‘Multiple factors will determine success of shutdown’

The effectiveness of the 12-day ‘complete lockdown’ in Chennai and its surrounding districts in combating the spread of COVID-19 will depend on multiple factors, public health experts and epidemiologists have said.

From surveillance and testing to simple measures like handwashing and wearing of masks and the cocooning of the elderly and other vulnerable sections of the population, there are several factors at play.

“Basically, what we need is aggressive surveillance of symptomatic persons in the most-affected wards of Chennai,” an epidemiologist said. “All wards do not have the same number of cases. There are streets within these wards where cases have spread widely, and hence we cannot rely on contacts. Anyone who develops symptoms of fever, sore throat and breathlessness should be tested immediately,” the epidemiologist added.

It takes 24 to 48 hours for the COVID-19 test result to arrive, and during that period, the individual concerned should remain under home quarantine, the expert said. “The areas are congested, and when people roam around, they pass on the infection to others. This is how cases have spread in Chennai. We have failed to quarantine people at the time of testing. If the test result returns positive and if the individuals concerned are residents of a congested area, they should be shifted to a COVID-19 care centre, while middle-income groups can be advised to remain in home isolation,” the epidemiologist said.

Noting that the lockdown had no effect in slums, the expert said, “We need to reduce the amount of time an infected person is out there in the community. We need to detect symptomatic persons, quarantine them while they are being tested, and isolate them if they test positive. Only then will the lockdown be effective. Otherwise, it will be a failure.”

Listing a few ways in which the lockdown could be effective, former city health officer P. Kuganantham said, “It will help in preventing the unbridled movement of people in thickly populated parts of the city. We can draw up strategies to prevent deaths, which have been gradually rising over the past two weeks, and look for new ways to curb the rampant spread of the infection by revisiting the prevention and control measures that are already in place.”

He said that the lockdown should be utilised to improve focused testing of vulnerable groups and persons with co-morbid conditions. “Besides, it should be used for finding better ways to treat symptomatic and critically-ill patients at tertiary care centres instead of asymptomatic patients, as it causes a burden on healthcare workers,” he added.

“The maximum benefit of a lockdown can be attained only if people adhere to the guidelines on regular hand washing, wearing of masks in public places, protecting the elderly and other vulnerable sections and seeking medical care and testing early,” said K. Kolandaswamy, former director of public health and preventive medicine. He reiterated that hand washing could cut the chain of transmission. “Handwashing facilities should be created in private establishments and public places,” he said.

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