a virus) to TB (spread by bacteria)?

 

   As of now, nobody knows for sure.

 

   Because ultimately, scientists are still groping for answers. They know very little about Covid and what little they know seem to change almost on a weekly basis.

 

   Which is why the best thing for us to do may be to not wait for science to come up with the answers. Everything we know suggests that social distancing works. (No scientist disputes this.) Because the virus is spread though touch, washing your hands works. Staying at home and avoiding crowds works. And it’s probably a good idea to wear a mask if you are going out. It may or may not protect you but if you do have the virus (and many carriers are asymptomatic) it may stop you from infecting others.

 

   What all of this leads to is a single inevitable conclusion: some kind of lockdown (perhaps not as drastic as by this one) must continue.

 

   Because in the foreseeable future there will be no miracle cure, no silver bullet and no magic vaccine.

 

   Till we can see the light at the end of the tunnel it is up to us to look after ourselves.

 

   

Posted On: 08 Apr 2020 07:05 PM
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