Over the initial phase of the national lockdown (March 24 to April 14), India reported a 20-fold increase in confirmed SARS-CoV-2/COVID-19 cases (468 to >10,000), and a 36-fold increase in deaths (9 to 330). Increased testing may partly account for this; but testing is still inadequate and this data represent underestimates. The case-fatality of 2% to 3% is indicative of the large number of deaths India can expect.
Debates about the relative merits of mitigation to “flatten the curve” versus allowing “herd immunity” to build naturally are increasingly irrelevant. The failures in widespread testing for infection or for immunity imply that transmission-chains via asymptomatic, mildly-symptomatic and presymptomatic people remain undetected. Most countries, including India, are inadvertently employing hybrid strategies.
The lockdown (an extreme example of mitigation) has been extended to May 3. The dire socio-economic consequences and the scale of human tragedy that play out daily make a prolonged total lockdown undesirable. Alongside infection-control, a strategic plan of action to mitigate suffering and to stimulate economic recovery is urgently needed.
As a series of measures
In a recent interview, the Union Health Minister, Harsh Vardhan, asserted that lockdowns and social distancing are the most effective “social vaccines” available to fight the pandemic. A social vaccine has far broader implications.
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