Dr. T Jacob John, India’s foremost virologist, epidemiologist and researcher in a daily conversation with Jagdish Rattanani, journalist and editor of Foundation of The Billion Press, to build what we call the COVID-19 diary
It is 17 days since the lockdown began. Under the lockdown, infection should have remained flat or come down unless you went in to the family and looked for intra-family infection. So, if you are finding the number if infected growing, that means the effect of the lockdown is not visible yet. You can argue what we see today is what happened 14 days ago, because if somebody get infected today, it will show up after (a maximum of) 14 days.
In sum, it is early to say whether our lockdown is successful for the objective of flattening the curve, because the curve doesn’t look anywhere near flattening. If you look simply at the available numbers, or the graph, numbers are growing and the slope of the curve is getting steeper, not flatter.
This is disappointing to say the least. Lockdown will work only where people live in independent houses or flats or where the distance between households is at least two metres. In overcrowded living conditions, lockdown may not be effective -- universal use of mask will help in such households. Lockdown and mask use are complementary for minimising transmission.
Lockdown will work only where people live in independent houses or flats or where the distance between households is at least two metres. In overcrowded living conditions, lockdown may not be effective -- universal use of mask will help in such households. Lockdown and mask use are complementary for minimising transmission.
If you know India well, if you travel India widely, that every town…in my town (Vellore) there are 25-30 places when you walk into the street and houses are like packed matchboxes. And the streets are about 10 feet wide and people are always on the street as there are is no room inside. So, women are chatting, collecting water, the kids are playing, play cricket, adults are also sitting and chatting. So, the street is the living room for innumerable family. This is the case for the entire nation. Cities like Mumbai have higher density and the problem gets worse.
We have to think in terms of how the lockdown is going to influence physical distancing. That should be given to the local administration to plan; you tell the city commissioner and city people, who can make sure that people are maintaining physical distancing. If they cannot, remove some of them and put them in schools or whatever. That time should have been given to local government, and that was not given.
This virus spread was coming. That was known from January. They should have given time to plan. We needed responsibility with accountability to planning and making sure social distancing and physical distancing can happen. I still have not figured out what the deep strategy was for announcing this lockdown at 8 pm, effective midnight. Just four hours of notice? There must have been a very strong logic or rational behind it. I still have not figured it.
Even today, the health minister says there is no community transmission. So, if there is no community transmission, then the lockdown is too pre-mature. Only when community transmission has come about will the lockdown help to flatten the curve.
The curve has to start before you flatten it.
But it can also work as preventive measure, can’t it? Because, if there is a lockdown, then you will separate out those infected. And you don’t get the curve, isn’t it?
That is a way of thinking, but the day you remove the lockdown, you must realise, you created for every infected person five infected persons within the family. The moment they are getting out, it is five times the number of infected people at the end of lockdown than at the beginning of the lockdown. So the curve will take off, then you have to do a lockdown again. So, lockdown should have been when curve started to go up. You cannot flatten a curve without a curve being alive.
Was the lockdown pre-mature?
No, I don’t think it was pre-mature, but to say that there is no community transmission and then have a lockdown, for those who believe it, it is a pre-mature move. I believe that community transmission has started early March. So therefore, the lockdown is very timely, but it hasn’t given time to local government and administration to take responsibility with accountability for making this whole thing successful. For international media, they have done a great and bold decision, but it is a bird’s eye view. The worm’s eye view from inside that is what I am talking about.
This conversation was recorded on Saturday, April 11, 2020