India is staring at a crisis greater than Covid-19. It is time to open up
Continue to test, trace, and quarantine patients. But the rest of the nation has to get back to work
India has extended the national lockdown — but admittedly, with a range of relaxations across zones. But the government should have been more liberal in its opening up. Other than the key districts in the severely hit red zones, which are still struggling with a high percentage of coronavirus cases (Covid-19), the rest of the country needed to be given space to breathe again.
If there is one conclusion, I have drawn from travelling across the breadth of six states for close to 50 days, it is this. A greater calamity than Covid-19 — humanitarian, social and economic — is imminent if a uniformly imposed lockdown is continued any further.
This is not to argue that the initial clampdown and enforced physical distancing did not serve its purpose. Data scientists have confirmed that the number of infections would have been substantially higher had the decision not been taken to effectively shut down the nation.
But five weeks on, we know that, to start with, India is a global outlier in the number of fatalities from the pandemic. Immunologists such as Dr Siddhartha Mukherjee say the scientific reasons for this are unclear. Others such as Kiran Mazumdar Shaw of Biocon argue that it may be our demographics (we are a distinctly younger nation) or our previous exposure to zoonotic viruses. Whatever the reasons, the present death rate is not higher than that of other diseases that claim Indian lives every day. On the contrary, if you look at the fact that 1,300 Indians die from tuberculosis (TB) every day, and as many from cancer, the fatality rate of the coronavirus so far does not even come remotely close.
In the meantime, apart from the impoverishment of migrant workers and the ignominy they have been subjected to, there are other grave crises emerging. Key among them is the lack of access to health care for poor citizens. In Agra, I met with the family of RV Singh Pundhir, a retired middle-class resident with a chronic kidney disease, who was denied his scheduled weekly dialysis. He was asked to get tested for the virus first. By the time his result came (he tested negative), he died. In Aligarh, I met five young girls who cremated their father, a poor tea vendor and long-term TB patient. He could not get an ambulance or medical intervention in time. Similar stories have emerged across states, including in Delhi, Haryana and Punjab. Several public hospitals have been converted into Covid-19only facilities, and are thus off-limits for patients. Beds may be reserved for poor patients in private hospitals, but travel to India’s smaller towns and you will find many of these hospitals non-operational. Personnel are either not showing up to work or the fear of criminal action in the case of Covid-19 cases emanating from their premises has made several institutes wary.
As we wait to return to life, the biggest gear shift needed is in that of attitude. While aggressive contact tracing and quarantine are still essential, we cannot treat testing positive as a doomsday scenario. Up until now, we have been shutting down entire entities — housing societies, hospitals, factories, workplaces — if even one person tests positive. Instead, science tells us to isolate the individual and those who came into direct contact with her; not to throw the baby out with the bath water. If every positive case triggers panic, we shall never be able to rebuild our lives or our nation.
There are bigger problems now to tackle: How to kickstart the economy should have all our attention. If we do not send workers back to their villages with dignity, a reverse migration by them could mean that factories will find it impossible to reopen. And let’s not forget that millions of Indian children have been edged out of the school system as classes go online. Only 27% of Indian homes have one member with access to the Internet, according to National Sample Survey Office data of 2014.
As Adar Poonawalla, the chief executive officer of India’s Serum Institute, which is working on producing a Covid-19 vaccine, points out, the biggest flaw in a uniformly imposed lockdown is that it quarantines healthy people. We have to nuance our approach; what’s needed is not a sledgehammer that clamps down, but a sieve that sifts those who really need medical help from those who can just stay at home for a fortnight and get better.
The present paranoia is ironically preventing people from testing. Private laboratories in the Capital confirm that the twin fears of societal stigma and being placed in an inhospitable quarantine centre are making people hesitant to test. In other words, the more we treat coronavirus victims as criminals instead of mundane contractors of a disease, the tougher it will be for India to fight the pandemic effectively.
Five weeks of the lockdown has served its purpose. It has also served its time. The lockdown must ease. More of this will be a cure worse than the disease.