As widespread disruption of livelihoods created by lockdowns have been reported from several parts of the world, several senior scientists have come forward to suggest alternative responses as well as offered insights for understanding the new threat in proper perspective.
Some of these scientists are highly regarded in terms of their professional achievements and hence their viewpoints are receiving attention. Michel T. Osterholm, Director of the Centre for Infectious Disease Research and Policy, University of Minnesota has said (21 March 2020, Washington Post, Facing Covid-19 Reality – A National Lockdown is No Cure) that if we consider the effects of shutting down and people rendered unemployed, “the likely result would be not just depression but a complete breakdown, with countless permanently lost jobs, long before a vaccine is ready or natural immunity takes hold. The best alternative will probably entail letting those at low risk for serious disease continue to work, keep business and manufacturing operations going and ‘run’ society, while at the same time advising higher risk individuals to protect themselves through physical distancing and ramping up our health care capacity as aggressively as possible. With this battle plan we could gradually build up immunity without destroying the financial structure on which our lives are based.”
The views of Dr. Sucharit Bhakdi have been widely discussed in this context. He is one of the senior-most scientists in this field and his work has been very widely cited. He has been head of the Institute of Medical Microbiology and Hygiene in Germany. Recently he sent an open letter to German Chancellor Angela Merkel, calling for urgent re-examination of the response to Covid-19. He said it was difficult to find scientific rationale for the sweeping measures that have been taken more in panic than on the basis of studies which firmly establish very high risks.
The risk has been inflated by mistakes like assuming the presence of Covid19 virus in a dead person to be necessarily the cause of death. Earlier he had stated that some of the anti-Covid “measures are grotesque, absurd and very dangerous…The life expectancy of millions is being shortened. The horrifying impact on the world economy is threatening the existence of countless people. The consequences on medical care are profound. Already services to patients in need are reduced, operations cancelled, practices empty, hospital personnel dwindling.”
Dr. David Katz, founder-director of the Yale University Prevention Research Centre has said (20 March 2020, the New York Times, Is Our Fight Against Coronavirus Worse than the Disease): “I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life – schools and businesses closed, gatherings banned – will be long-lasting and calamitous, possibly graver than the direct toll of the virus itself…The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.”
An important contribution to the debate on the most appropriate and reason-based response to Covid-19 has been made by eight senior Indian scientists who have written a review article in the latest issue of the prestigious Indian Journal of Medical Research. This review article titled ‘The 2019 novel coronavirus disease (Covid-19) pandemic – A review of the current evidence’ has been written by Dr. Pranab Chatterjee (lead author), Nazia Nagi, Anup Agarwal, Bhabatosh Das, Sayantan Banerjee, Swarup Sarkar, Nivedita Gupta and Raman. R. Gangakhedkar.
All eight scientists are with leading institutions. Speaking in a global context, these scientists have broadly called for a community-rooted and people-centric approach, a view that has been attracting a lot of favorable attention from public health experts. This is also seen as a response with immense potential of creativity of ordinary people as well as experts. Expressing doubts about lockdown-driven approach, this review article says that this is a drastic public heath measure.
“While the benefits of such a move remain to be seen, the long-lasting negative impacts of such a measure should not be underplayed. Such drastic measures can lead to social, psychological and economic stressors on the whole population, leading to long-lasting adverse health outcomes. Instead of coercive, top-down quarantine approaches, which are driven by the authorities, community and civil society led selfquarantine and self-monitoring could emerge as more sustainable and implementable strategies in a protracted pandemic like Covid-19.”
Further this review article notes, “There have been elements of imposed travel restrictions and redlining of affected areas, the long-term impacts of which on sectors like economy, agriculture and mental health remain to be seen. In this run to devise technological and medical solutions to yet another PHEIC (Public Health Emergency of International Concern), we have not focused on opportunities to strengthen health systems and community resilience through people centric approaches.” Speaking of the overall weakness and inadequacy of the global response, this paper says, “The emergence of SARS-CoV-2 has once again exposed the weaknesses of global health systems’ preparedness, ability to respond to an infectious threat, the rapidity of transmission of infections across international borders and the ineffectiveness of knee-jerk policy responses to emerging/re-emerging infectious disease threats.”
Further these scientists say, “The response mounted to the Covid-19 threat has largely been reactive. The lack of a reliable Early Warning, Alert and Response System, inability to mount transparent confinement measures, lack of community engagement for self-deferral and isolation and overdependence on quarantine measures have exposed the fissures in the ability of health systems across the world. It has clearly demonstrated the weak preparedness against emerging and re-emerging dangerous pathogens across the world.”
Speaking of future tasks the article says, “The infectious disease threats of our times are far from over, and if these are to be contained with lower magnitudes of loss to human life and economy, we need to invest in building up people-centric health systems, which pre-empt and prevent, rather than work in reactive feedback loops driven by the burden of human misery.” Such alternative perceptions are critical in terms of policy reform and should get adequate attention in various countries of the world and certainly in India also.
(The writer is a freelance journalist who has been involved with several social movements)