What India Must Do to Beat COVID-19

America is completely unwilling to impose a national lockdown due to economics. Americans argue that the cure cannot be worse than the solution; that the economic stresses created by a national lockdown would wreak havoc. America’s libertarian spirit only exacerbates this. 

Yet, India – a nation eight times poorer than the US by PPP per capita, imposed a nationwide lockdown of 1.3 billion people for several weeks. In facing COVID-19, arguably no country faces a larger dilemma than India. Densely packed slums, such as the Dharavi slum in Mumbai, along with the sheer number of large cities in India – India has 10 cities larger than Chicago – make public health in India a difficult challenge. However, lockdowns cause immense difficulty for the poor – who often live off of daily wages and who have no savings. 

The national lockdown in India certainly aided the public health front. Without the lockdown, India would almost certainly be leading the world in cases right now – instead, it finds itself having roughly 90,000 cases, among the lowest in the world on a per capita basis. Being a poorer nation, India lags in metrics such as hospital beds per capita – overloading the medical system would be devastating. Much fuss has been made regarding India’s lack of testing per capita, but this does not take into account India’s test positivity rate of less than 5% – far lower than that of the US or many European countries. India’s test positivity rate indicates that the testing situation in India is adequate, and that anyone who wants a test can get a test. India’s government also intelligently allocated resources – for example, Indian Railways converted old train cars to quarantine facilities.

Nevertheless, there have been significant problems with the implementation of the national lockdown. The plight of India’s migrant workers, many of whom have been forced to walk hundreds of kilometers to return home, is well documented. While India’s lockdown was quite possibly the best public health measure adopted by any nation during the COVID crisis, India’s failure to properly take care of migrant workers is shameful. India could have either properly sheltered migrant workers – Punjab used schools to do this, and unused rail cars may have also been an option – or they could’ve arranged for trains to transport migrant workers back to their home state. 

India is now doing away with a total, nationwide lockdown. The Indian government has now classified all 733 districts into red, yellow, and green zones for COVID – with red zones having the harshest social distancing measures, and green zones having the lightest measures. These districts are to be updated weekly. Additionally, India is easing up on social distancing measures – allowing cabs and buses to operate, and lifting limitations on office workers. However, there is evidence to suggest that India is easing up on lockdown measures too early. New case counts in India have ballooned, from around 1800 cases per day in late April, to more than 5,000 cases in a single day on May 17. Most of this increase may be attributed to increased testing – nevertheless, a country cannot reopen if it is reporting thousands of daily cases. Daily death counts have also steadily grown – from around 75 in late April to around 150 today. As the centre and states continue to ease up on measures, new cases will continue to grow, as virus spread is an exponential function. While India has developed a contact tracing app, Aarogya Setu, this app only has 100 million downloads in a nation of over 1 billion active mobile users.

The economic pain is undeniable. Estimates indicate that 120 million may go into poverty due to COVID-19. However, using a case fatality rate of 0.5%, if half of the Indian population is infected, 3.25 million Indians could die. Uncontrolled disease spread will also destroy economies – people will not spend money when they are surrounded by death. On the surface, the Indian government faces a difficult choice – mass poverty, or mass death and great poverty. To escape this difficult dilemma, India must quickly suppress COVID-19, aid the poor, and implement enormous stimulus packages to bolster the Indian economy once the virus is defeated.

In order to suppress COVID-19, India must reimpose the lockdown it originally had, and move the country back to Phase 1 of lockdown. Lockdown 4.0 is simply not strict enough – interstate transport cannot occur, and businesses cannot safely reopen, when a country is reporting thousands of new cases daily. Instead, the virus must be crushed, as it has been in New Zealand and Vietnam. Narendra Modi has the political capital to do nearly anything – he is the most popular leader on Earth at the moment, with approval ratings of around 90%. Therefore, a reimposition of a harsher national lockdown will be obeyed – a popular, charismatic leader such as Modi can dramatically influence the behavior of Indian citizens. This lockdown must be nationwide in order to ease the burden on the country as a whole. Currently, Indian COVID-19 cases are concentrated largely in Maharashtra, Tamil Nadu, Delhi, and Gujarat – and hospitals in Mumbai are already overwhelmed, while states such as Himachal Pradesh have reported little to no new cases. However, India’s government cannot handle severe outbreaks in multiple states – if cases are concentrated in Mumbai, resources can be diverted to Mumbai, but if outbreaks are occurring in multiple locations, it is more difficult to concentrate medical resources to fight the epidemic. As seen in South Korea, Singapore, and China, cases can easily unexpectedly reemerge, seemingly at random. The virus must therefore be suppressed nationwide.

India must ensure that no one goes hungry during lockdown. India is agriculturally self-sufficient, and produces enough food for itself. Therefore, the problem is distribution of food. India’s public distribution system has been overwhelmed, and is mired in inefficiency. India can learn from Odisha, which dramatically improved its public distribution system throughout the 2000s – obviously, these improvements take time, but in the age of COVID-19, rapid solutions have been implemented by all organizations. Additionally, India must properly care for its migrant workers. In order to do this, India must leverage its existing resources – chiefly, unused schools and railway resources. India has 7400 railway stations, over 1 million schools, and tens of thousands of railway cars. These facilities can be used to house migrant workers, and serve as quarantine facilities or food distribution points. These steps have already been taken in a limited fashion, but India must expand this leveraging of resources if it is to extend its lockdown.

Lastly, in order to continue India’s rise to become an economic titan, India must implement an enormous, pro-infrastructure stimulus package. The package recently implemented was a stopgap, rather than a stimulus – while it was necessary for short term economic security, it will not help India in the long term. India still needs to make massive strides in infrastructure development, cleaner energy, and mass education. India needs a far larger stimulus which focuses on improving the productivity of the citizenry – a stimulus that builds schools, improves roads, initiates high speed rail development, and hastens India’s transition to CO2-free energy source such as nuclear power. In the short term, this stimulus would increase Indian debt – but in the long term, it would accelerate India’s GDP growth, ultimately “paying for itself”.

The Modi government has performed fairly well in the face of COVID-19. However, they risk squandering a month’s worth of progress, and leaving millions in poverty. A reimposition of the national lockdown, along with a larger stimulus package, is the quickest path to ensuring that a stronger India emerges from COVID-19. 

 

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