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During the first lockdown that lasted from March 25 to April 14, 2020, to slow down the spread of Coronavirus, Prime Minister Narendra Modi had decided that an expert task force be constituted to suggest a plan that will help to eventually ease the lockdown restrictions. He asked states to give their opinions on the way forward. The Kerala government has been most proactive, they constituted a committee that brought together the best minds together.
The committe included legals experts, former bureaucrats scientific experts, policy experts, eminent citizens and social activists such as: Filmmaker Adoor Gopalakrishnan, Chief Editor and Managing Director, Malayala Manorama Mammen Mathew, Joint Managing Director, Mathrubhumi Shreyams Kumar, Bishop Emeritus, Mar Mathew Arackal, Former Secretary, Department of Telecommunications, Aruna Sundararajan, IAS (Rtd.), Jacob Punnoose, IPS (Rtd.) former State Police Chief, and & Executive Director, Pushpagiri Medical College, Tiruvalla, Raman Pillai Senior Advocate, High Court of Kerala, Rajeev Sadanandan, IAS (Rtd.) Former Additional Chief Secretary, Health & Family Welfare Department, Government of Kerala & CEO, Health Systems Transformation Platform, New Delhi, Dr. B. Ekbal Member, Kerala State Planning Board, Neurosurgeon, Public health activist and Chairperson, Expert Medical Committee for COVID Control, Dr. M. V. Pillai MD Professor of Oncology at Thomas Jefferson University, Philadelphia & Senior Advisor to Global Virus Network, Dr. P. A. Fazal Ghafoor MD, DM President, The Muslim Educational Society (MES) & Professor of Neurology MES Medical College, Perinthalmanna and many more.
The committee had recommended that the lockdown be extended to continue the attempts to flatten the Coronavirus curve, saying continued restriction on “large scale movement of people across international and state boundaries is critical.” This should not be considered unless and until the situation is under control in every state, they recommended.
In its extensive recommendation document submitted to Kerala Chief Minister Pinarayi Vijayan, the expert committee flagged concerns over the economic hardships, even leading to famine and law and order issues. This they said would undermine both the lockdown and the health management objectives. Instead they recommended a “phased approach to withdrawal of the lockdown”. These are the key recommendations, presented after editing for clarity.
Even before a withdrawal is considered, the following work must continue stated the recommendation document:
The country and the state should continue to ramp up preparatory work for the rise of COVID19 cases. In some cities/states, the cases will exceed the local capacity.
Ramp up production and procurement of test kits, ventilators, PPEs for healthcare personnel. Central government should release funds for this, and create a mechanism to distribute them on a need basis to avoid both state governments trying to outbid one another or creating supply side disruptions.
Establish a national coordination mechanism so that states could support one another with experience, expertise, equipment and finances.
Maintain supply chains of essential goods and services. Central government should ensure coordination between states as well as logistics operators.
Supporting the agricultural sector, in production, marketing, storage and transport is essential.
Ensure that modern technological leaps in education, judiciary, local business, telemedicine etc are not lost when the lockdown is withdrawn, as there are huge economic and efficiency gains attached to it.
The committee’s states that a lockdown exit strategy needs to consider:
The trajectory of the epidemic over the next few weeks / months.
State’s capacity to build up an effective and responsive healthcare system.
The actual impact of the total lockdown on the economy.
Specific impact on the poorest, most vulnerable sections and financial capacity of the State to support them.
The committee has noted that terms like ‘lockdown’ and ‘social distance’ are experienced differently in a large and diverse nation like India. Here, “density of population, crowded living conditions, and economic realities are very different,” it stated. “The public health impact of the mass migration of lakhs of labourers pursuant to the lockdown and their plight in makeshift camps and clusters is as yet completely unknown.” That the testing needs to be ramped up, even as restrictions are lifted was a major recommendation.
OBJECTIVES OF THE LOCKDOWN WITHDRAWAL STRATEGY:
Health related:
Reduce spread of the COVID-19 virus
Minimise loss of healthcare professionals, maximize their safety and availability to work
Increase case management capacity in existing and new hospitals
Increase testing to eliminate community spread
Ensure access to normal healthcare requirements, maintain normal healthcare capacity
Maintain public health initiatives:vaccinations, food/nutrition of children and pregnant/feeding mothers
Non-Health related Objectives
Ensure access to food and other essentials
Maintain purchasing power of community
Ensure law and order
Maintain open communication and social cohesion
Re-establish livelihoods (opening of establishments etc.) Increase livelihood opportunities, new employment schemes
Facilitating return of migrant labour to their home states, without spreading disease
Facilitating arrival of non-resident Keralites without increasing disease spread
Improve public transport facilities without increasing disease spread
Criteria for Phase II relaxation of lockdown
● Not more than one new case of COVID infection a fortnight prior to the date of review.
● Not more than 5% increase in the number of persons under home surveillance from the date of previous review.
● There are no COVID infection hotspots in the district.
Criteria for Phase III relaxation of lockdown
● There are NO NEW CASES of COVID infection for the fortnight prior to the date of review.
● There has been a decrease of more than 5% of the number of persons under home surveillance
● There are no hotspots of COVID infection anywhere in the district
Phasing of Restrictions
PHASE-I RESTRICTIONS:
No person shall travel outside the house without wearing face masks.
Everyone to carry valid Identity (Aadhar, Passport Ration Card, Driving License etc.) to prove place of residence and explain purpose of travel.
