The Coronavirus (COVID-19) pandemic has seized the world. Most countries have asked their people to self-isolate and quarantine themselves at home. Although this could be effective in reducing the transmission of the disease, this is not enough. Rather, I think this would just slow the transmission process.

We are just slowing the disease transmission and not Stopping it

The Coronavirus is highly contagious and stays in the air for hours and on surfaces for days [Ref]. People may shed the virus in feces for weeks! With social distancing and "lockdown", we may stop the viral transmission via the respiratory route for some time, but it may continue to infect people via the fecal-oral route for a long time (just like typhoid fever and cholera).

The lockdown will affect all individuals who work on daily wages and earn just enough to meet their ends. The coronavirus pandemic will cause more poverty. I even foresee protests and unrest as poverty will strike us hard because of the lockdown. I don't even think the "Tiger force" will work smoothly. They may even transmit the disease from home to home.

So what can we do?

One thing is for sure, we can not fight Corona like this and we can not stay at home for long. We are following the west. Although we have a totally different culture and social setup. And, we also know that the policies of the west are also not successful. To cope with this situation, I am making this proposal to the Government of Pakistan and even the rest of the world. (Anybody can contradict my proposal).

The Concept of Partial Lockdown?

Before understanding the process of "Partial Lockdown", we need to identify the high-risk groups.

As per the CDC, the following classes of individuals are at a high threat of extreme illness from Coronavirus infections [Ref].

• People 65 years of age and older
• People with preexisting chronic lung diseases including those with moderate to severe asthma and smokers
• People with heart diseases especially those with heart failure
• People who are immunocompromised including HIV exposed/infected, immune-deficient people, people on disease-modifying drugs and steroids, those on chemotherapeutic drugs for cancer, and patients who have had an organ transplant.
• Those who occupy nursing homes or other long-term care facilities
• People who are severely obese and have a body mass index of at least 40
• Existing illnesses, such as diabetes, kidney disease, or liver disease (particularly if the disease is uncontrolled)
• Pregnant females.

The concept behind the proposed suggestion of Partial Lockdown is to exclude all the above high-risk individuals. Thus, individuals who are excluded from the above high-risk groups may be allowed to resume their activities.

Importantly, the Bread-earning member should be allowed to go out and continue with his job. We can not stop everyone from going out and dying at home of starvation. Neither should we rely on our government, rather we should help our government to overcome this Crisis.

Bread-earning members should be allowed to go out and work

The age-group should be brought down to 50 and children below 10 years should also be asked to stay at home and avoid public places. Between 10 and 50 years of age with no co-existing chronic diseases, the risks of having a severe COVID-19-related illness are very low. People might argue that these people will take the virus to their homes and infect them.

So, YES, that possibility exists but people should also take some responsibility. Proper contact precautions, hand hygiene, changing clothes (before and after work and entering the home), wearing a mask, and avoiding gatherings at home should be part of the strategy. Places of leisure activities such as wedding halls, restaurants, and gyms should be completely locked. Restaurants and Hotels may continue with the "Takeaway" services.

Places of leisure and social gatherings should be completely Locked

Schools and Universities should ideally start functioning online and via video-conferencing. All the individuals who have symptoms should be asked to stay at home. Testing for COVID-19 is not essential unless the illness is severe enough requiring hospitalization.

Testing for COVID-19 may be offered to only those who need hospitalization

I may add further suggestions later to this list. This was just a brief conversation I wanted to share as I was getting uncomfortable when people were suggesting ImranKhan for a complete Lockdown. Moreover, the media persons are blackmailers and have terrorized the whole nation with their "Breaking News".

They are not playing their roles as responsible citizens. Most of our patients are in "Panic" rather than have shortness of breath- as they describe. This is all the result of the "COVID-HORROR" that the media is currently conveying to the people.

In Summary,

The Government should identify low-risk individuals and allow them to work. However, they should be strongly communicated to practice contact precautions and to avoid gatherings.