Lockdown to have longlasting impact on nation’s health, says ICMR

Ghughuti Bulletin

https://www.livemint.com/news/india/lockdown-to-have-longlasting-impact-on-nation-s-health-says-icmr-11586370925642.html

NEW DELHI :
The government’s apex biomedical research body has said the novel coronavirus-induced lockdown will have a longlasting impact on the health of the nation and that the travel bans currently in force are unlikely to have any effect in the short and medium term.

The observations by the Indian Council for Medical Research (ICMR) come at a time when the government is considering extending the 21-day lockdown. ICMR described lockdowns as a “drastic public health measure”.

In a review of the current evidence on covid-19, published in the latest issue of Indian Journal of Medical Research, ICMR said the experience of Wuhan, the Chinese epicentre of the pandemic showed that while the benefits of a lockdown remain to be seen, its long-lasting negative impact should not be underplayed.

“Such drastic measures can lead to social, psychological and economic stressors on the whole population, leading to long-lasting adverse health outcomes,” said lead author Dr Pranab Chatterjee, translational global health policy research cell-ICMR, in the paper, which is aimed at informing India’s public health response.

Instead of coercive top-down quarantine approaches, it said community- and civil society-led self-quarantine and self-monitoring could be more sustainable and implementable strategies in a “protracted pandemic like covid-19″.

Reviewing the World Health Organization’s (WHO), International Health Regulations (IHR) that are an international legal instrument that is binding on 194 countries across the globe, the ICMR paper said that in keeping with these regulations the health ministry had banned all travel to and from China. However, it cast doubts on the medium- and long-term impact of such travel bans.

Gaps in the current evidence literature leave the Indian healthcare system with little choice but to prepare for combatting a potential epidemic spillovers in the years ahead.
Gaps in the current evidence literature leave the Indian healthcare system with little choice but to prepare for combatting a potential epidemic spillovers in the years ahead.

“Modelling studies suggest that in the short-term, these are unlikely to have meaningful impact on global transmission of SARS-CoV-2 (covid-19), unless sustained 90% travel restrictions are implemented in combination with more than 50% reduction in local transmission,” said the authors.

Such bans may only provide a symbolic shield unless the ongoing outbreak is also staunched. It said the long-term impact of travel restrictions and red-lining of affected areas on the economy, agriculture and mental health is unknown.

The ICMR paper said gaps in the current evidence literature leave the Indian healthcare system with little choice but to prepare for combatting a potential epidemic spillovers in the years ahead.

“When the first cases emerged in December 2019, bats were likely in hibernation, and if there was an intermediate host, it might have played a role in continuing local transmission of the virus. Hence, despite there being about 89% similarity with the genomic sequence of SL-CoVZC45 and bat-SL-CoVZXC21 (both bat viruses), there still remain doubts regarding its direct ancestors,” the study said.

While bats have been implicated as the “original reservoirs” of the virus, given their wide flight-range in Asia, specific host control is difficult and unrealistic. Also, there may have been an “intermediate reservoir”—a live animal being sold in a Chinese market.

Extensive research on bats carried out by the National Institute of Virology, Pune may provide critical insights for any “spillover event” of the pandemic, the study said.

Going by current evidence, it is difficult to say whether this virus will become entrenched, with endemic, seasonal or annual epidemics (like pandemic H1N1 influenza), or whether it will “extinguish”, like SARS.

The review concluded that there is a need to invest in health systems and community-led response mechanisms.

“The emergence of SARS-CoV-2 has once again exposed the weaknesses of global health systems preparedness, ability to respond to an infectious threat, the rapidity of transmission of infections across international borders and the ineffectiveness of kneejerk policy responses to emerging/re-emerging infectious disease threats,” it said.

The ICMR wrote the review in association with the Department of Microbiology, Maulana Azad Medical College, and World Health Organization, South-East Asia Regional Office, New Delhi.

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