Commentary: What happens after the lockdown?

In this issue of Indian Journal of Ophthalmology, Nair et al. have reported on the ophthalmic practice and patient care by Indian ophthalmologists during the nationwide lockdown imposed to prevent COVID-19 spread to the community.[1] Early 2020 saw the new coronavirus pandemic spreading rapidly, which necessitated an emergency protocol beyond 'social distancing' akin to mass quarantine. Lockdowns limit movements or activities in the community while allowing essential services to function optimally.[2] Based on the impact in Wuhan, the lockdown in India started on March 25, 2020 and is scheduled to expire on April 14, 2020.[3]

As the end of the nationwide lockdown is imminent, the question that arises in our minds is what next and how do we go about resuming our personal and professional life? Social distancing would still be of paramount importance, but considering our profession, we will need to exercise caution at our place of work. Some recommendations based on consensus are as below:

1. Single point of entry to the hospital with screening of patients, attenders and all staff - questionnaires to assess the risk of exposure, thermal scan, consent to undergo treatment or work in the setting of exposure risk to COVID

2. All to wear a mask – the type of mask depends on the risk of exposure

3. One room to be designated for the care of patients with COVID infection or with known exposure. Personnel in this isolation room to be equipped with Personal Protective Equipment (PPE)

4. All staff to ensure handwashing on an hourly basis

5. One attendee per patient norm to continue and to minimize the waiting period.

Though we have had coronavirus epidemics previously, we don't seem to have learned much to help us with the way forward.[4] Moreover, the therapeutic options and vaccines are limited as of now.[5] Hence, the only option to contain the spread is by taking personal care and ensuring that our patients are not exposed as well. And most importantly, to report to the authorities if we are exposed or infected! That brings an all-important factor to the forefront. The impact of the lockdown and the disease itself, on the individual, the organizations and the society at large. Whether an employer or employee, the economic ramifications are large. The psychological pressures faced during the self-isolation are only going to be augmented once we meet the challenges of resuming work. But the human race is the most evolved, we will make it through this pandemic, learn from it, and come out stronger!