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Saturday, Oct 24, 2020 10:45 [IST]

Last Update: Saturday, Oct 24, 2020 05:18 [IST]

Covid-19 2ndwave: Confusing signals call for better care & management

Dr.ALOKSHRIVASTAVA

The pandemic of Corona,it appears,is going to be longest one and most lethal in terms of casualties,having touched the mark of about 41 million cases resulting into 11,26,255 deaths globally.India is placed at 2nd spot with 1 lakh 15 thousand 923 deaths despite better or shall we say, impressivefatality, positivity (6.1%)and Recovery rates(88 %). With 'only' 7 lakh 72 thousand Active cases as opposed to about 77 lakh confirmed cases, its hitting the headlines for the overall "Slump" or downfall for more than a Fortnight.And at 44,913, on19th October, India's tally of fresh cases was lowest in 90 days(since July 21). Perhaps encouraged by these statistical stimulations,NitiAayog, has declared that Corona could be under"control" by February 2021.

All this should not mean that bright days are not far off.We must not forget that apart from forthcoming festive season stretching upto January 2021,early onset of winter is bound to play real havoc as people in general fail in cleaning hands,wearing masks properly or in observing social distance discipline.

While the top notcher USA has entered the 3rd wave, India, alongwith West Europe has heralded into the second wave for over a month.Whereas China,the country of "birth" is conspicuous by its 'absence' (allegedly having 85,407 cases and 4634 deaths), Taiwan,South Korea,North Korea & New Zealand have won the first round or wave.The vital statistics of Russia,too lately are a subject of debate apart from that of Brazil, three months ago.

Each time one attempts to scribble a few lines to commence another write up in public interest, fresh facts or "old wine in new bottle,” both emerge.  In a situation of tug of war between USA & China leading to latter under reporting of Corona figures, news pertaining to its economic "recovery" would surprise if not baffle. And perhaps the economists may have the "last laugh". It’s plain,not a sophisticated logic NOT to believe that China's economy is "reviving" with 4.9% growth in Quarter 3. GDP is reported to have got a boost with acceleration of retail sales,investment and industrial production,despite lagging behind of services sector,including tourism,travel and education. If based on verified facts,these may have boosted the confidence level of the factory and company heads,thus giving positive signals to the markets,if not reassurance per se.

When a leading Singaporean Researcher opines that successful handling of a health crisis by a country like China gives an indication about currents of recovery in economy, one may show some inclination especially at a time when
the world economy in general and an "Emerging Giant" such as, India, inparticular, is still experiencing a slump situation. It’s in the backdrop of return of not less than 22 lakh "migrant" workers to Bihar alone, leading to 23.5 % unemployment in April'20 as compared to marginal improvement of 21.73 % in May.
According to highlights of a study published in a national daily on 20th October,unemployment is being reported in double digits in as many as 10 states not only due to lack of jobs in the service and industrial sectors and usual joblessness in villages after sowing of Summer crops but it is very much also on account of low opportunities under MGNREGA,despite tall claims to the contrary by the Union and State Governments.Cases of Uttarakhand,Haryana,Tripura,J&K,Goa,Rajasthan,Delhi, HP, and Bihar could be considered definitely alarming according to the monthly data of the Centre For Monitoring Indian Economy. Two big states,Punjab and West Bengal too have near double digit unemployment.
In all these states, demand has been reported to be on lower side despite weeks of unlocking. So how can we believe that percentage of national unemployment fell to 6.67 % in September 2020?

Why only unemployment, the GST collection during more than two quarters too belies all expectations. When market borrowing by the states as an interim solution did not get requisite support, Centre has jumped the fray,perhaps as a compromise.But who and how to do debt servicing later, cannot easily be answered at a time when barely a "commitment" has been made for meeting the revenue loss to the states.

