Coronavirus outbreak: Brace yourself for life's biggest behavioural change after lockdown
Even as the lockdown has been extended until May, Mumbai's unsatisfactory infection record, say stakeholders, means that when restrictions are lifted, it will be gradual and make unprecedented behavioural demands on us
In her just-released monograph of Shivaji Park, veteran writer-translator Shanta Gokhale references a crisis from the early 19th century that strangely, seems similar to what the city and its people are enduring now. In Shivaji Park, Dadar 28: History, Places, People, Gokhale discusses the plague of 1896 that "threw up a complex narrative of class, caste, community, traditions, ignorance and prejudice". She writes, "The steps that the British government took to control the epidemic, such as forcible examination, isolation and quarantine, caused intense anger among the citizens."
Many left for their villages, mostly to escape the disease—said to have originated in the Chinese mainland and reached the port city of Bombay through naval routes. With no cure, superstition was rampant even within the medical fraternity, and there seemed to be little acceptance about a bacilli causing the illness. It took months for the resistance to fade. Ukrainian bacteriologist Dr Sir Waldemar Mordechai Wolff Haffikine's vaccine was the miracle Bombay desperately needed.
And yet, the city was never the same.
Despite tough measures by the colonial authorities, nearly 50,000 are said to have lost their lives. In the next few years, the city's heart—Fort and the Native Town—expanded. The dense cover of toddy palms and coconut groves were cleared to allow for free flow of sea air. And new housing areas had to be created on Mahim island and beyond, in an attempt to decongest the city.
At Prabhadevi's Siddhivinayak mandir, which sees 30,000 devotees every day, priests performing the arti with face masks on, might become the norm. They followed the rule prior to the temple closing its gates during the lockdown. ic/Getty Images
For today's generation of Mumbaikars, this time challenged by a virus called Corona, the city's "second creation" story scripted by that horrific 19th century epidemic, is a lesson on how diseases change the way we live. The crippling plague opened up this city. Coronavirus has shut us, inside it.
With Maharashtra topping India's infection chart with 1,574 positive cases and 110 deaths as of April 10, the end of the devastation is a while away. The greater challenge, believe experts, lies beyond that difficult milestone, pointing to the start of a new way of life.
Dr Om Shrivastav, director, infectious diseases at Jaslok Hospital and Research Centre, and consultant at Sir HN Reliance Foundation Hospital, says this isn't the first epidemic to hit the city, and won't be the last. "We will need to re-look at how we conduct ourselves. Civic responsibility is going to be important."
In China, where the Coronavirus outbreak is said to have originated, housing societies are tasked with ensuring that individuals don't leave their homes, until the quarantine period ends. "What worked for China is the strong level of discipline among the locals," says Anjan B, an advertising professional, who hails from Assam and now works and lives in the southern Chinese city of Guangzhou, 983 km from the pandemic's centre of origin, Wuhan. "Having lived under an autocratic government for years, they've developed an attitude of fear and subservience. It has held them in good stead."
A woman and child ready to game one of the first trains leaving Wuhan, on April 8. Residents say going to restaurants is no longer simple, involves multiple checks and they’d rather order takeaway than endure the grind. Pic/ Getty images
On April 7, the Chinese government lifted the lockdown in Hubei's capital city Wuhan, more than 10 weeks after its borders were first sealed. While masked residents make a slow, uncertain appearance on the streets, emerging from the lockdown hasn't been easy.
Anjan says lockdown was never imposed in Guangzhou, which has so far reported 460-plus cases, but Wuhan was too close to home to not take the crisis seriously. "The government locked Wuhan just before the Chinese New Year holiday on January 25. This holiday generally stretches for a week, but this time it was extended till February 10. Meanwhile, a decision was taken locally to shut down theatres, restaurants, malls and public spaces. Only grocery stores and supermarkets were open. And if you were found roaming without a mask, you'd pay a heavy fine," he says. "All of February, not a single person dared to step out of their home. It felt like a zombie apocalypse film."
