Part 49-COVID-19: New Strategies Are Needed to Maintain Social Distancing During Food Shopping to Minimize Exposure Risks (Part 3)

New strategies are needed to reduce crowd gatherings at supermarkets and food stores:

Previous experiences confirmed that banning all large gatherings for any reason would markedly diminish the spread of highly communicable diseases. This is the basic principle and value of social distancing, which directly applicable to the COVID-19 pandemic.  As a rule of thumb, to be effective, general gatherings of more than 8 to 10 persons should be avoided. 

Constrains associated with curfew:

Currently, after several continuous days of 24-hour locked down or curfew, when the government finally allowed a break in the morning for 6-hours for people to purchase food, thousands flock together at supermarkets, exposing themselves and the employees. This is made worse since no information was provided by the government on what is coming next. Thus, with the temporary lifting of the curfew, no wonder why thousands of people were panicked and packed into supermarkets.  

What happened to the public health principle of social distancing? A significant proportion of the population does not have the financial capacity to buy food on a large scale or facility to store food at home; most of them buy food on a daily basis. This is a life and death situation for them, which administrators and politicians have no clue about.

During the short break from curfew, many individuals have been in the liens for over 5-hours to reaches the supermarket to see "empty" shelves.  Over-crowded supermarkets and air-conditioning, while people are coughing make a perfect place for COVID-19 to spread.  Government violated its own intentions of crowd control.  This poor judgment of authorities opened the doors to the spread of COVID-19; consequently, new outbreaks might come in the weeks to come.  Another example of not thinking through the consequences of taking harsh actions that may or may not be rational. 

Serious food insecurity for low-income families:

Governments in emerging economies and developing countries neither have financial capacity nor logistics to deliver food to all villages.  The promised food distribution by the government so far has only materialized in a few localities.  For example, 19 out of 25 locations contacted, to-date failed to receive any of the promised food trucks; so, despite claims, the distribution and access to food is not uniform.  Despite governmental assurances, there is a major shortage of food in the country, but it is not uniformly distributed; the lower middle class and the poor are the most seriously affected. 

Based on the failure of social distancing alone, imposing the curfew or locking-down cities become an instant letdown and counter-productive, and failed to deliver the intended public health measures. This error of judgment could now become the niduses for a new wave of multiple outbreaks within the next few weeks.  Governmental approaches that do not take into account broader effective public protection are illogical and harmful to the population.  This can get worse due to the limited capacity of COVID-19 testing in government hospitals and insufficient intensive care facilities, especially if a large peak of outbreak occurs in the future.

Actions must be sensible and justifiable:

Instead, there are several sensible options one could create to minimize crowd gatherings and facilitate peaceful shopping to obtain food.  For example, one can create a system that allows each day over a 6 to 8 hours period, approximately 15% of the local population to reach supermarkets to purchase food.  During this period, the rest must observe the 24-hour curfew rules. 

For this to be successful, all food stores should be allowed (perhaps mandated) to keep open every day, from 6 or 7 AM to noon or till 2 PM and a limited number of shoppers are allowing to enter it at a time.  Such would markedly minimize the rush to purchase food and avoid the risks form exposure of thousands of vulnerable people and the store staff, to COVID-19.  It’s also a good business model that would allow markets to transport and refill foods each day after closure.  This will significantly reduce the exposure of both store-workers and the public to COVID-19. 

An example of what should be done:

The large gatherings and rush, as happening recently on the day of lifting curfew must be avoided to reduce the risk of spreading COVID-19, yet no tangible step has been taken.  Following is one straightforward example of how this can be implemented.  Utilizing the first number of National Identification Cards (NIC) that everyone carries around can be used to allocate each person, one morning a day, a week for essential shopping.

As illustrated below, it is easy to spread this out through the week allowing less than 15% of the local population attending supermarkets and local shops; from Monday through Sunday to obtain groceries, during the allotted period.  It is practical and easy to implement and cost nothing.  It would also avoid the current mad rush and large gatherings and fighting in queues/lines, and the associate exposure risks.  In industrialized countries, where all adults are mandated to have drivers’ licenses to be used as their ID, the code or numbers in drivers’ licenses can be used to achieve the same purpose.

There are several models that can be used for crowd-control for shopping food to minimize risks to the public.  Explained below is one such easy way to implement this, where NIC cards can be used justly and effectively.  The first number of the ID card (in several countries but not in all) represent the decade of birth.  For example, if the first number is 5, it confirms that the owner was born between 1950 to 1959.  Here is an illustration of how it would help to arrange peaceful, no-rush, food-shopping across the week:

Monday:        All those who were born before 1950

Tuesday:        Those who were born from 1950 to 1959

Wednesday:  Those who were born from 1960 to 1969

Thursday:     Those who were born from 1970 to 1979

Friday:          Those who were born from 1980 to 1989

Saturday:      Those who were born from 1990 to 1999

Sunday:         Those who were born from 2000 onwards (millennials)

This also has an advantage that similar age people will be shopping for food on a given day; so, the night before, stores can target the needs of that sector, expediting the shopping process.  A store security guard or a policeman at the entrance to the supermarket can check the first number of the NIC card to verify that it is his or her turn to shop on a given day.

This verification process would take less than 10-seconds and will not hold the line/queue. Because of the demography and the age-distribution in a given community, each of these seven shopping groups would not consist of more than 15% of the local population of shoppers.  Unfortunately, no such principle has been used in any country yet.  There is always a first time and the governments should consider such to help people.

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Professor Sunil J. Wimalawansa, MD, Ph.D., MBA, DSc, is a physician-scientist, educator, social entrepreneur, and process consultant. He is a philanthropist with experience in long-term strategic planning and cost-effective investment and interventions globally for preventing non-communicable diseases [recent charitable work]. The author has no conflicts of interest and received no funding for this work.