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Covid-19: Err on the side of caution

N Madhavan | Updated on April 09, 2020 Published on April 09, 2020

In the absence of firm data, India’s post-lockdown Covid-19 strategy should prioritise life over economy

As the unprecedented 21-day total lockdown in India winds to an end, the government is facing some very difficult choices. The number of infections — in excess of 5,000 — continues to rise with the infections doubling every five days. The stringent measures put in place by the government is yet to flatten the curve. The Indian Council of Medical Research has said that the country is between stage 2 and stage 3 (large scale community transmission) of the virus life-cycle. So many State governments have sought extension of the lockdown on the grounds that more time is needed to contain the virus.

At the same time calls for easing the lockdown have risen too. After all, the number of infections in a country with 1.3 billion people pales into insignificance compared to that in the US (over 4 lakh cases), Spain (1.4 lakh cases and counting) and Italy (1.36 lakh-plus cases). Not just infections, India’s Covid-related deaths (around 160) is way lower than what other countries are reporting. Italy has lost 17,000 lives while Spain has reported 14,000 deaths and the US 14,000.

Also, India’s fatality rate is just half the global average. And for a country where 2.79 million people contract tuberculosis every year and 4.35 lakh succumb to the disease (1,100 a day), has India over-reacted to the coronavirus? Validity of this question is increasingly gaining ground even as the economic activity in the country has come to a grinding halt pushing the Indian economy, already reeling from the effect of a sharp slowdown, over the cliff.

The lockdown’s impact on the workforce, which is predominantly unorganised, has been severe. It does not help that most of them lack a social safety net. The fear now is that they may survive the virus only to die of hunger. Though the fiscally constrained Modi government has announced sops amounting to about one per cent of the GDP to ease their pain, this paltry relief may not reach those who need it the most. Under the circumstances re-starting the economic activity, many feel, is critical to tackle poverty and hunger.

Also, longer the lockdown greater will be the difficulty in reviving the economy. It will also push the already fragile banking system deeper into the abyss. So, considering the relatively low level of infections and deaths, should India adopt a more unique strategy rather than aping other severely affected countries and continue with a total lockdown?

Why infections are low

To answer this question, it is pertinent to look at the reasons that has helped India keep the infections low. The country, experts say, moved fast to keep out foreign visitors by suspending visas by second week of March. It also resorted to a total lockdown early. India’s lockdown began when its death toll touched 10. Compare this with China where it shutdown Hubei province when the fatalities touched 30 or Spain (200 deaths), the UK (335) and Italy (800). Scientists have also attributed the low infections to India’s universal immunisation programme (including the BCG vaccine).

It is also being said that the potency of the virus is low in higher ambient temperatures and average humidity — something most parts of India enjoy at this point in time. The younger demographic profile could also have helped India, some add. But none of this is backed by scientific research. Also, it is a fact that India’s level of testing, compared to countries with higher cases, is significantly lower. India is conducting 102 tests per million people significantly lower than Italy’s 8,379 tests, South Korea’s 7,710 or Spain’s 7,596. Is the lower testing camouflaging the actual number of cases in the country?

The government has three options before it when it comes to a post-lockdown strategy. Continue the lockdown for a week or more, opt for a staggered opening up or lift the lockdown completely. While the third option is pretty much ruled out as the infection curve is yet to flatten, the government’s ability to take a calibrated decision on either extending the lockdown or lifting it in a staggered manner is heavily impeded due to lack of data.

There have been attempts to map the hotspots across the country so that they can be cordoned off and rest of the country can be opened for economic activity. Identifying hotspots based on positive cases alone may not be the right thing to do. What about areas where there are a large number of asymptomatic cases? They will end up infecting a lot of people before the symptoms even show up.

Thus, without extensive testing the government will not be able to identify hotspots effectively. Opening up the lockdown without accurately identifying and shutting down the hotspots will lead to a second wave of infections which countries like South Korea and China which have flattened the curve are experiencing now.

Start extensive testing

The safer way then is to extend the lockdown for a couple of weeks while ensuring that essential economic activities including harvesting of rabi crop are permitted. The government can use this time to roll out extensive testing. Unlike South Korea, India with its large population cannot undertake universal testing. But that does not mean it cannot resort to extensive sample testing.

The Covid-19 tests have to be undertaken in a large scale in identified hotspots and other susceptible areas to zero-in on infected cases. At the same time, the extensive antibody testing should be rolled out across the country. It will reveal if Indians, indeed, have higher level of immunity against coronavirus due earlier immunisation. At the end of the two weeks, the government will have enough data to clearly identify hotspots that will remain under quarantine. If a large section of the population clears the antibody test, it is a scientific proof that Indians have resistance against the virus and the government will be emboldened to lift the lockdown.

It is clear that the government, as things stand today, is flying in the dark. In such a scenario, it is safer to err on the side of caution and extend the lockdown. A hasty decision to open up, even partially, could result in the country paying greater price in terms of life and economic output.

Published on April 09, 2020

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