It was only by mid-March, that the situation eased in Guangzhou, with employees allowed to come in every alternate day. By April 6, all offices had reopened, almost two months after they shuttered. Arcle, a Chinese national, who lives in Nanning, 1,200 km from Wuhan, says his city hasn't reported a single case. Yet, local authorities kept business on hold till February 25.
Though restrictions have been lifted in China, life is far from normal. "I used to run in the park, I don't anymore. Most of us are not comfortable going out," says Arcle.
A new "health code" service available on popular Chinese apps, is being used to keep tabs on individuals. It assigns each person a colour-coded status based on their travel and history, and a QR code, which can be scanned by authorities for data. A person with a green code is allowed to travel freely. A yellow code holder is asked to be in home isolation, while a red code indicates a COVID-19 positive case. Many in the service industry, have already started using it. Anjan says, "You can no longer enter a restaurant, enjoy a meal and leave. When you walk in, the restaurant management checks your body temperature. You then have to share your QR code. If you are identified as a 'risky' consumer, they could ask you to leave. Everyone opts for a takeaway instead of going through this grind."
In an interview to this paper last week, Dr Nachiket Vartak, a systems biologist behind a research group at the Leibniz Research Centre in Dortmund, Germany, had projected a higher number of infections in India, putting it down to a higher population, and population density.
"India has just entered the rapid rise phase of the epidemic. All indications are that the country will reach the midway point of the epidemic in the second week of May. The curve for India could start flattening mid-June. To limit the number of infections, we have to continue social-distancing at least until the end of May, possibly longer," he tells this writer over email.
Mumbai-based historian Namrata Ganneri, who undertook a Commonwealth-funded research at the University of York (2018-2020), which focused on the early history of post-independent India's smallpox eradication programme, says that population density was an extreme challenge in tackling the disease in India then, and continues to be the hurdle in fighting epidemics even today. Like COVID-19, the Variola major virus, which was responsible for the spread of smallpox infection in India and the subcontinent, spread through nasal and mouth droplets of infected persons. "But India managed to tackle it. We were also successful in beating another dreaded disease, polio," she says with hope.
The last edition of OML's NH7 Weekender held in Pune and Shillong in December 2019, saw a footfall of a hundred thousand. OML's Gunjan Arya says that because live events will take a while to return, they must reach out to their fans via the digital medium
At its peak, in 1967, post-independent India had 84,902 smallpox cases. Eight years later, the numbers had dropped to 1,436. This, says Ganneri, was possible because of the smallpox programme launched in 1962, which was eventually supported by the World Health Organization's worldwide programme. "The most important measure undertaken then was 'surveillance containment'; it's similar to what we are trying to do now. The only difference was that we already had a vaccine for smallpox." Once a person was found to be a carrier, s/he was isolated. This meant that the patient's family members, also could not leave their home. "A guard was posted outside the house, and they were given food supplies by the administration. As long as the person had the infection, the family remained under lockdown. Meanwhile, each and every person living within a 1.5 km radius of the patient and family, would be vaccinated in the final stages of the programme. This was advocated as a major strategy, primarily because it was realised that because of India's population size and density, it was impractical to vaccinate everyone. So, authorities, decided to vaccinate the most vulnerable instead." India was eventually declared smallpox-free on April 23, 1977.
A success story like smallpox proves that pandemics can be nipped in the bud. But self-discipline will play a key role in how we tackle the situation.
In Maharashtra, a mix of hardcore measures and appealing to the public will show results. Two weeks ago, Sangli had reported 25 cases, 24 in Islampur and one in Wadgaon village. Tracing the infected and sealing their neighbourhood, tracking and quarantining their first and second contacts and handling the lockdown with an iron hand has meant that no new case has been reported, making Sangli a model like Bhilwara in Rajasthan.
Retired IAS officer and independent policy analyst Shailaja Chandra, who has seen several health epidemics including the 1994 plague in Surat, says the Bhilwara model is a good option for the districts. "In our system, it's more than possible to cordon off areas. [State] governments know exactly how to do it, and they also have the manpower to oversee this. It's already being done in Noida, Gurgaon and parts of Delhi too. Implementing this in urban areas is easier, because you are not dealing with hundreds of dispersed villages. But I am not sure if this is a long-term solution. If extended, it can lead to social unrest. What can make it work, is watchfulness and restrained behaviour adopted by the community itself," she says.
