Proposed Phases to control Corona Virus

Originally posted on 30th March 2020

         Proposed Phases to control Corona Virus

The whole strategy has to be in phased manner, with every phase having its own importance, so that over a period of time it can be controlled.

  This model is based on taking following scientific factors into account: 

  1) Incubation period of 1-14 days

  2) Symptoms display in 1-14 days 

  3) Transmission mechanism of virus

  4) If a person is infected, in initial days even in medical testing it may come NEGATIVE.

  5) If a person got infected and tested after 14 days of infection, it will come POSITIVE

  6) If a person is isolated for 21 days and he doesn't show any symptoms of infection than it can be safely assumed that he is not infected or it may be asymptomatic case.  

  7) If a person is isolated for 14 days and he is tested after 14 days and it comes NEGATIVE it can be safely assumed that he is not infected.

Stage 1 – 2 weeks	Stage 2: 2 weeks
Self-Quarantine	Group- Quarantine
1)    Complete nationwide lockdown  2)    Stop full interstate / city movement   3)    Self-Isolation of 2 weeks of everyone 4)    Test only suspected cases  5)    Fully strict-Quarantine (defined later) for 3 weeks, for all recent contacts of newly suspected cases. 6)    This will reduce spread of virus 7)    This will identify maximum number of infected cases, without much spread. 8)    Zoning of area: Divide all cities into small-small zones 9)    Prepare supply chain to equip each zone with supplies of 2-3 weeks within the zone.	1)      Continue lockdown  2)      Group-isolation of 2 weeks   3)      Allow full movement within each zone  4)      Restrict any movement from one zone to other zone.  5)      This will identify any asymptomatic case also and any new case also.

Stage 3: 1 week:	Stage 4: 2 weeks
Group- Quarantine	Group- Quarantine
1)    Allow full movement within each zone  2)    Restrict any movement from one zone to other zone.  3)    Identify all the zones where no positive case is reported 4)    Identify all the zones where even a single positive case is reported 5)    Declare zones in point 1 as SAFE ZONES and point 2 as INFECTED ZONES. 6)    Do speedy and volume testing only of the people who have moved in and out of these SAFE zones. 7)    All the areas where test for these people also come NEGATIVE, declare those zones as SAFEzone. 8)    This phase is will give buffer time for reassurance that SAFE zone is actually safe 9)    After that allow full movement between SAFE zones.	1)    Divide INFECTED zone into further small zones 2)    Allow full movement between these small zones 3)    Keep testing only suspected cases  4)    Fully strict-Quarantine (defined later) for 3 weeks, for all recent contacts of newly suspected cases. 5)    Restrict any movement from one zone to other zone.  6)    Equip each zone with supply of 2-3 weeks. 7)    Normalize the movement between SAFE zone to SAFE zone

Stage 5: 1 week	Stage 6: 2 weeks
Group- Quarantine	Self-Quarantine
1)    Same as stage 3 but only for infected zone. 2)    Identify all the zones where no positive case is reported 3)    Identify all the zones where even a single positive case is reported 4)    Declare zones in point 1 as SAFE ZONES and point 2 as INFECTED ZONES 5)    Do speedy and volume testing only of the people who have moved in and out of these newly found SAFE zones. 6)    All the zones where test for these people come NEGATIVE declare those zones as safe zone. 7)    After that allow full movement between SAFE zones.	1)    Now deploy full resources to the INFECTED zone only. 2)    Put everyone in INFECTED ZONE to strict self-quarantine for 2 weeks. 3)    Equip each house with essential supplies for 2-3 weeks 4)    Anyone not allowed to come out of house at all. 5)    No movement in and out from INFECTED zone. 6)    Normal movement restored in all SAFE zones

Stage 7: 1 week	Stage 8 :
Self-Quarantine	Group- Quarantine
1)    Perform Speedy and Volume medical test on everyone in INFECTED zone 2)    Quarantine all the infected and treat them 3)     Quarantine all the contacts of infected persons	1)    Allow regular movement within the INFECTED zone  2)    Restrict any movement in and out of the infected zone  3)    Keep treating and quarantining any infected person and his contacts. 4)    Keep reducing the INFECTED zone by further zoning 5)    Keep moving the people who have strictly quarantined themselves for 2 weeks and are medically tested to be not infected.

Reason why this model will work:

Stage 1 of 2 weeks:

1)    Although its lock down, still people will have some movement for essential shopping, so it’s not full self-quarantine.

2)    As everyone is maintaining social distancing, spread will be less and most of the infected cases will get identified.

Stage 2 of 2 weeks

1)    If zones are divided into group of around one lakh people in each zone, each zone can be group-quarantined. It is easy to manage also.

2)    If none of the persons in the zone shows any symptoms after end of stage 2, that means none of them was infected at the start of the stage 2

3)    As they come in contact only with "NOT INFECTED" persons in last 2 weeks, that means they could not have contacted the virus during this phase.

4)    Which basically means it can be inferred that this full zone is safe and everyone is infection free.

5)    Still there is a caveat that some people need to move in and out of zone or comes in contact with people coming from out of zone. In that case they may contact infection in last few days of stage 2 lockdown and symptoms will not be visible by the end the lockdown.

