With Covid-19 cases spiralling, India will hit the one million cases mark by the end of next week. The number will spread panic and media might go bonkers over it. States like Kerala that were once touted as “models” and declared winners in the fight against Covid-19 are now back to implementing “triple lockdowns” to contain the spread of infections.

Karnataka, which was once basking in the glory of a low infection rate, is now busy considering the Kerala model of triple lockdowns for implementation in its crown jewel city, Bengaluru.

Let us be clear: there are no models that Indian states and cities can follow, either from global experiences or Indian ones. However, there could be small learnings from each experience, and each learning can be adapted by states and cities. India has to learn from its own experiences.

The two lessons one needs to learn are the ones no one is talking about as the numbers spiral.

First, you can’t kill the virus by killing economic activities and shutting down cities and states. Lockdowns and containment areas should be as small as possible: a house here, a lane there, not imposed on entire wards or districts or states or on transport in general.

What widespread lockdowns do is destroy the micro-economy and accentuate a shortage mentality among the people. Thus, in a crowded city, people will rush to buy essentials whenever they can, if necessary, by risking more infections. Lockdowns essentially kick the can down the road. We keep current infection rates down and encourage future spikes.

Second, this fight can’t be won by state interventions alone; the war has to be waged by every Indian, every company, every infected person, and every person at potential risk on his own. What the state can do is rapidly scale up the healthcare infrastructure so that the most serious cases can be prevented from succumbing to the virus.

If we accept these two propositions, what states and people must do are quite clear.

#1: Communicate, communicate, communicate: Everyone, from the PM and his ministers down to chief ministers and their ministers, municipal commissioners, ward officers and city councillors, village panchayat pradhans, MPs, MLAs, corporate and community leaders must speak the same language of citizen responsibility – and loudly.

This not only means keeping as much of physical distancing as possible in public places, but also hand hygiene, masks and gloves. What governments can do is make these freely available to anyone who wants them. Every one of these leaders must repeatedly and consistently give the same message as often as possible, even if they sound like stuck records.

#2: Use technology for contract tracing, testing and quarantining. The preventive methods go without saying, but clearly from now on, as the numbers head into the millions, physical contract tracing is not going to be effective. Consider the kind of state capacity and manpower you need to keep track of the millions who may have been met by infected persons when they didn’t know they were infected. Consider also the impossibility of tracking the movements of lakhs of people who have been asked to home quarantine.

The only real alternative is the use of technology, including the Arogya Setu app. Privacy concerns should be temporarily suspended in order to protect public health. Contact tracing should be enabled through this app and also other means so that warnings can be sent to the people concerned to either quarantine themselves or get themselves tested.

But the app isn’t enough. We need cheap gadgets and GPS tracking devices that quarantined people can be asked to wear so that they are not tempted to cheat and infect more people unknowingly by wandering around the neighbourhood.

#3: Effective focus on data, analysis: The current obsession with total infection rates actually stampedes both the public and state governments to impose lockdown and draconian measures. The media must be encouraged to report active cases as the main headline number daily, and not the cumulative totals since January-February.

Consider the fact that as at the end of 9 July, total cases had risen to 793,802, but active cases were far lower, at 276,685. We should not spook ourselves by going for the highest available number.

Recovery and mortality rates are also important to track. Total recovery rates – which come with a lag after one is cured – should be an important number to emphasise. There is no point in panicking people when mortality rates are far lower than for influenza or monsoon diseases.

#4: Offices, transport and commercial establishments should be asked to follow SOPs, and take Covid-19 insurance on behalf of all their employees. Prescribing limits on how many people can work in offices is needless micro-management. Companies and malls should be penalised not for the occasional Covid-19 case in their midst, but for not following SOPs or providing for the care of the infected or quarantined.

#5: Ramp up, ramp up healthcare: One can look at the Covid-19 pandemic as a threat or an opportunity, an unavoidable drain on resources or an investment for the future. India has a golden opportunity to ramp up healthcare facilities in cities and towns and villages as never before. A 70-year deficit in investment should be made up in the coming two years, and these will serve us forever, providing sustainable jobs for the future.

We also have an opportunity to end the healthcare monopolies of high-cost doctors and hospitals. One wonders why ayurvedic and unani doctors, who have as much of an understanding of human physiology as MBBS doctors, should not be roped into the fight against Covid-19, and also be allowed to prescribe basic allopathic drugs and refer serious cases to specialists. The closed-shop mentality of our high cost healthcare system must be decisively ended.

Above all, we have to junk the lockdown mentality which is defensive and self-defeating, to take the offensive and fight Covid-19 on the latter’s turf, with vaccines and cures and care.

Lockdowns undermine our economic and physical abilities to fight back. Triple lockdowns may be okay for a state with little economic activity, but not for states that are engines of growth like Karnataka.

Physical Contact Tracing

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