What Chandra is referring to is restraint and the willingness to adapt to new circumstances. When the lockdown lifts, Mumbaikars, like the residents of Wuhan, will have to prepare to experience their city differently. The luxury of chatting up with friends, sitting cheek by jowl, on the teeming Marine Drive promenade on a Sunday evening, may no longer be acceptable. The definition of leisure might change. And, for the entertainment industry, the return to normalcy might take longer.
Given that protecting lives is number one priority, and then, protecting livelihoods and the economy, the entertainment industry will be lowest on the government's agenda, fears Gunjan Arya, CEO of media and entertainment organisation, OML. "They have far graver issues to solve, which is understandable," she says. "Honestly, going digital is going to be a big part of the new normal. In China, they have opened up some theatres, but with alternate seating [seats and rows are left vacant].
Movies might be a first response with respect to entertainment for the masses, sporting events might happen behind closed doors and for televised audiences only, and live events like concerts that once offered people an opportunity to congregate, will come much later. For now, it will have to be us trying to make sure that we reach out to fan bases across the board, using the digital mediums available to us," says Arya. Two weeks ago, OML held the first digital edition of the tentpole festival, the Bacardi NH7 Weekender, that's in its 10th year. The last edition held in December 2019 witnessed one lakh footfalls. "The response [to the digital edition] was phenomenal. It was the first festival to go live with a variety of acts. In fact, we are coming back with it again this weekend."
She offers the example of CBS drama series, All Rise, which is set to produce a 'virtual' episode themed on the pandemic, shooting footage in the actors' homes and using VFX to create backgrounds. It's the first episode of a primetime scripted series to be produced while practising social distancing, by using remote programmes like FaceTime, WebEx, and Zoom. This is also India's future, she thinks.
Like her, some educationists believe that even after the summer break ends in June, they may wish to consider a bigger push to virtual learning.
At Fort's Cathedral and John Connon School, teachers have been holding virtual classes from 8.30 am to 2.30 pm, on weekdays. "There is a change in the complexion of teaching, no question about that. In my opinion, the interface between teacher and student is important. That is why we are using Zoom for a lot of our classes. And, teachers, parents, and students have taken well to it," says Meera Isaacs, school principal.
Municipal and zilla parishad schools are not very far behind. Piroja Shroff, CEO of English E.Teach, an initiative launched in 2009, has been at the forefront of providing digitised textbooks to state-funded schools. "We have taken all the English textbooks in the Maharashtra government syllabus, and converted them into animated videos, which unfold page by page, based on the text. These are fun and engaging," says Shroff. Pre-lockdown, their material was distributed on pen-drives to 41,000 schools across Maharashtra and nearly 800 schools in Mumbai. "Once the lockdown began, we decided to move our content online and set it up in a way that children could access it easily. We tapped into the WhatsApp groups with the teachers and started the 30-day Challenge on March 30," adds Shroff. Every day, Shroff's team sends a WhatsApp message across the groups, with links to the videos, classified grade wise, for the day. The teacher forwards the message to all the parents in their network. Shroff admits, "nothing can replace the role of a teacher in the life of a young child, but since that is not available to us right now, this is a good second-best option. Parental involvement [in teaching] will slowly start increasing, as they will be the ones spending time with their children."
Management trainer and bestselling writer Radhakrishnan Pillai says India will also finally come to accept the "work from home" culture. "India is exploring what matured economies have been doing for the longest time. People in India still want to meet each other every day. But now, companies will be forced to adapt," he says.
Noted urban designer Harshad Bhatia suggests a stress on physical distancing instead of social. In a city where land and space are limited and the population is large, the diktat to stay indoors leads to "social crowding".
Mustansir Dalvi is professor at the Sir JJ College of Architecture. The recent restriction on movement means that there is a renewed focus on the local, he feels. The only trips he makes out of his Navi Mumbai home is to buy groceries. "You realise the value of what's local. Earlier, you were too busy commuting for an hour every day, zooming across suburbs via flyovers and freeways."
