A way out is to lift restrictions in a graded way, with reverse quarantine for the elderly and those with comorbidities
As the World Health Organization (WHO) had pointed out on March 25, the unprecedented measures of the shutdown can only buy time and reduce the pressure on the health-care system.
Contrary to WHO’s advice of using the opportunity to carry out more precise and targeted measures to chase and contain the virus, there have been no concerted efforts to aggressively test and isolate positive cases even in hotspot and containment areas.
Any strategy adopted for lifting restrictions should bear in mind that the actual number of people who have been infected is many times more than the laboratory-confirmed cases.
While extending the lockdown in hotspot areas appears not only prudent but also essential, there should be more focus during the remaining days of the lockdown on silent areas that have not reported any case or just a few cases.
Increased surveillance of those exhibiting severe acute respiratory infection (SARI), influenza-like illness (ILI) and any COVID-19 suspect cases in the silent areas will help determine if restrictions should be eased or continued after May 3.
Sikkim, which has walled itself up has not reported a single case; some northeast States have reported only a few cases. These States would not need a continued lockdown, once the true infection prevalence is ascertained.
Most importantly, the decision on whether to continue the restrictions or not should be taken at the local level; a centralised approach to decision making will be hugely counterproductive.
On herd immunity
This brings to the fore a more natural way to slow down and bring the epidemic to an end through herd immunity that happens naturally during an epidemic.
Herd immunity arises when a sizeable population gets naturally infected over a period of time so that the virus does not easily find a susceptible host to infect, thus bringing the epidemic to a halt.
The herd immunity that these scientists are referring to is not very dissimilar from the one practised by British Prime Minister Boris Johnson who intended using it as a strategy to end the epidemic.
Strictly following containment measures, wearing a mask and maintaining physical distancing not only slow down the rate of infection but also the rate at which herd immunity is achieved naturally.
WHO cautions that “there is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection”.
Infected people may have some level of protection against the virus, but the level and duration of protection is still unknown.
It is still not clear if it is a case of reinfection or reactivation (where infected people have not been able to completely clear the virus).