BENGALURU: As local administrations in India prepare for a second wave, infections, two new studies that evaluated interventions such as lockdowns and travel restrictions in containing Covid-19, found that proper testing and exit strategies are crucial.
One study, published in the International Journal of Infectious Diseases in the first week of December, was authored by AIIMS doctors Giridara Gopal Parameswaran, Saptarshi Soham Mohanta and others.
“Imposing a lockdown during the first wave was a good decision, but the health care system wasn’t prepared to handle the exit then. We found that exit strategies played a major role in the increase in the number of cases. The study showed that aggressive measures like lockdowns may be inherently enough to suppress an outbreak, however other measures need to be scaled up as lockdowns are relaxed. Premature withdrawal of lockdowns without adequately planned interventions for the post-lockdown phase may lead to the second wave,” Giridara Gopal, co-author of the study told TNIE.
Globally, there has been an ebb and flow in cases, and countries have tried various means - including reimposing lockdowns - to contain the surge in numbers.
In such a scenario, experts believe that India too needs to be prepared and the crux of the containment tool kit would be the testing strategy.Gopal said that ascertaining the actual number of cases would depend on categorisation of testing.
“Presently, when we claim a certain number of infected cases, it is not very clear if that is the actual scenario. This is because we have various types of testing in India - Rapid Antigen Test, TrueNat, RT-PCR, etc. When testing strategies are different, the data can vary too. We will not know the exact spread of the virus,” he said.
Explaining, he said, “If the government tests one lakh people in an area where there are about 100 infected people, the positivity rate will be low. However, if they test in a place where 10,000 people are infected, the chances of learning the actual positivity rate is high. Meanwhile, testing categorisation like age group, whether the person was symptomatic or asymptomatic, what comorbidities they had, seroprevalence in an area etc, also plays a role. This data would help to draw actual models about the virus spread and plan strategies to handle the virus better,” Gopal said.
The researchers also noted that India’s socio-economic disparity needs to be considered.
Another study from The London School of Hygiene and Tropical Medicine (LSHTM), published in The Lancet Public Health on December 7 suggests that travel restrictions are effective in countries with low Covid-19 cases, or which have strong travel links with countries having high rates of infection.
Travel restrictions may have been effective during the early stages of the pandemic, but that the measures are unlikely to do much when the virus is spreading rapidly within a country.
“...these measures carry a high economic and social cost, so it is important that governments use travel restrictions in a targeted way... they should take into account local infection figures, epidemic growth rates, and the volume of travellers arriving from countries heavily-affected by the virus,” the study said.