A specific way to approach this, says Dalvi, would be with the "pedestrianisation" of the city. "I think Mumbai is the only city in the world, which does not have a single pedestrian-only road. The great cities of the world are all characterised by pedestrian avenues and boulevards, where people can interact with each other. Now, I realise that sounds ironic, in the era of social distancing. But, it will offer an important perspective which the city has been missing in the light of huge infrastructure projects," says Dalvi.
While Mumbai's most ambitious infra project, the Metro, is going to have to wait, the locals have rarely stopped since having launched services in 1853. A source in the Indian railways tells mid-day that discussions about restarting services are currently on. "It is unlikely to happen immediately after the Centre's restriction ends, because that will do more harm than good," says the official. On an average, about 80 lakh commuters use the Western and Central lines. "Even if we start fewer services, there is a likelihood of overcrowding in the already packed trains. Further, even if trains are opened to 10 per cent of the population, it would still amount to eight to 10 lakh passengers every day. One can only imagine what could happen, if an infected person gets on board. This is going to be our biggest challenge."
International air travel, which is said to have brought the virus into the country, will take the biggest hit, believes Ashwani Lohani, ex-chairman and managing director of Air India. "People will only travel if and when essential. Those who previously travelled for business will most likely opt for online conferences. But those flying internationally for leisure, might not do it for a year or two," says Lohani. "I have a feeling that people will prefer remaining close to their natural base because, there will be a lot of apprehension on everyone's mind. Domestic travel hence, is the key. The 25 million Indians who used to go overseas, will now holiday in India. We will have to take measures to promote and boost domestic tourism. This kind of travel too, might only happen in the winter schedule, not sooner."
And, when commercial airlines restart operations, it will be with new policies in place. "Even now, when airlines carry sick passengers, they get a med form filled up, and this concern will definitely go up in the light of the Coronavirus. People will be afraid of travelling with anyone showing symptoms."
What everyone seems to agree on, is that "gradual" is the way to go. And as the country journeys from lockdowns to lifts, time will reveal what we can go back to going, and what must be buried forever. Chandra says, "Even when life goes back to normal, it will be a while before we meet each other, the way we used to. Continued isolation of the elderly might be needed, till we get a vaccine. We may also have to become more self-dependent when it comes to household chores."
And how long before we can hug? Germany-based scientist Eike Steinmann, professor of molecular virology at the Ruhr-Universität-Bochum is non-committal. "Maintaining a distance of two metres is currently critical."
'Traditional policing will need to evolve'
Dr PS Pasricha, former Director General of Police of Maharashtra, says that as the pandemic spreads, those enforcing law and order will find it challenging to police people. Unemployment is likely to increase, and this could lead to a rise in petty crimes. "The pre-requisite would be to have good community policing, where you involve community members, NGOs, college students, even the Mohalla Committees, to resolve small conflicts. Police can be observers, intervening only when required. The police will have to win the confidence of the local residents, and let them know that their role in policing is crucial at this critical juncture. Locals can also be asked to patrol specific areas," he says. "Once the community is with the police, a resolution can be found."
Mental wellbeing to become need number 1
Infectious diseases specialist Dr Om Shrivastav says that the biggest burden of the lockdown is the fatigue that weeks or months of isolation is likely to generate.
Rahat Sanghvi, a trauma-informed mental health professional, says that the lockdown has taken control away from us. "It's going to be overwhelming for people to create a future when the future keeps changing," she says. "Once the anxiety is generated, you can't just wish it away. It will still exist in some manner, which is why a lot of somatic complains like headaches and fatigue come up. Pre-existing physical issues that you may be dealing with, like allergies or asthma, could flare up. Your emotions don't just exist as ideas in your head, there is also a chemical reaction occurring in your body. If you are stressed, there are changes in your cortisol levels [stress hormone produced by the adrenal glands, located above the kidneys]. Your immune system is functioning differently because of these changes," adds Sanghvi, suggesting developing a healthy social support system around you. "Reaching out to everyone might not be feasible. So, finding that one source of social support and building a relationship with the person can help."
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