India appears to be losing the war on the coronavirus epidemic. But this is a war that has to be won. So it is necessary to go back and see what was done right and what went wrong. Plus, most importantly, try to find the contours of the right strategy to stage a turnaround and start winning the war.
First, what was done right. India was about the earliest among countries to declare a lockdown. This gave it an enormous opportunity to stem the flow of infection. But perhaps most critically, it gave the country time to set its medical house in order so that it would be in a position to offer adequate healthcare facilities at its hospitals to take in all those who would be infected once the lockdown was lifted and required hospitalisation.
The other right thing done involves Kerala and hinges on how different it is from the rest of the country. It began with a great advantage — a robust healthcare system which gave primary healthcare enough resources and left supervision to local government. It also planned for the pandemic as soon as it knew that it had arrived in China as the Malayali diaspora would inevitably bring it back home. So it expanded healthcare facilities.
Perhaps most importantly, it has been able to impress upon the people to behave responsibly, obey advisories on wearing masks, maintaining social distancing and washing hands frequently. Its overall strategy has been to trace, quarantine, test, isolate and treat. It is not as if it had money to splurge. Since test kits cost money and can be used up quickly, it tested not everybody but as per strategy.
That is where the good record ends. As different phases of lockdown have ended and normal economic life allowed to gradually resume, infection levels have gone up. That was expected but what has not happened and what is critically needed is over time acquiring the ability to curb infections so that the curve starts bending. The curve is still rising and every few days India has the dubious distinction of rising one more step in the global league table of nations with the highest number of infections.
What needs to be done
The issue that is crying out for action and is yet to find an answer is: what has to be done beyond lockouts to beat the virus. In groping for an answer, what will be of no help but is being done by different States is to impose every so often a severe lockdown in response to a rapid rise in infection. This will create enormous hardship, particularly for those who are at the bottom of the pyramid. It will only achieve what has been graphically articulated by Rajiv Bajaj: bend the wrong curve, that of GDP, instead of infection.
To understand what needs doing, we can look at what has been done by countries which have decidedly got the better of the infection. This list includes Japan, South Korea, Taiwan, Singapore, Germany, Norway and of course China. Of these, China put in place the severest lockdown and was able to do so because it is a totalitarian state. This option is not available to us. Of the rest, Germany made a robust use of the lockdown.
South Korea provides the most useful model to examine. Critically, it learnt from history, the SARS, H1N1 and finally the MERS epidemic which hit in 2015. Its strategy evolving out of these rested on three pillars — fast and free testing, using a lot technology in tracing, and enforcing isolation for the most severe cases. It sought to maintain a balance between the requirements of public health and the need to protect individual privacy. Its success in using technology to deliver public health is captured in innovating drive through testing which does not even need people to get out of their cars.
The citizens’ cooperation that the system received is implicit in the systematic separation of the sick it was able to achieve. And obviously there was no cheating over quarantine or else the result would have been different. Most significantly, it was able to contain the infection without having to impose a general lockdown.
Prospects gloomy
Two obvious attributes that made all the success stories possible without a general lockdown taking away income from those who need it the most is the people’s willingness to abide by the discipline required of them and the efficiency of the system. Both these tasks have to be delivered by the ruling dispensation of the day, particularly the respective State governments which have to craft their strategies according to particular requirements.
It is difficult to improve the efficiency of the administration overnight but it is possible and imperative for the political leaders to plead with the people to abide by the dos and don’ts. Unfortunately this has been seen a task of enforcement and the police have been empowered to ensure that people follow the rules. What may help is if the task of persuading the people is given to the volunteers of political parties. They may be able to successfully exhort and persuade where the police have failed by wielding the danda .
The current prospects on both the counts are gloomy. The people are unlikely to become responsible overnight and party volunteers are unlikely to step in and get results where the police have failed. So the prospect ahead are of a continuously rising infection curve and periodic debilitating lockdowns. Only a vaccine, it seems, may be able to save us.
The writer is a senior journalist