The next steps

Lockdown has helped, but testing must be scaled up

It is by now certain that the lockdown will be extended for a large part of the country. This decision is no doubt sensible, and many public health experts will agree that it is necessary to reduce India’s chances of reaching the community infection stage of the pandemic. The government has said without the lockdown, Covid-19 cases could have spiralled to 820,00 by April 15, and with containment measures and no lockdown, it could have gone up to 120,000. Yet that is not the only aspect of the issue to be considered. The government should also be working on a blueprint of how to combine controlling and tracking the spread of the virus, alongside a partial restarting of economic activity.

While there is little doubt that the lockdown would have averted a worst-case scenario in terms of infection, more testing and selective quarantining may have worked as well. However, deducing the exact nature of the change from India’s testing data is not a statistically sensible exercise, given how low the penetration of testing has been. The growth rate in the number of positive tests has certainly changed — till the third week of March, the number was doubling every three days, and now it appears to be taking more than that. However, this cannot be seen as a proper reflection of the prevalence of infection in the population unless the amount of testing is radically scaled up. This must be the priority for the government.

It is important to note that comprehensive lockdowns are not the only tool in the governments’ arsenals. Some East Asian countries have dealt with controlling the spread relatively effectively, using a high penetration of testing combined with quarantine measures and contact tracking. There has been a wide differential in terms of outcomes across various countries. On the one hand, it is obvious that San Francisco effectively locking down before New York, or Ireland doing so before England, has had an effect on the relative spreads in those places. On the other hand, countries such as Austria or Denmark have begun to lift their lockdowns. The virus has been far more fatal in Italy than in, say, Germany. It is not clear what is causing these significant differences across geographies, so the government should be open to alternative theories about control and spread.

What is certain is that a phased plan for emerging from the lockdown is needed, although much more widespread testing — for both infections and the antibodies that indicate a past infection — is needed. Contact tracing should also be beefed up so that it is possible to quickly identify hotspots. Once there is a clear map of where the virus is spreading more quickly — which can happen only after testing is far more intensive — it may be possible to design a plan which allows for quarantining or restricting those areas, alongside other infected, their contacts, and especially the vulnerable. It may be then possible to manage the reopening of the rest of the economy. Simply extending the lockdown is not an optimal solution. It is clear that there is still a great deal of work to do for the government, particularly in terms of scaling up testing.