The unlocking in a phased manner from June 14 may be the preferred way to gradually get back to normal living.
But it has thrown up major challenges to keeping focus on the larger objective - that of avoiding a deadlier third wave of Covid-19, especially when the vaccination programme is yet to cover over 95 per cent of the eligible population that is largely oblivious to Covid-appropriate behaviour.
The State Government’s decision to unlock has come when the current wave of the pandemic is still far worse than the first.
Although numbers are on the decline, it is only in relative terms. The daily additions to the Covid-19 tally are still high.
The highest addition in a single day during the first wave was 10,947 on October 7 last year. In the second wave, the highest single-day addition was 50,112 on May 5. On Saturday, it was 9,785, but still close to the highest count in the first wave.
On the Covid-19 death front, the highest number of fatalities in a day during the first wave was 179 on September 18, 2020, while the second wave’s highest was 626 on May 23. On Saturday, it was 144, just 35 short of the highest in the first wave.
The first wave’s peak in active cases was 1,20,929 on October 10 last year. But the number is as high as 1,91,796 on Saturday. This, while the vaccination drive is still far from covering a good percentage of the population.
PACE OF VAX DRIVE
Health Department data shows only 30.04 per cent of the estimated 16 lakh health care workers across the state are vaccinated. This is the largest segment vaccinated.
Merely 1.12 per cent of the two crore front line workers, just 13.73 per cent among the 1.66 crore-strong 45-plus age-group segment, and only 0.02 per cent of the 3.25 crore in the 18-44 age-group segment, have been vaccinated.
With just 29,94,425 of the 7.07 crore vaccine-eligible population vaccinated, a mere 4.23 have been covered so far. Dr Anand Ambali, vice-president of Geriatric Society of India and expert at BLDE Hospital, Vijayapura, says, “People aged between 18 to 45 years have to get immunized as early as possible. The vaccine is the only weapon to fight this virus. The government has to step up the vaccination drive to immunize the maximum number of people in the next few weeks.”
Dr Giridhar Babu, epidemiologist at the Indian Institute of Public Health, Bengaluru, and member of the state’s Covid-19 Technical Advisory Committee, says, “Meticulous micro-planning and energetic mobilisation campaigns are necessary to improve the vaccination coverage. Lessons from other supplementary immunisation programmes - such as measles - will be helpful. Besides, it is also important to address issues among population groups who have concerns about vaccines.”
According to Dr B Unnikrishnan, Additional Dean and Professor of Community, Medicine Kasturba Medical College (KMC), Mangaluru, as the third wave is likely to affect those who have not been infected, including children, it is important now to take stock at the local level and find out if we are prepared.
“The preparation should begin now. At the district level, micro-planning has to be done. Evaluate the resources available, as we have already seen a lot of deficiencies in resources in the second wave which was the main reason for the virus spread. Herd immunity can be achieved either by infection or by vaccination. So, vaccination is the key,” he says.
Dr S A Kora, Head of Department of Medicine at B V V Sangha’s S Nijalingappa Medical College and Hanagal Shri Kumareshwar Hospital and Research Centre, Bagalkot, says, “Although the government is geared up for unlocking, it has to enforce strict rules to prevent mass gatherings until 50 per cent of the total population is immunized.”
INTER-DISTRICT TRAVEL
The government has excluded 11 districts from the unlock phase, where lockdown restrictions will continue until further notice.
These districts are Bengaluru Rural, Chikkamagalur, Shivamogga, Davanagere, Mysuru, Chamarajanagar, Hassan, Dakshina Kannada, Mandya, Belagavi and Kodagu.
The positivity rate here is still on the higher side due to which inter-district travel from these places to districts where partial unlocking has been allowed is not allowed.
A major challenge seems to be people’s movement between Mysuru (which is one of the 11 districts where lockdown will continue) and Bengaluru as many native Mysureans who are working in Bengaluru and are planning to move to Bengaluru following the partial lifting of lockdown in the latter.
“Frequent shuttling between these two cities, especially when one of the districts is having a lockdown, might be a great chance for virus exposure. The district administration needs to focus on this. Also, movement of labourers from Chamarajanagar (also among the 11 districts) to Mysuru or Bengaluru can fuel the spread of Covid-19. This needs to be focused,” says V Santhosh, member of an NGO working in Covid relief in Mysuru.
Dr Kora says, “The district administration should restrict inter-district movement until the positivity rates come down below 5 per cent in the state. It is not just about the people, even movement of vehicles, excluding ones linked to health emergencies, should be restricted for the next two weeks.”
Dr Unnikrishnan of KMC says there cannot be a one-size-fits-all strategy. “It should be a district-appropriate strategy as every district has its own problems. Hence district-level focus is crucial to contain its spread.”
Dr B Rajendra Kumar, senior physician who is treating hundreds of home-isolated patients through phone and WhatsApp calls in Kolar, says as the district borders Andhra Pradesh and Tamil Nadu, and with several routes to enter the district, “The lockdown should have continued for another fortnight with existing stringent conditions.”
COVID-APPROPRIATE PUBLIC BEHAVIOUR
Experts have pointed out that with mutated variants of the SARS-CoV-2 viruses still on the way, it is of utmost importance for people to take responsibility for their own safety.
District Surgeon, Kalaburagi district Hospital, Dr Ambaraya Rudrawadi, says people tend to assume that the government’s step of relaxing the lockdown norms means being allowed to do whatever they like.
“If they start mixing with groups by attending fairs and programmes while forgetting to maintain social distance and not wearing masks, Covid cases might increase again. People should learn from the terrible memories of the second wave and follow Covid-19 protocol until the disease vanishes. They should realise that the government’s decision to relax lockdown is to enable leading a more normal day-to-day, and not to risk their lives,” he noted.
Dr Rajgopal Shenoy, a medical professional from Kasturba Medical College & Hospital, Manipal, says
"But they (the state government) should have taken consideration of population as another criterion for unlocking. Places which see big crowds should have more stringent containment measures. Public awareness about social distance is still poor and just out of fear of the police, people wear masks, that too not properly.”
He says at least for another four weeks, people should assume their place is locked and behave accordingly. Local administrations should keep an eye on garbage disposals as, during the rainy season, the fight is not just against Covid-19 but also to keep a check on diseases like malaria and dengue, which could complicate matters, he warns.
Geriatrician Dr Ambali says that as children are suspected to be more vulnerable in the third wave, they have to remain indoors and schools should remain closed till the positivity rate falls to below 5 per cent. At present, it is 8.76 per cent and reducing.
Health expert Dr Jagadish Nayal says, “Awareness among the people is a must. A majority of people even today think curbing the spread of viruses is in the hands of the government. That notion needs to be changed.”
MAJOR CHALLENGES BEFORE STATE GOVT
Inoculation drive
30.04%: Vaccinated among health care workers.
1.12%: Vaccinated among frontline workers.
13.73%: Vaccinated among 45+ age-group segment.
0.02%: Measly vaccinated among 18-44 age-group segment.
INTER-DISTRICT MOVEMENT
11 districts to continue lockdown with existing stringent conditions.
Fears raised over people crossing district borders.
(With inputs from Karthik K K; Marx Tejaswi; Prakash Samaga; Mahesh Goudar; Udaya Kumar B R; Divya Cutinho; Raghu Koppar; Prajna G R; Ramkrishna Badseshi; Thipperudrappa B; Mallikarjun Hiremath;G Subhash Chandra; & V Velayudham)