As the State government is toying with the idea of a Statewide lockdown in an effort to reduce COVID-19 transmission, public health experts and clinicians are sceptical whether it will benefit Kerala now that community spread is more or less established.
The State went into the first lockdown when the case burden had crossed 500.
“At that time we had imagined that in a small State like Kerala, 500-plus cases is a huge number and we felt that any further rise might lead to more deaths. We are not quite worried about the mortality figures now, but as disease transmission goes up, cases will climb and mortality figures will also rise proportionately. Reducing people’s mobility is one way of reducing disease transmission and, hence, as far as the administrators are concerned, a sudden reduction in numbers can be achieved by a total lockdown. But apart from the huge economic and social costs, a lockdown may not achieve more than a temporary or artificial reduction in case numbers,” a senior public health professional said. People’s interactions might go down during the lockdown, but the infection will not disappear. Transmission dynamics will ensure that cases start climbing again after lockdown.
A health official said in Kerala, COVID-19 at its peak would see an estimated 75,000 people at a time in hospitals. This is a huge number. Hence politically, it might suit the government to declare a lockdown.
The State should examine if the disease transmission is uniformly high across the State or whether it is intense only in certain clusters. How many clusters are there, what is the positivity rates in these clusters and where are the next cases going to be are crucial questions at this point.
Non-COVID-19 care
The Indian Medical Association (IMA) feels that a lockdown has no relevance now that community transmission is already happening. “A cluster-wise lockdown, followed by intense testing in the area to identify, isolate and treat positive cases might be a better strategy now,” said P. Gopikumar, IMA State secretary.
He said a more serious concern was the cost of lockdown on non-COVID care. “As it is, non-COVID-19 care is seriously affected. A lockdown will further affect their access to care and cause much suffering to people with chronic illnesses,” he added.
