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Covid-19: an answer will now help mitigate the impact | Opinion – analysis


So far, some of my friends have asked if we are in panic mode and overreaction to the new outbreak of coronavirus that has spread from China to more than 100 countries. After all, what are 40 cases in a country the size of India where an estimated 22,000 people die each day? Is all the attention Covid is receiving justified? After all, isn’t the common flu much worse and we don’t pay much attention to it?

Let me clarify. Covid is not like the common flu. The estimates we have of lethality (proportion of infected people dying) is approximately 20 times greater than the common flu. Each year, influenza infects approximately 300-500 million people and kills about 300,000 to 500,000 people. Now, imagine if there was a new strain that would infect as many people as the flu but kill 20 times more people. Then we are seeing a mortality figure of approximately six to 10 million people, with approximately one sixth of this in India. An additional million deaths, even in a country the size of India, is a significant figure.

The 1918 flu pandemic, which killed about 50 million people worldwide, had a lethality rate similar to what we are experiencing with Covid-19. Until we have clear evidence that Covid-related mortality is much lower than what we have measured so far, we simply would not want to risk a large number of deaths. For comparison, the excessive number of deaths would be twice that of HIV / AIDS, tuberculosis and malaria combined.

Any disease is easier to stop at an earlier stage when we can prevent its spread through the main approach used now, which is contact tracking. This method, which was also widely used in India for previous disease control efforts, including smallpox, involves talking with infected people, determining who they may have been in contact with, and then tracking those other people to detect signs of infection. . It takes a long time and is painful, but there are people in the government who are doing exactly this at the moment. They know very well that contact tracking only works when we have fewer than 1,000 cases. Once the number of cases exceeds this, we have no easy means of containing the spread, except for closing most of the economy.

People point to the declining cases of China as evidence that the disease goes away on its own. It is true that all infections decrease after a peak. But we must understand what it took China to do this: it quarantined large cities the size of Delhi. They had the means to shut down all activities, deliver food to every home every day, create huge makeshift stadium hospitals where they could care for patients, and screen hundreds of thousands of patients.

These are measures that would be difficult to implement in a country like the United States and almost impossible in India. It is not that the government is not trying hard enough. It is simply that we, as a society, are not prepared for that kind of state control over people (and for good reason, in the absence of an outbreak of disease). Therefore, the main way to contain the outbreak is through our individual actions: social distancing, avoiding unnecessary trips and meetings, frequent hand washing and taking our hygiene into account, which includes avoiding touching our faces often, sneeze and cough. the air and spit. Our namastes They are certainly useful, but spitting, which is still very common, is not.

In many ways, it is better to bother at this stage to stop the epidemic. If we succeed, there will be armchair critics who will affirm that we overreact. But containing the epidemic would itself be the result of our robust reaction. What would you rather we do? Wait and see how bad things get before trying to reverse an epidemic that would have already infected millions of people?

All this does not mean that we should panic. Panic is counterproductive. Simple measures that have been repeated by public health experts are all we need to be sure. While I am confident that the epidemic will be contained, I also believe it will be because we act responsibly as individuals and collectively as a society. If we bet Covid dies from the heat or suddenly disappears, that could happen, but he wouldn’t bet the lives of millions of Indians.

Ramanan Laxminarayan is a researcher at the Center for Disease Dynamics, Economics and Politics, a public health research organization based in Washington DC

The opinions expressed are personal.

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