Any establishment (private or public sector) operating shall mandatorily undertake measures of sanitation, provide masks and sanitisers, daily disposal of waste, provision of adequate supply of potable water as well as for cleaning purposes. Failure to do so will be tantamount to an offence under relevant provisions of the Epidemic Diseases Act, 1897 and Disaster Management Acts, 2005.
Occupancy of government vehicles should be restricted to two per vehicle excluding the driver, and buses.
Buses/Vans carrying frontline care workers or other public servants should not exceed seating capacity of vehicle. All passengers shall wear masks while travelling.
Only one person per house will be allowed outside the house at a time for a specific purpose.
No person above 65 with any history of comorbidity, or undergoing treatment for cancer or major ailments should be permitted movement outside the house. However, special passes for those who have no assistance and have to leave home to meet their household needs.
Movement of private vehicles should be restricted with odd-even schemes.
Total clampdown on all vehicle movement on Sunday other than for critical services and emergencies.
No gathering for any purpose more than 5 persons should be permitted.
No religious congregations to be permitted, all places of worship to remain closed.
Government offices and banks may reopen with staggered 50 % roster-based attendance, followed by a five-day week during the period of the restrictions.
Attendance at marriages and funerals should be restricted to 10 persons.
Airline and rail movement for passengers into the State should be totally disallowed.
Total employees at any work site (other than Government Offices) shall be restricted to ten persons or 25% of staff strength whichever is higher. Owner of the establishment will be bound to observe this restriction. Failure to do so will be tantamount to an offence under relevant provisions of the Epidemic Diseases Act, 1897 and Disaster Management Acts, 2005.
Super Markets and Malls, Film Theatres, Bars, Conference Halls, and Centralised AC Rooms in hotels etc. with closed Air-Conditioning should not be reopened.
Shops selling Jewellery, Textiles, Electronics, Fancy ware should not be opened during the first phase.
PHASE-II RESTRICTIONS:
Autos (with one passenger) and Taxis (with three passengers) be allowed.Owners should ensure that hand sanitisers are kept in the vehicles and made available to the passenger. All occupants in the vehicle should compulsorily wear masks.
Bus travel for short distances within a city or town may be permitted subject to a strict discipline of one person per seat only, no standing passengers permitted, and all passengers to compulsorily wear masks. Owners must provide hand sanitisers before allowing entry of passengers into buses.
Activities under NREGS to be allowed with use of cloth masks and sanitisers.
All Micro, Small and Medium Enterprises (MSME) shall be allowed to reopen with use of cloth masks and sanitisers.
Private establishments employing more than five persons should ascertain that the employee does not have any of the symptoms associated with COVID19. Owner of the establishment will be bound to assist the employee suffering symptoms to visit the nearest health centre. Failure on the part of the owner or the employee will be punishable under the relevant provisions of the Epidemic Diseases Act, 1897 and Disaster Management Acts, 2005.
Attendance at marriages and funerals shall be strictly restricted to 20 persons.
Total employees at any work site or private organisation shall be restricted to 20 persons or 25% of staff strength whichever is higher.
To ensure physical health, people may be permitted to walk for at least half an hour in the immediate vicinity (within a radius of 0.5 km) of their residence before 7.30 a.m. in the morning, keeping a safe distance of at least two meters from the nearest person.
PHASE-III RESTRICTIONS:
Inter-district bus transport be allowed with 2/3rd capacity, observing social distance protocols, compulsory face masks, hand sanitizers and no standing passenger policy.
Domestic flights for essential passengers, doctors, health workers, patients etc. may be permitted to be operated at 50% of the seating capacity.
International air travel and travel from other parts of India by air may not be allowed till full relaxation of lockdown restrictions in the State. Non resident Keralites stranded in various countries, but keen to return to home in phases must be necessarily brought home by air.
They should go through a serological test for screening (where results are available in 5-10 minutes if positive and then move to quarantine. A confirmatory RTPCR to rule in or rule out Corona should also be followed within a day or two. If found asymptomatic and RTPCR negative they can be quarantined at home with Telemedicine / telemonitoring.
All returnees must be put on compulsory quarantine of 28 days at designated Corona Care Centres and not at their respective homes.
However, NRIs who submit documentary evidence of a negative COVID test done in the countries from where they come can stay at home under surveillance for 14 days. The District Medical Officer shall certify the acceptability of the test conducted abroad.
Entry into the State may be allowed, but all new entrants should undergo 14- day home quarantine.
Universities, Schools and Colleges shall be opened ONLY for Examinations. Seating arrangements should follow the safe distance rule, and halls should have hand sanitisers at entry points.
Religious congregations in and outside mosques, temples, churches etc., large marriages, political meetings or conferences or cultural gatherings shall continue to be prohibited during this phase.
All IT companies may be allowed to open partially. Staff engaged in production and development of software applications should continue to work from home.
Shopping malls/stores may be allowed to function with a limited number of people allowed in at a time to ensure physical distance between customers.
Hostel and residential facilities may be opened. The owners and the management to be responsible for preventing overcrowding, maintaining safe distance between occupants, and ensuring that persons suffering from COVID19 symptoms are immediately taken to the nearest health centre.
Online sale of liquor may be started by BEVCO.
SUGGESTIONS FOR COURTS
Regular sitting in Quasi-Judicial bodies such as permanent Lok Adalath, Consumer Forum, Ombudsman can be reduced to once or twice in a week.
Filing of fresh cases in various Quasi-Judicial bodies can be done Online.
Video conference facility can be utilised in SubOrdinate Courts at least in one of the Court Centres in every district.