Photo: Reuters
Photo: Reuters

Opinion | The strategy we need to suppress contagion

An Imperial College London study shows a stark variation in the human cost of adopting different strategies against Covid-19. Stiff measures to quell the bug are India’s best hope

The novel coronavirus, which causes the highly contagious disease Covid-19, has not just kept the world on edge, it has posed collective and individual dilemmas of a kind unfamiliar to us as a species. Better safe than sorry, however, seems the mantra of those who likely know best. “Sigh," tweeted Neil Ferguson on Wednesday, “Developed a slight dry but persistent cough yesterday and self isolated even though I felt fine." An epidemiologist at Imperial College London, he is the lead author of a report released earlier this week that proved an eye-opener. By modelling the pathogen’s path for the UK and US, it projected various curves it would take under alternative strategies. We in India are not quite as badly hit, yet, but the study has lessons for us, too. There are ominous signs that we are on the verge of an outbreak beyond the few who were globally exposed to the menace. For such an eventuality, we should be ready to deploy an appropriate strategy to flatten the curve of cases. Over 175 countries have been struck, over 220,000 people infected, and more than 9,000 lives lost since the crisis erupted in China’s Wuhan late last year. On the country-wise chart of casualties so far, India figures very low, given the size of our population. Good pre-emptive moves could keep it that way.

The Imperial College report analyses two basic strategies of virus control: mitigation of its spread, and its suppression. The first refers to measures adopted to slow but not necessarily stop its spread, “reducing peak healthcare demand while protecting those most at risk of severe disease from infection". This entails the isolation of suspect cases and social distancing of the elderly and others who might fall badly ill. The second strategy, in contrast, “aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely". It relies on heavy curbs on human interaction for a sustained period, perhaps till a vaccine arrives. While this approach would be far more disruptive of economic activity, the study’s graphs of the two scenarios make it clear that the human cost would be vastly lower. The difference runs into millions of fatalities. Evidently, even the well-off West cannot afford mere mitigation. In India, the trajectory of the virus’s spread could differ, some may argue, but no valid reason has emerged to think it will, and if at all it does, the divergence would be too slight to matter. Given India’s healthcare deficiencies, should our outbreak of coronavirus go into “community transmission" mode, nothing short of an all-out clampdown would be able to keep our hospitals from getting overrun.

On Thursday, Prime Minister Narendra Modi urged citizens to stay home this Sunday. Yet, our broad approach to the threat of Covid-19 is a jumble of actions that vary state by state. These appear both mitigative and suppressive. Specific clamps, zone by zone, assume that we have reliable data on the nooks and crannies this stealthy bug has reached. But the country’s testing capacity is too low for us to be sure of accuracy. As testing escalates, we might soon need stiff Central action to suppress further contagion. Large numbers of Indians live cheek by jowl. Local conditions and social norms do not offer any comfort that we can somehow escape the steep upturns that the worst hit countries have seen. If we are to thwart a catastrophe, let’s pay attention to academic warnings. Like Ferguson’s.

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