After India Tames COVID

Challenges in Bouncing Back

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FEBRUARY 2021 Download this Article

India is walking a tight rope. The dilemma is one of its kind. COVID is no longer a full-blown pandemic nor a small one that local clinics and nursing homes can manage. It can neither be in lockdown as fewer cases are reported or be opened fully without restriction, risking another wave.

If the restrictions are too long, a large population will slip into irreparable poverty. The economy will be unable to make a full recovery, and the slowdown will continue. Already, before the COVID lockdown, the Indian economy was stalling.

If the restrictions are too few, there is a high risk of contagion. In turn, it will create panic and push to lockdown again. Traces of rebound is already seen in Maharashtra and Kerala.

कोविड के बाद सामान्य स्थिति में लौटना भारत की चुनौतियां

Then how can India fully restart? What is the right time to fully open? It is the question facing all countries, and each has its own unique COVID situation. Hence, there is no exact empirical formula.

Although each country has its own set of priorities, and it must match that accordingly. But the base of restart will be the containment of COVID-19 contagion.

The statistics, if trusted, is favouring India. Compared to Europe and the USA, the recovery and mortality rate has been remarkably low; hence restarting would require a uniquely Indian approach.

How do we define the containment, and what is the safe criterion?

There are different mathematical parameters available from the science of Epidemiology and Virology. That will give the threshold limit where we can allow the country to restart and lift all restrictions fully.

Some call it the “Herd Immunity”. It may work in theory for all other contagions, but the British government failed miserably with this approach.

For India, by its very nature of geographical, social, and business diversity, finding a route to restart fully is more complicated than it could get in any other monolithic country.

First, we do not know about the real numbers of infected. Currently, testing is negligible. Those recorded numbers are the ones who have been to the hospital or tested for some particular purpose like travel.

Therefore, statistically, the real geographical or demographical distribution of infection is mostly unscientific. Hence, the curve fitting will be an exercise in vagueness.

Presently, this is what all the governments worldwide, including India, are facing. They solely rely on the vaccination programme strategy, depending on a connection between vaccination and hence protecting their population against the virus.

Meanwhile, those who are not vaccinated are clear of COVID-19, if without symptoms, for 14 days. It is widely understood.

These are the numbers that are used to define a healthy population.

By that calculation, if a locality in lockdown is free of any infection for the last 14 days, can it restart? A possibility, if and only if this island had behaved like an island in isolation. This model is what India must build and the only way to escape mass testing and 100% vaccination.

The truth about contagion is its difficulty to manage. In a best-case scenario, until the country does not get its Patient No.1 clear, there is a high risk of relapse. Then there are cases of variants, infusing the complexity from international borders.

We have South African and Brazilian variant already affecting the European lockdown and restart.

The big question to ask is, how many times, and how long can a nation or city come under lockdown to prevent another contagion?

The recent report about asymptomatic carriers is damning. It means that we may have a population without vaccination for 14 days and still have COVID carriers.

कोविड के बाद सामान्य स्थिति में लौटना भारत की चुनौतियां

As it is assumed, the only way out of this is vaccination, social distancing, hand hygiene and face masks. It is not a guaranteed method, though, but it can only lower the risk. We should also realize that depending too much on vaccine will become a single point of failure.

Suppose there is a relapse in a small locality. What is the strategy, then? The only answer is to again lockdown that place as it happened in Amravati and parts of Pune. If the situation still goes out of control, we will be back on 22nd March 2020.

The government can repeat the cycle of restrictions for local areas, villages, cities, and, if required, the country until patient no. 1 is clear of COVID.

There are two parts to the contagion of COVID-19—the preventive and curative.

Prevention has always been better than cure. We, as humans, continuously live amongst virus and bacteria. It is our immunity that protects us. As a formal strategy and social distancing, hand hygiene, and face mask, we must broadcast and practise immunity-boosting measures.

A nation is as strong as its citizen’s immunity. It could also mean a national strategy for kinds of food, exercises, and lifestyle.

On the curative side, there is good news. The vaccines are here, and many of them. However, their availability for all is still an issue but will get sorted out in due course.

Then there are reservations about the lasting side-effects. In the intermediate arrangement, the only hope now resides on Hydroxy Chloroquine's efficacy, anti-viral drugs in combination with antibiotics.

These are drugs that have been in use for an exceptionally long time. The side-effects are generally known to the population. So, there isn’t any element of surprise.

After a year into the pandemic, people are habitual in following social distancing and hygiene rule. The vaccine will play its part whenever it is available to all.

I am afraid this cycle of lockdown and restart will continue till 2023. Hopefully, though each cycle, there will be a reduced impact. People and governments have already learnt to live with it and find their way around it. No guesses, it is going to be a long haul.

कोविड के बाद सामान्य स्थिति में लौटना भारत की चुनौतियां

As the country grapples with restrictions, already we see the resurgence of poverty. The economic system of the nation is getting tested, and we are failing.

All the high claims of lifting millions above the poverty line have proven wrong. Visible is the distress of a large population who didn’t have more than a week’s financial reserve, leave alone the financial security for life.

Poverty will be a silent killer, standing behind COVID-19. If decisive steps are not taken to negate poverty, social unrest will spoil the positives of lockdown. It is also the other way around. The very fact that people are restless, the government in desperation risk-taking risky steps.

The economy needs a restart but account for risking contagion, restrictions, and consequential poverty. The interconnectedness of small businesses giving employment to the majority in India is adding to desperate measures.

It brings us to the issue of migrant labourers. Most of the agricultural activity is carried out by seasonal labourers, who moved across states in millions. Currently, they are stuck as national transportation is also restricted.

Moving them to the right place for agricultural activity means restarting the entire railway and transportation system. It’s a tricky proposition and prone to chaos and uncontrollable contagion again.

Singapore witnessed a relapse of infections. Mainly due to the dormitories of the migrant worker. All this while the world was in praise of their containment efforts, and few cases had turned the success story into a tragic one. Learning from Singapore reflects how carefully India must handle its migrant workers.

There is a social aspect to this lockdown too. Many migrants have been to their villages due to lockdown. Usually, families back home are financially supported by the migrant incomes in the cities. In this case, it had stopped abruptly.