Curfew & Covid-19: Cost Of Crowding Will Be More Than The Cost Of Curfew
Dr. Thangamuthu Jayasingam
Nature (online edition) heads today 31 March 2020 as “Coronavirus latest: lockdown in Europe could have averted tens of thousands of deaths.” Infection control measures put in place in many European countries – such as national lockdown- are reducing the corona virus. Across 11 countries in western and northern Europe between 21,000 and 120,000 deaths will be probably have been avoided by the end of march according to a new model by a group at Imperial college London.[1]
Isolation has been the tried and tested process of limiting the spread of contagious diseases over history and is well documented in the cases of diseases such as tuberculosis, small pox and leprosy. Many were considered as terminal illnesses and the isolation was to prevent others from being infected as cure was not possible at that point of time in history. Although vaccines have been developed for those diseases and they are not incurable anymore, we have had new examples over and over again requiring isolation as a best mode of reduction of infection in the system. Corona (COVID-19 Virus) is the latest in the series that had almost affected the entire world at different levels.
Different countries have approached the problem of coping with the infection differently, but ISOLATION has been the prime mode of spread control from China to Sri Lanka. It has been noted that the countries which were reluctant to make large scale isolations have had to eventually pay the price of escalation of the infection and then subscribe to isolation controls one way or the other. Many countries have today closed their borders, stopped internal travel and transport between cities and districts and also ships and flights have been cordoned off. These indicate the seriousness of the threat of infection by Corona Virus, as it stands today. The United States, one of the more affluent countries, has the highest number of suspected cases which go beyond 100,000 and the death toll is on the increase. They have no answer as yet.
WHO congratulated China on a “unique and unprecedented public health response reversed the escalating cases”. Early models of the disease spread without containment effort suggested that 500 million people would be infected (40% population). Within seven days of lockdown the number of individual gave the virus dropped to 1.05, amazing says Adam Kucharski of London school of hygiene and tropical medicine. The control measures worked says Christopher Dye, an epidemiologist at Oxford.[2]
Social distancing is a technical form of isolation to make the distance between the subjects far enough so that the probability of disease infection is minimized. This together with washing of hands frequently would almost nullify the chances of fresh infection from the Corona Virus. Sri Lanka had done well regarding the control of the spread of the Virus, though we started a little late as pointed out by some authors. But as ACKNOWLEDGED by many experts, commentators and institutions, the closure of many if not almost all institutions and imposition of curfew have been in the right direction towards curtailing the spread of the infection. However the recent curfew patterns in parts of the country and the relaxation of curfews questions the fundamental purpose of all these actions, whether we are considering isolation as a prime means of reducing infection or as a routine mechanism in the process.
It has been observable that the social distances have been higher during normal days in the cities whereas during periods when the curfew is lifted and people pour out onto the streets to make the best use of the windows of gap in Curfew, this has extensively reduced the social distancing in buses, offices especially Banks, shops, super markets, road side sales outlets etc. Once the infection has spread increasing the distance again by reimposing the curfew does not matter. The next level operates in the family and neighborhood and thus increases the epidemic.
The fatality rates are lower than the parellels viz SARS(severe acute resp[iratory syndrome), MERS( middle east respiratory syndrome and Ebola. But the infection also seem to spread easily than others.[3]
One infected person would be able to affect around 500 members with Coronavirus over a few weeks given the rate of spread of this Virus as 2-3 as suggested by many researchers. This could be brought down to nearly 50 or less by increasing the social distances which was the theory behind closure of schools, airport, universities, offices and declaration of curfew.
Best example from Seatlle: Bedfords team calculated that over the six weeks several hundred people could have been infected. Basic reproductive number is taken as between two and three and if we half this with mitigation strategies then the outbreak will no longer grow”[4]
However, the current management of curfew where a longer period of curfew is interspersed with relaxation of the curfew negates the principle that social distancing should be maintained, as it has reduced the social distances and negates the benefit of the social distancing during curfew to zoom into zero. This is evident in the hustle and bustle that is visible during the curfew break, when people rush out on to the streets and into the supermarkets, banks and pharmacies to stock up. T
Prof Kalinga Tudor de Silva states, “others were seen congesting at the grocery stores, markets despite all steps by health authorities to control the pandemic”. Panic buying is a nature“ I cannot blame the public entirely. They are scared about the provisions for their families more than the virus”[5]
There is a probability that we would, and could, be in the next cycle of the epidemic which will be worsened by this process of negating social distancing. This was very well explained by the GMOA Vice Chair, who was on the TV recently and I presume these worthy professionals have briefed this to the Government and the corona task force.
As stated previously, the bigger the social distance the lower the probability for infection to spread. However if the mean distance is high, but frequent pockets of crowds make low distances periodically then the spread is made in the pockets, which then could infect the others singly or as a group later. I have witnessed many examples from Batticaloa from my own experience and others from social and other media.