6)    To overcome caveat of point 5 , 

a)    All the persons who moved in and out should be tested for infection, if they are also found NEGATIVE then this means whole zone is safe and secure.

b)    In the stage 1, zone has to be built self-sufficient, that means in stage 2, no movement in and out of each zone is needed.  

7)    It is for essential to test persons who have moved in and out of zone.

8)    Zone is built self-sufficient, so in this period there is no movement at all from in and out of the zone.

9)    With 14 days of stage 1 ( with minimum movement) and 14 days of this stage (with no movement from in-out of zone) , gives 28 days of group-quarantine.

Stage 3 of 1 week  :

1)    This phase of 1 week of group-quarantine ( zone-quarantine) gives additional buffer of 7 days , so with earlier 14 days it become 21 days of group-quarantine. 

2)    So if a zone without any contact with outside world is fully infection free, that zone is well above incubation period of virus. 

3)    If no one at all shows any symptoms and all the persons who have moved in-out and medically tested for virus that gives certainty that zone is secured.

4)    Now no medical attention is needed for this zone and normal movement can be allowed for this zone.

5)    Testing of everyone is not needed, as not a single person has shown any symptoms of virus.

Stage 4 of 2 weeks :

1)    This is to strictly isolate SAFE zone from infected zone that means the people who have already been secured, there is no chance that they come in contact with infected person.  

2)    This will enable normal movement in SAFE zones, so that life can come to normal and focus and resources needed are only for INFECTED zones.

3)    This phase is reiteration of Stage 2, so same scientific principle applies to it but it is only for infected area.

Phase 5 of 1 week :

1)    This phase is reiteration of Stage 3, so same scientific principle applies to it but it is only for infected area.

Phase 6 of 2 weeks : 

  1) By this time INFECTED areas have been reduced to bare minimum

  2) All the POSITIVE cases has been identified and getting treated

  3) All the known contacts are quarantined 

  4) But as this zone had infected people, there are chances that in last 2-3 weeks more people could have got infected who have not yet shown the symptoms.

  5) This time focus is on STRICT self-quarantine, as area is small compared to whole nation, it is easy to implement.

  6) Every house is strictly quarantined, with all the supplies they need for 2-3 weeks.

  7) If they were infected before start of this phase, they will start showing symptoms in 2 weeks.

  8) If they come POSITIVE they will be treated

  9) As in this there is strict isolation, there should not be any further spread.

10) By 2 weeks incubation period will be complete.

Stage 7 of 1 week:

1)    At this time volume testing of everyone should be done, so that any final person infected by virus will get caught here.

2)    With extra 1 weeks , in this no new case should get reported 

3)    By this time it will also get confirmed that SAFE zones were safe as no new case should have been reported from there . 

Stage 8 :

1)    Is iterative cycle to keep reducing infected area. 

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1)    Need on the spot policy based on situation if new cases come in SAFE zone. If any new case gets reported from SAFE zone, it needs lockdown and emergency response of volume testing in that zone.

2)    Stage 8 will keep going in cycle with INFECTED area getting reduced and people moving out of INFECTED zone after testing. 

3)    Idea is to keep decreasing the INFECTED zone 

4)    Each zone to be built in self-sufficient unit for 2-3 weeks.

5)    While volume testing is going on, it should be mandatory that NEGATIVE tested person should not come in contact with “NOT TESTED” person. Otherwise he may get infected after testing, defeating the whole purpose of volume testing. 

6)    INFECTED zone is the zone where any case is detected in last 20 days. 

7)    STRICT-quarantine: In this, house is provided with 2-3 weeks of full supplies and they are not allowed to come out of the house for anything.

8)    Timelines can be adjusted based on the ground situation

9)    During this whole process no international flight to be operated.  

10)  Even asymptomatic cases can also be handled. 

11)  There are advantages of group-quarantine over self-quarantine. In self-quarantine, after 21 days there can be people without any symptoms but having infection and once out of quarantine they can spread the virus.

12)  With model of group/zone quarantine, asymptomatic person can spread virus to others during the lockdown and at least someone will show the symptoms, that will enable to identify that virus still exist in that zone, and will enable to identify during lockdown itself rather than getting it spread after the lockdown.

13)  This proposal is based on how to best utilize the resources and how with minimum supervision lockdown can be achieved.

14)  In India right now deaths are due to illness but once our health system is pushed to limit then deaths will be due to non-treatment. 

15)  Right now it’s only one big gathering in whole India that has created a havoc, imagine if multiple such gatherings would have taken place in each state how much the count would have been and that will be the situation if virus still exist after lockdown.

16)  Prevention is better than cure, for India prevention is the only solution. If it gets to the stage of cure then whatever preparation govt. do we can see the health system collapse.

17)  At start of lockdown there were around 400 cases, if after lockdown there are more cases then we are again going back to the same or even worse cycle of increase. 

The model is based on combination of self-quarantine and group-quarantine, what that means is: 

   1) if a person is self-quarantined for 21 days and he doesn't show any symptoms then it can be inferred that he is not infected by Corona virus .

   2) If a group of persons ( 1000 or 50000 or any number) are group-quarantined for 21 days, with no contact with outside world and for 21 days none of them shows any symptoms then  it can be inferred that all of them are safe and none of them is infected by Corona virus.