The Student Alumni Relations Cell (SARC) of BITS Pilani recently launched a webinar series titled “Plugin”. Once a week, a distinguished alumnus is invited to speak on a topic of their expertise. The first session—which was presented via Cisco WebEx—was a presentation by Dr Ramanan Laxminarayan. Dr Laxminarayan is the director at the Centre for Disease Dynamic, Economics & Policy (CDDEP) and a senior research scholar and lecturer at Princeton University. In the session, he aimed to present a broad picture of the COVID-19 crisis, and particularly its impact on India.
How Viruses Emerge
The webinar kicked off with Dr Laxminarayan giving a brief history of the spread of viruses and bacteria throughout the world. He highlighted a growing trend among viruses in the way they originate—most viruses are zoonotic, meaning they originate in animals before making their way to humans. The reason behind this alarming trend, Dr Laxminarayan noted, is the intrusion into animal habitats of human activity.
60% of the biomass on Earth consists of mammals which make up humans’ diets, and this serves as a pathway for zoonotic viruses to infect humans.
Talking about the history of the coronavirus, Dr Laxminarayan explained that pandemic viruses are concentrated in South and South-East Asia because of the high concentration of both humans and animals in this region. Wet markets in China offer a wide variety of animals, both dead and alive. This makes them an ideal breeding ground for zoonotic viruses to transmit to humans.
Lessons learnt from SARS
The spread of the SARS virus across the globe in 2002 and 2003 served as a great model to devise a plan of action for future pandemics. Following SARS, many international health regulations were revised and these have been instrumental in preventing the current situation from becoming worse. ‘Every week of the year, there is some virus waiting to make its jump from animals to humans.’ To prevent any future virus outbreaks, Dr Laxminarayan said that it is imperative that early testing be carried out in order to eliminate viruses while they are still developing within animals.
Research into COVID-19
Talking about the model assumptions used to study this disease, Dr Laxminarayan explained how contact and transmission have been largely assumed to be age-assortative (i.e. people are more likely to socialise within their own age groups). It has been estimated by models that a 21-day lockdown can reduce disease transmission by 25% in case of a moderate lockdown and 44% in a hard lockdown.
Dr Laxminarayan then discussed a study conducted by the Imperial College which showed that implementing a suppression (social distancing) strategy early in the pandemic is the best way to reduce the number of cases to attend to on a daily basis.
According to the model in the study, consistent long-term social distancing and hygiene measures produced better outcomes than intermittent lockdowns between phases of business as usual.
This is especially crucial in a heavily populated country like India.
He further emphasised the fact that with the virus being just a few months old, the amount of research carried out on it is simply not enough. The episode of the Diamond Princess (a cruise ship docked in Japan which saw many of its passengers get infected), although tragic, served as a ‘contained experiment’ to study the transmissibility of this virus. From observations of the Diamond Princess, the reproduction number—the average number of people an infected person infects—for this virus has been estimated to be between 2 and 3.
Although it is claimed that temperature and humidity could reduce this number to 1.8, this claim is still being investigated.
Coronavirus In India
The latter portion of the presentation was devoted towards assessing the COVID-19 situation in India. India acted quickly by activating the Integrated Disease Surveillance Programme (IDSP) before any domestic cases were discovered. This made it mandatory for all travellers from China to be tested. Screening airports for infected patients was also a useful preventive measure. The fact that places with the highest numbers of cases—Delhi, Maharashtra, and Kerala—received the most air traffic further validates the policy of screening people at airports.
However, India’s low testing rate is—according to Dr Laxminarayan—still a matter of concern. Though India has one of the lowest mortality rates—number of COVID-19 positive deaths per million population—in the world, each death likely signifies more than 100 cases, and with India’s low testing rate, this number could be as high as 700 undetected cases.
Dr Laxminarayan then delved into the lockdown and its effects. The main purpose of the lockdown, he emphasised, was to buy time for the government to prepare hospitals for a surge in cases. It decelerated the virus’s spread because of social distancing and good contact tracing measures.
He explained that once lockdown is lifted, there are two possibilities. One possibility is that strict social distancing norms are enforced with a ban on mass gatherings. The other is that people, believing that the end of the lockdown signifies the end of the crisis, would return to work as usual, with little regard for social distancing. The latter situation would likely involve multiple lockdowns with breaks in between to control the number of infections and hospitalisations. Dr Laxminarayan pointed to the Imperial College study to emphasize that the former situation, with consistent social distancing, is much better than the latter with intermittent lockdowns.
Thus, he explained the need for a gradual loosening of restrictions and advised caution even after the end of the lockdown. All mass gatherings will have to be evaluated based on the number of people and importance to the economy and only those which are sufficiently vital should be initially permitted.
For example, factories producing essentials should be allowed to operate, whereas parties should be curtailed.
Highlighting the economic impact of the lockdown, Dr Laxminarayan pointed out that every day of the lockdown costs 4.5 billion dollars. Given that India has bought time with lockdowns, the best option now would be effective social distancing and hygiene measures. Nevertheless, COVID-19 is likely to be around until either a vaccine is developed and distributed or herd immunity is achieved (which will require 60-80% of the population to develop resistance).
Questions From The Audience
After concluding his talk, Dr Laxminarayan answered questions submitted by BITSians from all three campuses. The Director of BITS Goa and the Dean of Alumni Relations posed a question about the impact of COVID-19 on higher education. To this, Dr Laxminarayan replied that education should be the top priority of the nation. He encouraged those in the education sector to speak up and communicate their economic value and lobby for permission to operate at the earliest, albeit with caution.
On being asked about his path from BITS to his current role, he talked about how BITS served as a ‘liberal-arts college’ for him.
The flexible academic system at BITS allowed him to discover fields of interest outside his major.
He recalled a conversation that he had had with the head of his department about the value of oil: The professor had asked him if the value of oil is limited to just the cost of pulling it out of the ground, or if oil being naturally present underground holds some value on its own. It was this conversation that piqued his interest and eventually inspired him to pursue a PhD in economics.