Spike in Covid-19 Cases Could Have Been Avoided if Migrants Allowed to go Before Lockdown: Report

The current spike in coronavirus cases in the country could have been avoided if migrants had been allowed to go home before the imposition of the lockdown when the disease spread was very low, a group of public health experts said.

The death toll due to COVID-19 rose to 4,971 and the number of cases climbed to 1,73,763 in the country, the Union health ministry said.

"The returning migrants are now taking the infection to each and every corner of the country, mostly to rural and peri-urban areas, in districts which had minimal cases and have relatively weak public health systems (including clinical care)," said a report by a COVID-19 Task Force comprising public health experts from AIIMS, JNU, BHU among others.

The report compiled by experts from the Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) and the Indian Association of Epidemiologists (IAE) has been sent to Prime Minister Narendra Modi.

India's nationwide lockdown from March 25 till May 30 has been one of the most "stringent" and yet COVID-19 cases have increased exponentially through this phase, that is, from 606 cases on March 25 to 138,845 on May 24, they said.

"This draconian lockdown is presumably in response to a modeling exercise from an influential institution which presented a 'worst-case simulation'. The model had come up with an estimated 2.2 million deaths globally.

"Subsequent events have proved that the predictions of this model were way off the mark. Had the Government of India consulted epidemiologists who had better grasp of disease transmission dynamics compared to modelers, it would have perhaps been better served," the report stated.

From limited information available in the public domain, the experts said it seems the government was primarily advised by clinicians and academic epidemiologists with "limited field training and skills".

"Policy makers apparently relied overwhelmingly on general administrative bureaucrats. The engagement with expert technocrats in the areas of epidemiology, public health, preventive medicine and social scientists was limited," they said in the report.

According to the report, India is paying a heavy price, both in terms of humanitarian crisis and disease spread.

"The incoherent and often rapidly shifting strategies and policies, especially at the national level, are more a reflection of afterthought and catching up phenomenon on part of the policy makers rather than a well thought cogent strategy with an epidemiologic basis," they said.

The experts have recommended constituting a panel of inter-disciplinary public health and preventive health experts and social scientists at central, state and district levels to address both public health and humanitarian crises.

It has suggested that all data, including test results, should be made available in public domain for the research community (clinical, laboratory, public health and social sciences) to access, analyse and provide real-time context-specific solutions to control the pandemic.

"A Public Health Commission with task-specific Working Groups may be urgently constituted to provide real-time technical inputs to the government," it suggested.

Highlighting that physical distancing norms need to be practiced to slow down the spread of infection, the experts said at the same time, enhanced social bonding measures need to be promoted to address mental health concerns of anxiety and lockdown.

They further recommended extensive surveillance for patients with Influenza like Illnesses (ILI) and Severe Acute Respiratory Illness (SARI) through clinical institutions (including private hospitals) and testing, tracing, tracking, and isolating with marked scaling up of diagnostic facilities.