India’s make or break moment
The next 10 days will determine its Covid-19 trajectory
India is at the crossroads in its battle against the coronavirus disease (Covid-19). There are two scenarios. It will see a relatively manageable rise in the number of cases, but low fatality rates, a health system prepared to deal with new patients, and, sooner rather than later, the flattening of the curve. This is broadly South Korea’s trajectory. Or it will see a surge of cases; an unfortunate, dramatic rise in fatalities; overrun health facilities; and infected health workers — it will then remain at this peak for several weeks, before an eventual dip. This is broadly the trajectory of Italy and the United States.
Why is this period critical? One, India has finally ramped up testing (though experts believe it is still not enough); this means there will be an increase in known cases. This, in itself, is nothing to be alarmed about, as long as it is accompanied by aggressive contact tracing, isolation, and treatment. Two, it is now a little over two weeks of the lockdown. This is also, broadly, the period when those infected begin to show symptoms. Those who may have got exposed to the virus before the lockdown will, at this stage, be getting tested positive. But over the next week, the effect of the lockdown will become visible. The indicator to watch out for here is whether the rate of growth of positive cases begins dipping. Three, migrant workers went back home soon after the lockdown was announced — if that did lead to the spread of the infection, including in rural areas, it will begin getting reflected in numbers around this time. Four, the government has now had 15 days to ramp up the health infrastructure, put in place quarantine facilities, expand beds, procure personal protective equipment (PPES) and increase the supply of ventilators. Its record has been mixed, with specific concerns on PPES for health workers, the absence of which can undermine the entire health system.
The results will also determine the government’s decision on the lockdown. There appears to be unanimity among key decision-makers in the central and state governments about the need to continue with a set of restrictions, particularly for affected clusters. The difference is about whether a total lockdown should continue or it should be partial. The answer to that will be provided by the numbers over the next six days. India must hope for the best, but be prepared for all scenarios.