Covid-19: Effective quarantine could cut healthcare load by 90%, says study

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An effective lockdown and quarantine regime could dent the impact of the coronavirus (Covid-19) by 90 per cent, bringing it within manageable limits for India’s limited healthcare infrastructure.

 
Such an outcome would require over 50 per cent quarantine compliance among infected cases, according to a study — ‘Healthcare impact of Covid-19 epidemic in India: A stochastic mathematical model’ — published in the Medical Journal Armed Forces India.

The study was conducted by Kaustuv Chatterjee, head of department of Medical Informatics at the naval hospital INHS Asvini, along with Armed Forces Medical College Professor Kaushik Chatterjee, Associate Professor Arun Kumar Yadav, and Professor Shankar Subramanian.

 
The four doctors had set out to determine the magnitude of the pandemic, its impact on India’s healthcare resources, and to study the effect of non-pharmacological interventions such as lockdown and social distancing. The study suggests that Covid-19 would have peaked in July in the absence of any measures.

Effective implementation of measures like shutting down schools, colleges, offices, and mass gatherings in addition to social distancing, could reduce the number of cases significantly and slow down its progress two-three months earlier.

 
The model looked at effectiveness with varying degrees of quarantine. It can stretch on significantly at low levels such as 20 per cent quarantine (see chart 1). The impact on growth begins to set in when 50 per cent or more of infected individuals are isolated to prevent spread (see chart 2).

The paper suggests that immediate implementation of interventions “has the potential to retard the progress of the epidemic by April” and “bring down hospitalisations, intensive care unit (ICU) requirements and mortality by almost 90 per cent”.

 
The study concluded, “This will make the epidemic manageable, and bring it within the ambit of available healthcare resources in India.”

 
The mathematical model estimated that a natural, uninterrupted evolution of the pandemic would have resulted in 364 million cases and 1.56 million deaths, with the epidemic peaking by the middle of July. This assumes a certain natural rate of growth that has not materialised. It suggests that early measures by the government might have had a positive impact on reducing the growth rate.

 
The research also said the elderly are particularly at risk. They account for 10 per cent of the population, but would account for 43 per cent of the all hospital admissions and 82 per cent each of ICU admissions and deaths, according to the model.

 
“The elderly are most likely to get infected by household contacts. Hence, special (interventions may) have to be developed for them, with a greater focus amongst their household contacts,” the study said.

 
According to World Bank data, India has only 7 hospital beds for 10,000 people. The number of doctors is similar. China has 38 hospital beds in comparison, and 18 physicians.



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