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India’s Covid response conundrum

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The week that went by, saw us hit a grim milestone world over, a hundred thousand fatalities since the outbreak began, with half of them in a little over a week. It would be fair to say that given the depth of the spread of the contagion, though we are fairly early in the trajectory in the sub continent, the Govt has been largely proactive in its action plan as we close into this first phase of the lockdown and begin a new one. What remains to be seen is how much of a leg room have we got ourselves through these curtailments.

Projecting the extent of the crisis has varied from as dire as losing a few million lives to calling it the ‘small flu’. Multiple statistical theories of BCG induced immunity to the virus, India having received a less virulent strain etc., have been circling the news wires for long now.

The fact though is, nobody has a crystal ball on how to read this. The best metric is to trust the forecasted models and learn from countries ahead of us and how they are dealing with the epidemic and work out a strong containment strategy.  

What next : Do nothing, mitigate or suppress

Looking back a month into the lockdown, though there may be a few reasons to cheer that the shelter in place has worked to a certain degree, we got to pay close attention to the fact that we are behind majority of rest of the world both in tests/mil & as a result reported cases/mil.India along with Brazil, Mexico, Indonesia even Japan for that matter have among the lowest testing rates on record

Given the long incubation period of the virus coupled with asymptomatic transmission patterns and a significant lag in the incidence to mortality curves, it becomes paramount to maintain these closures in play.

Any logical action at this time within the bounds of this prolonged lockdown would be a welcome move to help face an otherwise dire collapse of India’s healthcare system that clocks among the lowest ratios of beds to heads in the developing world. As ICMRs awaits delivery of antibody testing kits along with scaling home grown solutions, it’s critical to rationalize test infrastructure and lock and test high risk clusters. Could a door to door population census styled test campaign be on the cards?

What to lock, when to open
Unlocking India is going to be a bigger challenge than being locked up. Job destruction is putting the nation at crossroads as a fall out from the enormous pressure being inflicted on the agrarian economy and consumption patterns of society

As much as we’d want a rational determination of re opening parts of the country, its very likely the virus that’s going to dictate the true timeline. Given the constraints, we’d need a calibrated and carefully tailored approach, that’s got to balance the impact of a glaring health crisis to managing the economic fall out in a post Covid world.

The sight of hordes of migrant workers walking back to villages, unemployment rates as high as 20% per CMIE’s latest data is a startling indicator on what’s to come . If not balanced,the economic fallout of the crisis could be more severe than the crisis itself.

The multi trillion dollar stimulus rolled out in the US if quantified in real terms is as big as India’s economy. Can India afford an equivalent dole? Answers may be divided, but we definitely need to do more than the 0.5 -0.8 % of the revival package injected by the administration, when the rest of the developed world is pumping as much as a tenth to a fifth of their GDPs to cushion their economies.

There have been multiple proposals from policy think tanks ranging from tapping into MNREGA to increasing work hours & wages to ‘Uberization’ of farm to market logistics to cash loading funds into Jan Dhan accounts to support communities in distress. We’ll probably see a lot of these coming to fruition through coercive action in days to come.

Will India surprise the world with handling this crisis drawing from the accolades it received the way Polio eradication was dealt with many years ago. Only time will tell!

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