Irrespective of lockdown, aggressive mitigation strategy should continue even as cases decline

Delhi is beginning to open up in a phased manner though technically the on-going lockdown still continues in its seventh week. There are going to be conditional relaxations for construction works and manufacturing units. This planned unlock starts in the city that was battered by a second wave of Covid-19 with 28,000 daily new cases and the highest positivity rate of about 35 per cent on April 26.

Lock-downs along with aggressive testing, tracing, tracking are time-tested suppression strategies which aim to reverse or slow the upward trajectory of pandemic growth. Lockdown helps in reducing case numbers by restricting people's movements and social distancing the entire population thereby decreasing pressure on health-care systems. The lockdown has to be followed by aggressive mitigation strategy with the intent of reducing demand of peak health care infrastructure and reducing fatalities and hospitalizations.  Timely lockdown such as this one did achieve its target as numbers have been dropping steadily bringing the positivity rate down to 1.5 per cent and new infections to around 1000.

In ideal conditions public health experts would like to sustain these reduced numbers for longer periods  for a gradual relaxation in restrictions.Since we are at  the end of the lockdown which is imminent, the question that arises in our minds is what next and how do we go about resuming our personal, professional and every day social life. 

Relaxations in restriction of movements will pose challenges as the city heads back to normalcy. We need to be extra careful when the infection rates are low in our regions but are seeing in other parts of the country or in other countries. In fact this is the time to intensify preventive strategies.Surely, we can't take being free of Covid-19 for granted after the lockdown ends - especially as newer variants are emerging every now and then. There is no room for complacency as next the few months  are going to be a big challenge to maintain low levels of transmission as well as  prepare for an imminent risk of impending wave of Covid-19. Many experts have been writing about multiple waves in coming months including in my own columns in this newspaper since June, 2020.

The well-being of our people and communities should be  our highest priority, and in line with public health advisories, we should be  taking all necessary steps to ensure ongoing safety as well as protection from virus.This can only be achieved by the following strategies:

First, campaign for masking should not be lost in the noise of virus, variants and vaccination.The mask compliance has to be one hundred percent whether indoors or outdoors. Masking will take care of all variants and is as effective as vaccine.This has assumed greater significance since we now know air borne transmission is the major way of virus spread.

Secondly, to safeguard ourselves and others , we should continue with the stay-at-home advisory even during the phased relaxation and not be part of crowds. The pandemic is not over until it is actually over in all states and majority gets vaccinated and virus does not have adequate number of susceptible individuals to infect and survive.

Thirdly, testing plays a major role in controlling the surge . We need to adopt aggressive testing and maintain daily target of one lakh tests in Delhi inspite of low number of new cases. Delhi has been testing the maximum numbers per million population in the country so far which has helped Delhi in overcoming this wave. We also need to increase genomic sequencing, the single-most important parameter to identify emerging variants and predicting new waves.

Fourthly, there is no option but to vaccinate everyone in the city.No one is safe until everyone is safe. This pandemic will end only and only by vaccination. The next few months, during phased unlocking with low new infections, gives us the ideal opportunity to inoculate as many people as we can. 

Everyone knows the drill of Covid-appropriate behaviour. The important thing is to adopt and practice it regularly and strictly. There is absolutely no room for complacency as we move out of lockdown in the next few weeks. We need to be proactive and chase the virus aggressively rather than being reactive with the virus chasing us.

(The author is Head of Neurology Department, Lady Hardinge Medical College, New Delhi. The views expressed are personal.)