Having thrown some light on dismal economic factors, if one returns to statistical "magic or lotion" concerning Corona, the more than optimistic picture presented by the NitiAayog on its possible "control" by February 2021 may not lead to any hope in view of large assemblies expected during the Navratras,Durga Puja,Dushera,Deepawali,Chhath,Christmas and of course New Year.As per a survey about 30% people have already planned to break the 'ice' of home isolation at the earliest opportunity.

Bihar Elections
Less said about the 'contribution' of forthcoming Bihar elections to the mess, is better.When so much of flouting and confusion has taken place under the nose of ECI Observers already, barely 6 days prior to the phase I, one cannot imagine the mind boggling, rather worsening of Corona situation as further campaigning and electioneering pick up momentum, with or without violence. But is anyone bothered?
In first place, in the midst of such a precarious health emergency, this election should have been postponed.

Even if we believe the 'improvement' in Covid situation for three weeks or so,the overall shooting of Confirmed and death cases in the country is bound to increase our worries strangely in a situation when positivity rate has improved tremendously and the fatality rate is much better than many major and densely populated countries of the world.
Japan Research Finding

A recent Japanese research finding that Covid virus remains active on human skin for as long as nine hours is bound to shoot up the B.P.of senior citizens above the age of 60.Also there is a disturbing disclosure about those keeping pets.In one animal farm of South East Asia, Corona V 2 virus was passed on by one of the caretakers to an animal who is reported to have infected another human being without retaining any infection on its body.When one comes across all this, novo rich need to think and decide fast. Also the usual advisories of the Union governmentdo not make a dent. Rather unlocking ordered recently or relaxations announced & being executed must be REVIEWED every week on a State to State basis, or else we will add to the mess.

Rising Mortality
Coming to the Mortality or Fatality figures, situation developing fast in the least populous state of Sikkim will have to be adequately taken care of 63 deaths as against 3643 confirmed cases needsbetter  attention ,follow up and monitoring ,apart from slowing down of the Doubling Rate of Chhattisgarh and a few other states.
Total casualties in Sikkim appear on higher side when we draw a comparison with relatively larger and more populous states and UT's, such as, Nagaland(27),Andaman & Nicobar(56),
Ladakh(66),Meghalaya(75),Dadar& Nagar Haveli(2) and Mizoram(0). Incidentally, Mizoram is the only state,NOT to record any Corona death so far. Excellent performance indeed. Innocent people of these low contributors to the Central revenue certainly deserve a better deal.
Perhaps close assessment of recent relaxations, especially in respect of tourism,hospitality and travel, coupled with what PM said in his recent address"Flexible Lockdown", would definitely work.

Ten Vital States
We should not forget that despite improvements and emerging positive signals, ten states &U.T.'s still contribute to 75% of the confirmed cases in  India.Therefore, much better prevention,care & management of the crisis is called for in West Bengal,Kerala,Delhi, Maharashtra,Andhra Pradesh and Tamil Nadu.Among the prime or improved performers,Rajasthan and Bihar may have to be mentioned.Latter has recorded only 1003 deaths and tremendous jack up in quantum of tests, though its population exceeds 12 Crores.Delhi too performs nicely but rise in casualties, every now and then upsets the balance.
Confusion About Some Drugs & Plasma Therapy

To sum up,in this age of computers & internet and social media, we keep fiddling with the life of poor patients by experimenting with drugs, such as,HCQ,Remdesevir,Lopanivir,Ritonivir,Plasma Therapy etc but appropriate vaccine for Covid is bound to elude us till Mid2021.
Twice in the past,Plasma therapy has been discouraged/put on hold by the intervention of ICMR, yet, with a lot of fanfare,Plasma 'banks' were set up in renovated settings and inaugurated by wasting public money in many states, if not fully availed of.Now ICMR has again expressed its reservations as a study has found the therapy ineffective in reducing mortality among the severe patients.So it is likely to be  off the standard treatment protocol for management of the disease.

How do we respond to slow but certain rise in the cases of common cold, flu, dengue etc. or take up urgent but postponed surgeries? No comments.

(The writer is former Chief Secretary, Government of Sikkim)

Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi