‘At the end of three weeks, lockdown deaths may compete favourably with Corona deaths’

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Prof Ujjwal K Chowdhury   |  

01-April-2020

Vol 11 | Issue 13


The entire world is virtually taken by the horns and taken to task as if by an invisible virus from the SARS family, named COVID-19, popularly called Corona Virus, and some 4.5 billion people around the world are in a lockdown now.

The fear of the virus and the fear of the economic recession setting in throwing millions of people out of job and disrupting economies of the nations, the powerful ones included, have virtually gripped the world.  But there is a contrarian view as well. Is the virus so virulent and dangerous that it called for such an aggressive all encompassing response?

Across Indian cities, migrant workers setting out on foot to their hometowns became a common sight following the national lockdown (Photo: IANS)

Many people rightly argue about the fact that the virus spreads geometrically, respecting no borders, with no preventive vaccine or antidote known to mankind yet, and has no class preference, affecting the royals and the plebians alike, and spreads through touch being highly contagious.

Rightly so. Still there is a contrarian view. And the purpose here is to draw attention to this contrarian view which I have learnt from various sources, like the posts of writer Jaideep Verma, articles in The Atlantic, The Morning Star, and interviews of survivors and scientists.

Statistics of the first eight lakh patients so far shows, that even an infected person of over 80 years has an 85% chance of survival. It is observed that Corona Virus affects mostly people with pre-existing conditions, which is why the fatality rate really starts notably increasing from the age-group of 50-59.

So many elderly who died across the world, Italy and Spain in particular, have died not due to Corona virus necessarily, but with many other ailments which aggravated Corona virus affliction.

Since this is a respiratory ailment that leads to huge thick mucous around trachea and the lungs, those with regular smoking habits are susceptible to the disease more, and hence, out of every three patients, at least two or more are men. This is one major reason of the virus attacking men more.

All SARS family viruses cannot thrive in hot climates, and hence, it seems that in warmer countries the fatality rate is considerably lower than other places so far, and the overall fatality rate of about 4.5%, the highest 10+% being in Italy, being a cold nation and with a large number of elderly population.

Undoubtedly, in the developing nations, low testing is a big problem, including in India as well. However, there are no reports of people with symptoms crowding hospitals as there are in many other countries. And it is important to understand that if there are indeed many latent cases as is feared, that would actually bring down the fatality rate, if not the infection rate.

Even with limited testing, the average number of new Indian cases is in the region of 100-120 a day; it has been like that for a week. It means there is absolutely no evidence of exponential community spread till date in India. And that has so far been the case in all of the warm weather countries.

It is also to be noted that by quick testing, identifying and quarantining the affected people, the disease can be arrested and it has been done so in Japan, Singapore and South Korea. Hence, the focus has to be testing and treating more than merely closing down businesses. The challenge in India or South Asia is the high density of population that gives a fertile ground to the virus to spread exponentially with poor living conditions.

The virus once again underlines the fact that minimum human dignity in living conditions, housing, public health and sanitation are needed to ensure a controlled or disease-free world. More than the ferocity of the virus, it is the ferocity of the unequal society that we must be worried about.

It has also been observed that for every nine out of 10 infected people, they need two weeks to recover with no medicine, isolated at home, as they are in minor ailment situation. Seriously ill needing hospitalisation, ICU or ventilator together is below 10% at the moment out of the 7.5 lakh affected people.

So, the vast majority of infected people can just recover by staying at home, with no medicine, but in isolation. Even seemingly well-educated people don't seem to grasp this properly. Yes, this one-seriously-ill out of 10 infected persons is a matter of worry, and if this number is huge due to societal transmission at the mass level, there is every reason to worry specially in nations with weaker medical infra-structure.

Jaideep Verma's research shows that in human history, untreated illnesses and unvaccinated viruses have the following as fatality rates:
 

Rabies - 99%; AIDS 80-90%; EBOLA 87%; Smallpox - 65%; Bubonic/ Pneumonic Plague 52%; Tetanus 50%; Cholera 47%; TB 43%; Chickenpox 30%; Typhoid 15%; SARS 11%; Spanish Flu 10%; Zika Virus 8%; Yellow Fever 7.5%; Diphtheria 7.5%; Coronavirus 4.5%; Measles 2.5%; Swine Flu 2.1%. So, Corona virus has among the lowest fatality rates in history.


But, this is the first virus to travel so far across the world, some 199 countries. And it has been made a larger demon than it is in this world polarised more than ever before in human history by social media and mobile technology. A global virus in an intensely globalised world should not be a surprise at all, spreading during peak travel season, both, domestically in China and internationally. The virus itself is more contagious than most other viruses that came before.

The virus is actually making the world realise the difference between strategic anti-disease battle and a nonchalant lackadaisical approach. China with brute force closed down Wuhan city and largely its province, Hubei, created in ten days a COVID Hospital with 10,000 beds, isolated Wuhan/Hubei from rest of China, encircled it by sealing the border using military, brought in thousands of trained doctors and nurses from across the rest of China to treat the patients in Wuhan under heavy protection, and thereby restricted patients to some 81,000, deaths to less than 4000, and got 73,000 fully treated by now. Today Wuhan is safer than New York.

