Evaluating India’s Covid-19 battle

With over 50,000 cases, it will get worse before it gets better

Over 50,000 people in India have now tested positive for the coronavirus disease (Covid-19). There are two ways to look at this number. At one level, it is alarming — for it shows that the disease has truly made its way in, and there is, undeniably, a level of community transmission where those infected are not necessarily people who have either travelled abroad or been in contact with those who have. It also shows that the lockdown may have been able to slow, but has not been able to stop, the spread of the disease. But at another level, the figure needs to be seen in a wider perspective. Given India’s size and population, the fact that there have been over three million cases globally, and the rate of fatalities is low (around 2,000 people have died), the situation could have been a lot worse.

But is it getting worse? Despite the stringent lockdown, the past week has brought disturbing news. There has been a surge in cases — to be sure, this can also be attributed to higher levels of testing, which is needed to trace the infected. From a doubling rate of 11.5 days on May 3, it has shortened to 10.3 days — which means that cases are doubling in quicker time. Each set of 10,000 cases are now increasing at a more rapid pace than the preceding set. Maharashtra, Gujarat, Delhi, and Tamil Nadu are particularly affected, and are contributing a substantial share of the cases. Uttar Pradesh and Bihar remain particularly vulnerable because of both the density of population and the fact that migrant workers are now in the process of returning home. Two other states — West Bengal and Madhya Pradesh — need to be carefully watched too, given reports of undercounting and administrative weaknesses.

The good news is that India now has a clear health protocol to deal with the disease even if there is no cure — ensure social distancing, test, isolate, treat. The bad news is that India has probably not peaked yet. And with relaxations in the lockdown, and possibly greater opening after May 17, there will be more mobility and human interactions. This, in turn, will increase the number of cases. It is not clear if India has the adequate health infrastructure to deal with this possible surge, despite the time given to gear up by the lockdown. The government must not succumb to the temptation of underplaying the challenge — sometimes visible in the regular Press briefings. The situation will get worse before it gets better.