India’s Covid scene is getting scarier

Paran Balakrishnan | Updated on May 27, 2020

With hordes of migrants returning to their home States, new cases are mounting at a worrying clip

It could have been a shot from a sci-fi disaster film: passengers wearing masks and plastic visors queuing up — standing far apart from each other — in front of an airline counter staffed by hazmat-suited employees. This was the first day of India returning to work and it was the most graphic reminder that life’s not returning to the old normal anytime soon.

India’s getting the worst of all worlds. It’s clear we’ve got to get back to work — most experts believe there are no more benefits to be reaped from extending the lockdown. “A lockdown will now kill more people than it saves,” says virologist Shahid Jameel, who’s CEO of DBT/Wellcome Trust India Alliance. But we haven’t vanquished the pandemic and infections are mounting at a worrying clip. We’ve been reporting over 6,000 cases each day and now stand at over 145,380.

In terms of the daily rise in cases, we now rank fourth after the US, Brazil and Russia. At this rate, it’ll only be a short time before we crest 200,000 and head for far higher numbers from there.

So that’s why the new normal is going to be very different from the old normal. Already, auto companies like Maruti and Hyundai, which have introduced far-reaching safety and sanitation programmes at their plants and are working single shifts initially, have workers testing positive. Nokia’s plant near Chennai, back at work for over a month, had to shut temporarily when 18 workers tested positive while Zee TV, working through the lockdown, has some 28 Covid-19 positive staffers. Other firms have workers staying on site and not returning home.

What’s more, we’ve now got a lethal cocktail. Take what’s happening in Kerala, which wrestled the number of daily new cases down to single-digits.

The achievement slammed into reverse with over 93,000 Malayalees returning from the Gulf and other parts of India since early May when travel curbs were lifted. That’s translated into 206 new cases in the last five days. On one day alone, the State had 53 new Covid cases, of which, 29 were returnees from other States, 18 from Gulf countries and five local-transmission cases.

Reverse migration

Other States face similar issues. Look at Assam, which had so few cases. Health Minister Himanta Biswa Sarma felt compelled to warn against rumour-mongers who claimed the Assamese enjoyed special Covid-19 immunity as a race. Assam got its first case only on March 31 and by May 7 had just 50. But after intra-State travel got the green light, that leapt to 540 and there were 147 new patients Monday. Sarma insists the State’s still in a good space because it’s enforced a strict lockdown and many of the new arrivals are falling sick in quarantine camps and not in the State’s cities and villages.

Bihar, though, which has some of India’s worst healthcare, has almost 200,000 migrants already home and another 200,000 en route. The State had 2,686 cases Monday, of which, over 1,700 were recent returnees. In Uttar Pradesh, too, the same story is unfolding with 1,423 migrants testing positive.

Kerala’s one State making clearly successful efforts to contain the threat from returning outsiders. Travellers’ baggage landing in Kochi is triple-sanitised and they can only travel onwards in buses travelling to each district. Front seats are cordoned off to minimise the driver’s risk. If returnees opt for a private hotel, their meals are left outside their door and plates must be washed before being put out. A similar, tightly controlled process happens on trains.

Given the situation, though, it’s understandable State governments are stalling new arrivals. Community transmission is now a given, says Jameel, though the government refuses to openly concede this. So, will the pandemic only end when herd immunity develops? The lockdown Vs herd immunity argument has gotten louder in recent weeks. Many doctors believe herd immunity — of the type propounded by Sweden’s chief scientist Anders Tegnell — is the only solution. But with India’s nearly 1.4-billion people, it involves terrifying numbers.

Jameel reckons 60 per cent or nearly 800 million people would need to be infected to achieve herd immunity. If 10 per cent of these needed hospitalisation, that would be 80 million, of whom, millions would require ICU beds and ventilators. India has 34,000 ICU beds, Jameel says. And even then, the value of herd immunity is debatable as it may be contracting Covid-19 only confers, like some other coronaviruses, short-lived immunity and not, as in measles, lifetime immunity.

Jameel believes the government must seek innovative solutions to the pandemic. He notes many people don’t go near a hospital because they fear being forced into an uncomfortable quarantine facility. That being the case, maybe home quarantine could be allowed for some. He also suggests involving community-based organisations in the battle. In Kerala, for instance, panchayat leaders play an extremely pivotal role.

Is there a silver lining to this grim scenario? Possibly. It’s Maharashtra, Gujarat, Madhya Pradesh, Tamil Nadu and Delhi that are racking up the big numbers with other States still reporting relatively low tallies though that may reflect insufficient testing and could swiftly change with migrants returning carrying the highly contagious infection.

Still, control the infection in big urban centres and we might start seeing a meaningful case reduction. But that’s a formidable ask. Mumbai’s hospitals are already being overwhelmed by the sharply rising numbers even though the State has put in new beds and told private hospitals to start treating Covid-19 patients.

Fear overplayed?

Then there’s the question whether the infection might start receding in around two months as it has in other countries like Italy. Even in the UK and the US, there are slight signs it’s passed the peak. Some experts believe we’ve overplayed the pandemic fear and Covid-19 will retreat whatever measures we take or don’t take.

Looking at the possibility of a vaccine, it may not be the magic bullet that will stop Covid-19 in its tracks but more like the one that shields against influenza — it lowers chances of contracting the illness and falling sick with the worst symptoms. So Covid-19 may be yet another illness with which we have to learn to cope with hopefully the fallback of developing drug therapies that can protect patients from the biggest killers triggered by the infection like Covid-induced pneumonia.

At the end, there’s only one figure, though, that matters and that’s the death toll. So far, we’ve gotten away relatively lightly compared to several European countries and the US. Our Covid-19 fatality rate is among the world’s lowest. Here’s hoping that continues as we face the undeniably challenging months ahead.

Published on May 27, 2020

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