Leaks and deluges

What connects South Korea, Vietnam, Singapore, Kerala, Karnataka and Andhra Pradesh? All these regions were, at some point of time or the other, hailed for their deft handling of the covid-19 crisis.

Some of them, such as Vietnam and Singapore have continued to do well. New Zealand has also done rather well, and it continues to keep its border closed. However, shit has hit the fan in Karnataka and Andhra Pradesh in terms of number of cases. All the diligence in containment earlier seems to be of no use now, only delaying the inevitable.

So what happened?

Essentially the way you deal with a leak and the way you do with a deluge are vastly different.

When you have a leak, you know that there is a good chance that you can try to stem it. You first put in some temporary measure to slow it down so that the hole doesn’t become bigger, and then you find something – a rubber patch, or some M-seal, or a piece of string, or some plaster (or a combination of these) to plug the leak.

Once the leak has been plugged you are safe. There are no more leaks in the foreseeable future. The damage is likely to have been limited.

When the flow of water from the damaged source is too heavy, though, stemming leaks just doesn’t work. You can try to stem it, but the pressure is so intense that the water finds its way around it. And the more the effort you put in stemming, the more the likelihood that when the water breaks through it is going to damage you.

When you are dealing with a deluge, the optimal strategy is to not try and stop the deluge. That is usually futile. The focus needs to be on mitigation and management – take the deluge as a given, and that some damage is guaranteed, and try to figure out how best you are going to limit the damage to the extent possible.

Some states in India, such as Karnataka or Kerala or Andhra Pradesh, had been blessed with “thin inlet pipes” in terms of the covid-19 virus. The initial case loads in these states was low, so a strategy of a lockdown (which was national anyways) combined with strong contact tracing and testing kept the disease under wraps. The “models” of these states were lauded at one time or another.

And then inter-state borders opened up. As people streamed in from neighbouring states that had not been blessed by thin inlet pipes, the pipes into these hitherto thick states became thick. Not realising this happened, these states continued with their old “trace and test” strategy. It doesn’t seem to be helping.

Cases are exploding in these states. And the same old strategy is being persisted with. Bangalore even did a week-long lockdown that ended on Tuesday, putting many livelihoods at risk.

I have come to firmly believe that there are no “good strategies” in terms of combating the disease unless strict border controls can be maintained. Anything any government does in terms of tracing and testing and locking down will only slow the inevitable – it doesn’t make the place safe from the disease itself.

The only purpose of containment measures, I have come to believe, is to spread out the severe cases over time, so that hospitals are not overwhelmed, and those who can be helped by medical care can get that help.

In fact, if you remember, this was the original meaning of “flattening the curve”. Over time, people have come up with their own definitions of the phrase, looking at the number of new cases, number of cases, number of deaths and what not.

The original purpose of lockdown was to let the infection spread in a controlled manner, not to prevent the spread of the disease altogether (which is near-impossible). We would do well to remember that.

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