GUWAHATI: A Covid-19 risk analysis by Assam State Disaster Management Authority has put 46% of the state’s 3.65 crore population in the ‘most vulnerable group’, which comprises 21.88 lakh senior citizens and 1.46 crore children below 18 years of age.The disaster management authority has put in place a response plan, which is based on a risk analysis and assumed possible non-clinical worst case scenarios, which includes likely mass spread of the disease, deterioration of law and order situation, food scarcity, social discrimination and even pressure on land for management of bodies due to spike in fatality.The “Strategic Response Plan for Covid-2019” prepared by the authority states, “…the rapidly changing scenario can grapple Assam and NE very soon.” The response plan has been developed to multi-stakeholder coordinated response at state, district and local levels to “streamline and better structure the response actions of ASDMA and DDMAs to support various departments in ensuring response actions of non-medical and non-pharmaceutical nature toward prevention and containment of COVID-19 in the state of Assam.”The authority has run a risk analysis and set definitions of certain possible non-clinical worst case scenarios before drawing up the response plan to deliver the anticipated response as the situation unfolds.“Further, it has been observed that the elderly people are more vulnerable and susceptible to COVID-19. Besides, other groups such as children and people suffering from different other diseases are also vulnerable. If we consider the most vulnerable group of people in the state, Assam has approximately 21.88 lakh senior citizens/above 60 years (6%) and around 1.46 crore would children below 18 years of age (40% of the total),” according to the risk analysis.One of the assumed non-clinical worst case scenarios is ‘mass spread’ and “in spite of best prevention measures, many positive cases may emerge in the state from people who have travelled from various COVID-19 affected places (within and outside the country).”In a scenario of mass spread, the need and demand for quarantine facilities will increase manifold and there may emerge a situation to convert any available facility at district and sub-district level into quarantine facilities and this may increase the need for identifying and provisioning manpower and supplies.Also “in such a mass spread situation, the demand for health services may increase manifold. This may create demand for transitional health facilities outside recognized health care facilities for which logistics, manpower and other resources will be required,” the response plan states.“Law and order situation” would also be concerned in the worst situation and “In a situation of increased spread and quarantine, law and order situation may deteriorate with requirement of stricter and extraordinary arrangements in quarantine facilities, crowd management in hospitals, arrangement and transportation of logistics and similar places.”“In a lockdown situation, the marginalized communities including the wage earners, workforce in the larger informal sector, farmers, household workers etc may be left with a situation of food insecurity,” is another assumed worst case scenario.The plan states, “To contain the spread further, lock down may become the only available option which may result in shortage of essential commodities for the masses.” It also assumes that “In such scenario, chances of exclusion and social discrimination with families of COVID-19 affected persons during/post quarantine may also create an alarming situation limiting access to commons and community support systems.”“In the worst case scenario, the fatality rate may also increase leading to increased demand for land and resources to manage dead bodies giving respect to religious sentiments,'' the plan adds.The authority also assumed another scenario of “possible interaction of flood, erosion and COVID-19 response” under which social distancing may become a challenging affair in a mass displacement scenario or in relief camp setting which may further aggravate the spread of infection.”