Bangalore- No Lockdown…Atleast do this!!!
Tags: Corona, Covid 19, Coronavirus

It is increasingly becoming clear that 7 days lock down will not be extended. Lock downs have severe economic and social effects which probably may be deterring the governments to take these steps.

However without commenting on the decisions taken, I would at least urge the government to do the following to bring down the incidence of corona cases in Bangalore City.

Action 1: Test 20000 people per day only in Bangalore. Keep increasing the tests every week to reach a peak of 30000 per day. Keep the numbers at 30000 per day for next 60 days.

Test positive ratio should come down to 2%.

Do not worry about the numbers !!! Only bother about severe cases which require hospitalizations, rest can be managed from home ( 80% of cases in Delhi was managed from Home ).

Action 2: Maintain 2500 contact tracers( drawn from state government employees and contract employees) and trace back the people and ask them to go on self isolation in a separate room for 14 days. Atleast two lakh people should go on isolation. This is very nominal compared to other cities.

New york has 4648 contact tracers.

Action 3: All citizens of Bangalore who have symptoms like Fever, Cough, Sore throat, fatigue, Loss of Smell and Taste and below < 50 yrs to self isolate for 14 days and inform the authorities. Their family members to self isolate for 7 days.

Isolation in this cases may be more important than speed of test.

So immediate announcement to public that they should self isolate and mandatory reporting will bring out all symptomatic people in the city out. Contact tracing them immediately will bring more on isolation.

Action 4: All citizens > 50 yrs and those vulnerable ( cancer/kidney disease/heart disease and others ) to go for reverse quarantine where they will not meet more than one person and are given separate rooms and toilets with ventilated room.

Wherever it is not possible, at least mandate the use of N95 masks or Surgical Masks for such cases even with in the household. Cloth masks may not be effective for vulnerable( WHO guidelines)

Mandate all workplaces to give these age groups and vulnerable group to work from Home.

Action 5: Restricting gatherings to only groups of 10 and only in open Spaces. Restricting Public Transport within Bangalore and avoiding the spread to other district by reducing the mobility is key.

Action 6: Smart Lockdowns- Identify clusters with in cities and continue the lockdown in regions with high test positive ratio, high deaths and also highest number of cases. These clusters should be sealed off and lockdown should be continued in this place, till the test positive ratio is below 5%, deaths are decreasing and cases are also decreasing. This is also in compliance in National Guidelines

Action 7: Adapt Odd even policy for Vehicles and also implement Wednesday/Sunday Lockdown. There is a basis for this based on a IISC study. This will have little impact on the businesses.

Action 8: Do not open Restaurants, Bars, Malls, Temples, Churches, Mosques and other places where high congregate settings may lead to more spread of the disease. Retail and Entertainment centers should be strictly regulated to maintain all the Name and Phone Numbers of the visiting persons for contact tracing.

Action 9: Mild Symptoms can go on home isolation. All patients with moderate breathing issues ( whether covid or non covid) should be given a first aid protocol in any hospitals like Oxygen Therapy and the first set of treatments like Remdesivir, Dexamethasone, Heparin to avoid the cases going into severe pneumonia cases. Quick action in this case by acting without waiting for the covid confirmation can save lives. The current problem of no reasonable care would also be solved if this approach is taken by the government. The treatment protocol and ICU protocol mentioned in the article below can be used.

Action 10: Monitor Oxygen Bed Capacity, ICU Capacity and Ventilator Capacity. Avoiding ICU should be the primary strategy. Early treatments and Oxygen Therapy has reduced deaths in many places. Recruit large number of nurses and junior doctors to provide these services. If possible open 1000 bedded Viral Pneumonia Hospitals to tackle large number of people.

Additional Oxygen Bed Capacity — 6000- 8000 beds

Additional ICU beds — 2000 beds

Additional Ventilators — 500

Action 11: Conduct Zone wise Fever Camps and do door to door screening for symptoms. In Chennai, 10 lakh door to door screening was done in 14 days. This can be achieved and symptom based isolation can work in this case.

Action 12: Special incentives to doctors to save lives. Additional pay to medical staff. Universal Testing of all medical staff and doctors. PPE’s, Masks and additional protection to doctors on front line and insurance of Rs 50 lakhs for all doctors who are in COVID war should be done. This is a health issue and only enhancement of health infrastructure can solve this problem.