Here’s what you need to know about India’s preparedness for weathering this pandemic, and the potential effects of the government lockdown.
1. What is India’s covid-19 situation?
India had more than 1,000 coronavirus cases as of Sunday and 27 deaths. The government maintained for a long time that there was no evidence of community transmission in the country. But people without any travel history or close contact with infected persons have also tested positive, and on Sunday, the Ministry of Health and Family Welfare acknowledged the likelihood of “limited community transmission.”
These relatively low numbers mask larger concerns about testing levels. The government’s original strategy was to test only symptomatic travelers and symptomatic contacts of those confirmed to be infected. It has since broadened its testing strategy to also include symptomatic health-care workers, hospitalized patients with severe acute respiratory illness, and direct and high-risk contacts of confirmed patients.
As of Friday, India had conducted only 27,688 tests. Government labs currently can process about 9,800 tests per day. And 29 private laboratories can also test for the novel coronavirus, for an additional capacity of up to 12,000 tests per day. Even with an adequate number of test kits, testing rate is low due to the limited number of laboratories that can process the results. Private laboratories are also allowed to charge up to $60 per test — even though 200 million women have been guaranteed just $7 a month under the government’s relief package.
2. How is India’s health infrastructure coping?
The country’s public health infrastructure is overstretched, making it particularly challenging in the event of widespread community transmission. Official figures tell the story: 1 doctor per 11,600 people, 1 isolation bed per 84,000 people and a total of 40,000 ventilators for 1.37 billion people. And poor sanitary conditions in many isolation wards are leading some of those quarantined to escape these facilities.
India also has the largest population of people with tuberculosis, a community especially at risk from covid-19. There are concerns about the lack of adequate personal protective equipment for all health-care workers.
This dismal state of the public health infrastructure implies that basic World Health Organization prevention procedures are even more relevant in a country like India. But hand-washing assumes access to regular running water, which much of India lacks. Soaps and hand sanitizers remain a luxury.
Social distancing measures, designed to slow the virus’s spread, won’t be particularly effective, due to the high population density in many parts of India. Crowded urban conditions also complicate contact tracing and isolation, as a recent coronavirus cluster investigation in a Mumbai slum suggests.
3. The short notice for the lockdown sparked panic
The first day of the shutdown witnessed blind police brutality against anyone on the streets, including doctors and street vendors. Landlords began evicting doctors and medical staff from their homes despite the government’s condemnation of such actions.
The government has invoked provisions in the Indian Penal Code and India’s Disaster Management Act to allow up to two years of imprisonment for anyone violating the shutdown. But full compliance with the lockdown is unlikely — blatant violations are happening even at high levels of government. For example, the chief minister of the largest state in India attended a Hindu religious gathering hours after Modi declared the shutdown.
4. India already faced economic head winds before the crisis
India has pledged its support to the Group of 20 for injecting $5 trillion into the global economy to counter the pandemic’s economic consequences. However, it will face adverse economic constraints, further exacerbated by its lowest economic growth in six years. One estimate predicts a three-week shutdown will cost India 4 percent of its GDP.
Although the central government challenged the Kerala High Court’s order not to levy taxes and recover bank dues from people during this time, it has implemented its own economic aid policies. The government has created a covid-19 economic response task force. The finance minister announced a $23 billion relief package for the poor, farmers, women and the disabled. The deadline for filing income tax returns has also been extended to the end of June.
All eyes will next be on the central bank’s monetary planning committee, which is due to meet and announce its policies on April 3.
5. The lockdown will hit India’s poor particularly hard
But the hardest hit is India’s very large informal sector — where approximately 450 million people work without formal contractual arrangements or job security. About 60 to 70 percent of the Indian economy is unorganized, which means many Indians depend heavily on daily cash earnings to support their families.
Without jobs or permanent housing, migrants workers now have little choice but to return to their villages on foot. In what might be the biggest mass migration in India since the 1947 partition of the South Asian subcontinent, the possibility of dying of hunger and/or exhaustion have become real concerns. At least 22 migrants have already died on this arduous journey. While some state governments have started to organize transportation, the lack of social distancing and the intermixing of urban and rural populations via this mass migration undermines the goal of the shutdown.
In the coming weeks, the ability to protect the underprivileged will vary. While some wealthier states have implemented contingency plans, poor regions do not have the same capacity. States like Kerala, Maharashtra and Delhi have announced aid packages to help their poor residents access food, loan waivers or free rations. However, the economic and human costs will ultimately depend on how the vulnerable in the poorest regions survive the lockdown.
With an already stretched health-care system, India’s success in containing the spread of the coronavirus will depend on aggressive testing, isolating confirmed cases, and securing protective equipment for health-care workers and providers of essential services.
Suparna Chaudhry is an assistant professor of political science and director of the Reiff Center for Human Rights and Conflict Resolution at Christopher Newport University.
Shubha Kamala Prasad is a PhD candidate in the Department of Government at Georgetown University.