Lancet India suggests some measures to curb Covid-19, says no to complete lockdown

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As the covid-19 cases surge in India, the Lancet India Task Force on Covid-19 has suggested a ‘containment measures checklist’ to the central government to contain the situation. It also asserted that these measures “must be done beyond the current binary discussion on a lockdown”.

It also recommends that variables like new cases per day (7-day moving average), rate of increase in new cases per day (2-week moving average), test positivity rates per day (2-week moving average), number of tests per million per day, and utilization rates of ICU beds be considered to decide on containment strategies.

Lancet has not given a nod to impose lockdown but it says that a series of actions are needed. It says there is targeted containment required and coordinated response. It suggested that the country must be divided into zones instead of lockdown.

As of April 25, India’s effective reproductive rate (R factor) for Covid-19 stands at 1.44. At this rate, each infected individual is infecting another one and a half persons. For the month of April, the rate of increase in reported new cases averaged 6.8 percent.

In the low risk zones, the rate of increase of new cases is less than 2 per cent and the percentage of ICU beds unutilized is more than 80 percent. In such zones, there should be unrestricted movement, open schools and colleges, shops, restaurants, offices, places of worship, factories can open with distancing and with 50 per cent occupancy.

In the medium risk zones, the rate of increase of new cases is between 2-5 percent, the test positivity ratio is between 5 to 10 percent and the percentage of ICU beds unutilized between 40-80 percent. In such zones, it should be ensured there is an unrestricted movement with advisories issued. Here, schools can be opened. Indoor confined spaces should be closed (specifics to be determined locally by consultation).

In the medium risk zones, the rate of increase of new cases is between 2-5 percent, the test positivity ratio is between 5 to 10 percent and the percentage of ICU beds unutilized between 40-80 percent. In such zones, it should be ensured there is an unrestricted movement with advisories issued. Here, schools can be opened. Indoor confined spaces should be closed (specifics to be determined locally by consultation).

In high risk zones, the rate of increase of new cases is greater than 5 per cent and the test positivity ratio is more than 10 per cent. Tests per million in hot spots would be less than 140 and the percentage of ICU beds unutilized is less than 40 per cent. Here, too, there should be restrictions on movement (with some exceptions).

Undoubtedly, Schools and colleges should remain closed till numbers fall to the medium risk category. Shops, restaurants, offices, places of worship, factories should be closed for a minimum of 6-10 weeks.