NEW DELHI: As the three-week nationwide lockdown is nearing an end in a few days, a group of top epidemiologists is busy brainstorming the medical parameters that will determine its extension, fully or partially.
A 12-member group under the community medicine expert Dr D C S Reddy has been formed by the national task force on COVID-19 to come up with an evidence based recommendation on the lockdown.
It has so far evaluated issues like rate of progression of the infection transmission in various states, extent of contact tracing and isolation of suspects, death patterns and the preparedness of health systems to deal with the rising cases.
The group includes several prominent virologists, infectious disease experts and epidemiologists working in institutions like the National Centre for Communicable Disease, AIIMS, Delhi, World Health Organisation, Indian Council of Medical Research and Public Health Foundation of India.
“We are likely to finalize our proposal by the end of the week,” one of the group members told The New Indian Express. “We are looking at the medical angles that will be the basis of relaxation or extension of the lockdown but of course these are larger administrative issues that will also take into account the economic issues,” he added.
A mega plan on the exit strategy proposed by the Centre, meanwhile, has suggested that states will be divided into four categories and lifting of lockdown and resumption of nomal services will be planned accordingly.
Government sources maintained that a complete lockdown could be extended in areas which have turned into coronavirus hotspots but some relief could be expected in areas where no fresh cases have been reported in the last seven days.
However, a new set of restrictions may be put in place if new cases come up in those areas.
“It is obvious that the the lockdown cannot be lifted in one go and therefore the draft exit plan suggests that the categorisation of states will be done based on the number of people infected by the virus,” an official in the Union Ministry of Health and Family Welfare said.
For instance, states with the highest number of cases will be in Category 4 and remain under complete lockdown and all non-essential services will remain suspended. States and districts with two or more cases per 10 lakh population are likely to be in this category.
Category 3 will have states and districts with 1-2 cases per 10 lakh population. In these states, the lockdown will continue, but some restrictions might be eased along with essential services.
Category 2 will include states where there is one or less than one case per 10 lakh population and Category 1 will include those states that have less than 5 cases and no new cases have been reported in the last seven days.
Under the proposal -- which is set to be reviewed -- railway, bus and air transport services may be eased for states falling in Category 3 but this relief may be limited within the states as inter-state travel will remain suspended. The coronavirus-hit states will remain isolated and entry and exit into such states will not be allowed.
While travel restrictions may be eased for states under Category 3, economic activities, educational and other services will remain suspended.
For states under Category 2, educational and economic services may resume after a go-ahead from the authorities. Road, rail and air transport services will resume in these states but travelling to Category 3 and Category 4 states will not be allowed.
The draft plan also proposes no restrictions will be imposed on states which fall under Category 1.
Public health experts meanwhile said that the government could now adopt a risk stratification approach.
“Areas with a cluster of cases testing positive or deaths could be completely contained with absolutely no movement in and out. The next high risk zones would be where there is evidence of seeding with either travel history or links to a hot spot,” said Dr Oommen John.
“Here again, the attempt might be to keep minimal inflow and outflow of persons. High population density areas would be under careful watch and dip stick surveys like the pooled testing could be a strategy to identify the high risk zones,” he added.