Manipur don't require complete shutdown

Dr Th Suresh Singh *

 COVID-19 :: Bishnupur Bazar as seen during Lockdown :: April 05 2020
COVID-19 :: Bishnupur Bazar as seen during Lockdown on April 05 2020 :: Pix - Shankar Khangembam

With only 1 +ve COVID-19, Manipur don't require complete shutdown. Normal functioning be from 15th with complete border seal and certain norms.

PM Modi is deliberating with experts/political leaders whether to continue present shutdown or not. ON April 8 he had video conference with political leaders. On 11th, he will interact with CMs.

PM seems inclined to extend the total shutdown. To me, it looks like our PM is over-burdened with many advisors. These learned advisors - be it at PMO, Health Ministry or ICMR - seems to be very impractical and theoretical at times.

Regarding the lapses in preparation, I will not elaborate here. But one can see these since 30th January i.e. appearance of 1st corona case - lack of PPIs, less no of testing kids, less effort to find cases, less testing, no proper guideline for treatment etc. etc. From the very beginning-the preparations are patchy, directionless and incomplete.

Our doctor-advisors also seem to have forgotten the basic principle of fighting an infectious disease.

This is done by
i) case finding
ii) case treatment and
iii) taking preventive measures.

i) Case finding:
a) House to house surveys and resurveys of suspected high +ve red-spots
This is done in National Leprosy Eradication Programme. Our ANMs, Male Health Workers, Supervisors, AWWs, Helpers etc. are quite accustomed to it.
No difficulty to implement it. No extra money, no extra effort for medical personnel.

b) More and more lab testing of persons with cough, fever or the 2 plus respiratory trouble. Less testing gives not only a false scenario, but also helps in disease spread - a danger in long term.

ii). Treatment :
Though no specific treatment presently, anti-viral antibiotics like Remdesivir, anti-malaria Cloroquine and HIV drugs like Lopinavir and Ritonavir combine are tried in China, Indian hospitals, USA etc. and by WHO.s

iii). Preventive measures :
a). Isolation- Present shutdown policy is the master stroke from India's greatest motivator PM. No dispute, no alternative to this, is the best preventive measure. However, present chaos in border crossing and Nizamuddin incidence is a spoiler to the whole massive exercise initiated by PM.

However shutdown be 14 days only. The reason being - Incubation period, i.e. from infection to appearance of symptoms is 2-14 days, a world accepted norm. If found +ve, treatment will take care of him. Another 7 day extra burden is unnecessary. PM must have his own reasons. If so, it be shared with us for evaluation.

b) Use of Mask everywhere and whenever available - Govt. approved mask, handkerchief or any locally made one. Basic ideas being - it is a 2-way traffic - not only prevents Corona and other Upper Respiratory tract infections from others, but also prevents self-spread to others.

And, this is the 2nd most cost effective strategy next to mass shutdown. Purchage 10/20 handkerchiefs for 100/200 Rupees. Carry and use 5,6,7etc.. At home, wash with proper soap and water and re-use again and again.

c). Use of Chroroquine as preventive drugs: The reasons for this is illustrated at Treatment above. It be used by health worker in hospitals, contacts and families and in red spot clusters/areas/cities. India is the most experienced one in use of cloroquine in National Malaria programme.

The Prime Minister's Mantra be - find out cases by doing house to house surveys and re-surveys and lab testing in high risk areas/ clusters as indicated above. Then total isolation of the areas or clusters for 14 days except essential items and essential systems. There is no need for total shutdown. It is simply not needed. The virus is going to stay long in India but in sporadic form, PM's strategy be on this.

Basic ideas put here are already found in the writer's various Manipuri Live-TV shows wef. 15th March and letters communicated to our Hon'ble CM/MM and Hon'ble PM.

Manipur situation : We have only 1 +ve case now. All the suspected persons who landed along with the 1st +ve case on 11th March have been isolated and followed well for at least 14 days or so.

Similarly, accomplices of 2nd +ve case from Nizamuddin have been quarantined and followed well. Health deptt. has done an excellent work. All of us be thankful to health + police deptt.

Lifting of complete shutdown wef. 15th forthwith with the following does and don'ts :

i) Complete border seal as is done now
ii) Air route be opened for once a wk for 2 wks, then twice a wk for 2 wks and then increase gradually
iii) Markets be opened twice a wK for 2wks and so as given above
iv) School and colleges be opened similarly
v) Normal medical OPDs to start functioning twice a wk for 1 month. 24 hr services for emergency to remain as of now. Pharmacist shops be opened day time with selected soaps opening at night area-wise
vi) Avoidance of crowded areas as far as possible be enforced strictly with penalty
vii) social isolation of 6 feet and face covering by mask/handkerchief, frequent washing of hands etc. be enforced strictly with fine and other penalty for at least 3-4 wks
vii) Gradual opening of essential services like bank, post office, treasury, electricity office, petrol pump/cooking gas etc. be started. At present it remains closed. The list is endless, one can add left out portions. But, there be no fear psychosis.

I would request our CM to declare it at once and be a role model in India and to put it in the PM video conferencing on 11th. In fact, all N-E states should follow this as we have 1 or 2 +ve cases only.

Our CM also should set up an independent advisory committee consisting of different stake-holders as done in other states, the sooner the better.

* Dr Th Suresh Singh wrote this article for The Sangai Express
The author is an ex-Director, Health & WHO Fellow
This article was webcasted on April 13, 2020.

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