Thread by @epigiri

Even if 1% of population gets infected & we have as much as CFR as in #southkorea, our efforts are averting between 0.5-2.3 million deaths. In terms of mitigation, we are the first country in the world to do a #Lockdown21 on a national scale #covidinindia #LockdownLessons 1ofn

How to move forward? First, some ground realities
1. Testing everyone is going to take time.
2. Treatment is going to available only later.
3. Vaccine development is far

Next, once lockdown is lifted, most of India is susceptible to new infections.

How to stop future infections?

If there are active transmissions going on, it will spread like wildfire later. So catch these foci of transmission and contain them to these local areas.

So, the focus is NOT on the states/areas that are detecting, testing and controlling well.

High focus should be on two areas to prevent spread later.

1. Identify states/areas which are silent or reporting poorly. If a state has not reported cases earlier (due to many reasons), hotspots or deaths will start getting reported (as no one can hide it) sooner or later

2. The NCDC has identified hotspots. The states should ensure transmission would not spread from these areas.

Both these (silent and hotspots) require heightened surveillance, regular review and strict containment.

Focus of action has shifted from national to state and sub-state level for effective mitigation and containment. If a state is not reporting enough cases, now is the time to make sure we are not missing a transmission. Otherwise, they can be hotspots once the lockdown is lifted.

Ask the right question, you will find the answer.
Where is virus? Who are at risk?
Why are states not reporting?
Why deaths are reported (now) when cases weren't reported earlier?
How to identify cases without testing?
How to isolate all cases?
How to effectively trace contacts?