But, in contrast, the Western democracies, like Italy, USA, Spain, and France did not have any plan in place in the first three to five weeks when the disease appeared in their horizons, and thereby allowing them to get into mass societal transmission phase. It is the difference in strategy and not playing on to a fear psychosis when late, that helps.

There have been many pandemics in human history, many of them far, far worse than this one (in terms of fatalities). But the reaction worldwide has been fraught with anxiety and panic in the face of the uncertainty of having no cure yet. Incidentally, uncertainty is a condition that people in this new world (mobile social media) deal with far worse than any previous generation in history - this has been well documented and discussed in recent times. The spread of panic, false content, abuse of faith based narratives (gomutra cure being one), and many more have had multiplier effect on heightening the fear factor this time.

WHO estimates deaths arising from common flu to be between 290,000 to 650,000 people every year, at a fatality rate of roughly 1%. Corona virus has killed about 34,000 so far in about four months, with very limited testing in many parts of the world (truer testing would lower its 4.5% fatality rate considerably as many mild cases will be identified).

Jaideep Verma has dug out flu related deaths in Italy and US and has shown that over the last three years, the elderly population (above 60) dying due to flu related diseases have been high, which only marginally increased due to the additional reason of Corona virus this year. For example, in the 2017/28 flu season, the US registered 61,000 deaths from flu of the entire population, largely elders. That's an average of over 10,000 deaths a month! In the 2018/19 flu season, there were 34,200 deaths - that's 5,700 deaths a month. So far, there have been about 3,000 plus deaths from Coronavirus in the US, including all ages.

It is worth repeating this - the Coronavirus has killed about 40,000 in four months, while an average of WHO's tally of common flu deaths every year is about 39,000 deaths per month and critically, within exactly the same patient base. This is a huge point that will no doubt be explored in great depth by the medical fraternity in months to come. But it is worth thinking about this - what would happen if there was intense 24-hour media scrutiny worldwide on the common flu deaths - at the rate of about 39,000 a month worldwide? What would it do to our minds? If we discount the absence of uncertainty (as common flu has prescribed cures, which is why the fatality rate is low), would it not lead to a similar brand of panic that we see now?

Obviously, this is not at all a case to downplay the Coronavirus pandemic. It has to be combated, and the key ways are well-known by now - social distancing, regular hand-washing, quarantines, and closing down travel. A lockdown in places where there are signs of community spreading is definitely desirable. Even as a precaution, this is a good option, for a limited period.

But the pain of the lockdowns could have been reduced by calling for short lockdowns at an early stage of the spread so that it is nipped in the bud, which in India's case was not done. The first case in India was notified by PIB on January 30, and partial lockdown on March 16 in many states and national lockdown was announced on March 23, some 50 days later.

In between were bitterly fought Delhi elections, barbaric Delhi riots, megalomaniac larger than life celebrations of Trump visit to India, and toppling of government in Madhya Pradesh. If the lockdown had been preponed by two weeks, and a preparatory time of two days were given for it, as happened in Australia and New Zealand, we could have done much better. The lockdown also could have been focused on certain areas of initial spread rather than a national complete lockdown crippling the economy.

In the USA, lockdown does not mean curfew. People can still move, at a much lower quantum, only for essential work and purchases, offices still run on skeleton staff, but social distancing (rather, physical distancing) is being practiced regularly, along with gloves, masks, washing, drinking warm water (ideally lemon water) et al. For two out of three Indians, social and physical distancing is a misnomer with over-crowded homes, unhygienic shared habitats and so on. The concerns are there.

Moreover, WHO has recently said that lockdowns don't reduce cases by a great deal, but delay the spread for a while which can calibrate the rush at hospitals. In that light, in the complete absence of evidence of community spreading, decision-makers who are willing to pay the price by offering the lives of socially and economically disadvantaged people on this scale, with a large part of the middle and upper classes wholeheartedly agreeing with this move, shows the kind of country India has become (which is also apparent in the aggressive ostracisation of doctors in many upper middle-class housing societies lest they catch the virus from them, doctors, who are in by far the highest risk category).

Given the huge humanitarian costs involved in India with a lockdown (a country with the largest daily wage worker population in the world and where more farmers commit suicide due to starvation than any other), the costs are especially horrifying. Bihar government has literally locked down incoming Bihari migrants from Delhi in lock-ups as if they are criminals, and put in close proximity to one another.

UP government drenched many such incoming migrants from Delhi in chemical disinfectants to 'purify' or 'cleanse' them - chemicals which can otherwise create new diseases. Many regional administrations moronically comprehend that as "curfew", with no food and provisions available (for example, Chandigarh).

Highly arrogant authorities are making life worse for disadvantaged people, while some even tom-tom "shoot at sight" orders (like the Telangana CM did). Accounts of extreme distress are already emerging - multiple stories of migrant workers walking hundreds of kilometres in the hot sun just to get back home (with starvation as their other perceived option) or two container trucks traveling from Telangana to Rajasthan carrying 300 migrant workers desperately trying to get home, for example. At the end of three weeks, lockdown deaths may compete favourably with Corona deaths.

The author is a columnist, television panelist, media academic, and is currently the Pro Vice Chancellor of Kolkata based Adamas University, being earlier the Dean of Symbiosis and Amity Universities.

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