How to Control Covid-19 Without a Lockdown (By Ashwin Tombat)

By Ashwin Tombat
19 April 2020 16:22 IST

On Thursday, Congress leader Rahul Gandhi suddenly emerged from a long hibernation to address an hour-long video press conference on India’s response to the Covid-19 pandemic. A few of the things he said made a lot of sense.

But the problem is, no one takes Mr Gandhi seriously – not even the chief ministers of his own party.

On Wednesday 12 February – more than two months ago – Mr Gandhi in a tweet had urged the central government to put in place necessary systems to combat the imminent dangers that the ongoing coronavirus outbreak could pose to India.

He was expectedly mocked by the BJP, which accused him of unnecessarily spreading panic.

But what was most surprising is that the three Congress-ruled states of Chhattisgarh, Punjab and Rajasthan, as well as the two states where the party is in a coalition government – Maharashtra and Jharkhand – did not take a single step to combat the coming contagion. Wasted words indeed…

Even as Covid-19 was ravaging China, and had spread to Iran and Italy, 27 crowded mega-events were held across India during February and early March, including the Shaheen Bagh sit-in in Delhi, three international festivals in Rajasthan, the Carnaval and Shigmo parades in Goa and the crown jewel of them all – the one-lakh strong ‘Namaste Trump’ rally at Ahmedabad on 24 February.

India could have acted against Covid-19 in February itself, or even earlier. Had it done so, the ongoing lockdown – and the absolute devastation it is wreaking on this country’s economy, especially its poorest people – might not have been necessary.

You may say it is convenient to say things in hindsight. And you would be right.

But one country did move quickly and decisively, as soon as the danger became known. That country is now reaping the benefits of its actions.

Taiwan is the country closest to China. In a study conducted in January, Johns Hopkins University said Taiwan and HongKong were the most at-risk areas outside of mainland China for coronavirus, owing to their close proximity, ties and transport links.

But Taiwan has managed to keep the Covid-19 pandemic completely under control without any lockdown. HongKong has not been quite as successful. But it is not under lockdown, and still has the Covid-19 infection well under control.

Let us look at Taiwan, which is the country that has kept the Covid-19 pandemic under control with the greatest success worldwide.

With 24 million people, Taiwan has around the same population as Australia, a country that is reported to have tackled the Covid-19 pandemic fairly well. As on Wednesday, Australia had over 6,500 cases and 63 deaths, while Taiwan had less than 400 cases and only 6 deaths.

Taiwan never implemented a lockdown. Schools and businesses have continued normal operations. Among its early decisive measures was the decision to ban travel from many parts of China, stop cruise ships docking at its ports, and strict punishments for anyone found breaching home quarantine orders.

Alongside, people were educated. They were required to wear protective masks, keep physical distancing, avoid gatherings of any kind and strictly follow Covid-19 precautions.

It was on 31 December 2019 itself, the very day when China first officially notified the World Health Organization (WHO) about an outbreak of “pneumonia of unknown cause” in Wuhan, that Taiwan got into action. Officials began to check passengers of direct flights from Wuhan for fever and pneumonia symptoms as they left the plane.

Starting 5 January 2020, all individuals who had travelled to Wuhan in the past 14 days and had a fever or cough were screened for 26 viruses, including SARS and MERS, and quarantined at home. The SARS-CoV-2 virus, which we now know as Novel Coronavirus or Covid-19, had not even been identified by then as the cause of the Wuhan pneumonia outbreak.

On 20 January, sporadic cases of ‘Novel Coronavirus’ began to be reported from China. Taiwan immediately banned travel from all affected regions of China.

It implemented a list of 124 specific actions, including border control from air and sea, case identification and tracking, quarantine of suspicious cases, reassurance and education of the public, fighting misinformation, formulation of policies for schools and childcare, and relief for affected businesses.

Taiwan relied on immigration controls, extensive testing and contact tracing, and strict quarantine measures, along with tightly enforced nationwide physical distancing policies to control the pandemic.

The government created a stockpile of 44 million surgical masks and 1.9 million N95 masks, and prepared 1,100 negative-pressure isolation rooms. It used military personnel to increase production of Personal Protective Equipment (PPE).

Daily press briefings included when and where to wear a mask, the importance of handwashing, and the danger of hoarding masks. It made plans to assist schools, businesses, and workers who had lost jobs.

Consequently, it never required a lockdown.

A lockdown cannot defeat the virus. It can only buy time, so that a country’s medical systems are not overwhelmed by too many people getting infected and requiring hospitalisation all at one time. As Rahul Gandhi said on Thursday, it is only a “pause button” for the pandemic.

The pandemic can be tackled only by breaking the chain of transmission – through strict physical distancing and tightly quarantining those who are infected and have contact with the infected – till a cure or vaccine is developed. Taiwan has shown that a lockdown is not essential for this.

A report published in the prestigious Journal of the American Medical Association (JAMA) last month said that Taiwan’s government implemented lessons learnt from its experience with the 2003 SARS outbreak. "Taiwan is an example of how a society can respond quickly to a crisis and protect the interests of its citizens," the report concluded.

Both Taiwan and the USA reported their first Covid-19 case on the same day, 21 January. Taiwan had already moved into action well before that date. The USA delayed its response. Today, it is the worst affected country in the world…

India identified its first Covid-19 case on 30 January. But unlike Taiwan, our government did not swing into action. It allowed life-as-usual to go on. In some things, it has dragged its feet even when advised to the contrary.

On 27 February, WHO advised all countries to create stockpiles of PPE for medical workers. But the central government prohibited exports of PPE only on 19 March. It took another five days to ban exports of ventilators.

Only on 20 March did the government allow those with severe respiratory ailments but no travel history to be tested for Covid-19. Testing of health-care workers started only on 24 March. Before this, only symptomatics with a travel history and those they were in contact with were tested.

The lockdown has even had unintended consequences for India’s fightback. It barred factory workers from going to work, leading to a shutdown of the medical-device industry. It sealed state borders, preventing transport of goods to hospitals…

It has been a terribly debilitating lockdown. The worst immediate sufferers have been migrant labour and daily wage workers, but the overall economic calamity – for all Indians – will become clear sooner rather than later. The irony is, had the government moved swiftly enough at the very start of this crisis, this lockdown might not even have been necessary.

Disclaimer: Views expressed above are the author's own.

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Ashwin Tombat

Ashwin Tombat has been the Editor of Gomantak Times and Herald. Worked as an Associate Editor of national magazine Gentleman in Mumbai, before shifting to Goa. Loves sailing, also participates in Marathons. Has worked as an activist in students's union and trade unions in Maharashtra. Also an artist of Street Theatre during student days.

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Previous Comments

Tombat, good write up.

Please realize Taiwan is an educated (not just degrees) and cultured society. They have values and are guided by science and facts-- the composite society as a whole. Because it is in their genes, their ancestors had common values and virtues and came to south and set up the country. In 'Bhaaji Puri' culture such as India, lock down is the only solution. And there are some in the media whose only objective is to oppose the establishment, no matter what.

BTW, I also enjoyed your writings in Gomantak Times, where you were an editor, several eons back. Good luck.

- Jeevan, USA | 22 nd April 2020 22:35


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