Slowly and steadily, the entire country is going into lockdown. Post the culmination of the self-enforced ‘Janta Curfew’ many states have taken steps to pass orders to ensure the curfew-like conditions are given legal backing.
As many as 80 cities go into lockdown till March 31 as of today. This is being done by almost all states with COVID-19 cases, to contain the spread of the novel coronavirus. As a result, Delhi, Mumbai, Bangalore are a few of the cities going into lockdown.
While markets, malls, cinemas and educational institutions were already shut before, the directive to close up shop has extended to other areas as well. Trains, metros and inter-state buses have been suspended across the country. In some cities and states Section 144 has also been imposed, a law which bans public gathering of more than 5 people.
However, this does not mean that the entire country is coming to a standstill. Essential services including water, power, civic services, groceries, milk, petrol pumps, medicine stores, takeaway and ATMs will be functional, with even government offices working at reduced capacity.
All these measures are being taken to ensure that the prevailing situation in the country doesn’t worsen. The country’s medical infrastructure is already not at par with some of the countries that were the centre of the virus outbreak.
India had 0.7 hospital beds per 1,000 people in 2011. China had 3.8 for the same year and Italy had 3.5. Even when it came to the number of physicians per 1000 people, India stood at 0.8, while China and Italy had 1.8 and 4.1 respectively.
A situation like Italy or Iran could put extreme pressure on the health infrastructure and medical professional in the country, a pressure our systems may not be in a position to deal with right now.
While a lockdown is one of the steps to deal the coronavirus outbreak in the country, the WHO’s top emergency expert was quoted telling how that’s not the only thing countries under the threat of the virus have to focus on.
"The danger right now with the lockdowns ... if we don't put in place the strong public health measures now when those movement restrictions and lockdowns are lifted, the danger is the disease will jump back up." -- Mike Ryan, WHO
Ryan also went about discussing how restrictions coupled with aggressive testing measures was a way to take the fight to the virus. Praising countries such as China, Singapore and South Korea for their disease management efficiency, Ryan believed these countries provide a successful model for other virus-hit nations to follow.
So apart from the lockdowns, what else India can do? And is the country prepared to effectively execute the measures?
Ensure Supply of Medical Equipment
A ready supply of medical equipment and supplies is the utmost basic requirement that the country needs to meet. It is imperative that masks, ventilators, gloves, gowns are in abundant supply. Shortage of personal protective equipment (PPE) could endanger health workers and weaken the coronavirus response in the country.
In countries where the virus outbreak is in full flow, several reports indicate how much of a problem can be posed for the medical authorities if they don’t have access to proper medical equipment.
Even the WHO issued guidelines on February 27, warning countries of an impending shortage in supply of PPE. “The current global stockpile of PPE is insufficient, particularly for medical masks and respirators; the supply of gowns and goggles is soon expected to be insufficient also. Surging global demand-driven not only by the number of COVID-19 cases but also by misinformation, panic buying and stockpiling − will result in further shortages of PPE globally.”
If protective equipment is used up without being replaced, that situation could become more widespread as the coronavirus outbreak worsens in the coming days and weeks.
Ensure Basic Income To Those Worst Hit
While a lockdown is the most effective way to keep people off the streets, it also has an economic and financial impact on the country. Payments dry up, business shut up shop, money stops flowing. All of this can have a massive impact on the earning, employment and revenue-generating capacity of a region even post the lifting of the lockdown. Therefore, in times of a crisis like this, the government must support those who’ve lost their earning capacity due to the lockdown.
Most of these workers don’t have any income security, no sick pay, and often very limited savings. As many as 22% of Indian workers find themselves below the poverty line. In the event of a lockdown, they lose the wages on which their household depends, and it is important that they must be looked after as well.
A basic income, even if it is until the time the virus outbreak is controlled, is a simple solution. It involves giving people modest, regular and unconditional cash payments. This payment will ensure that the most affected have the money to purchase necessities like food, water and medicines at a time when they have no earning source.
Several Indian states have already announced basic income measures. The UP government has announced that a monthly amount of Rs 1,000 each will be given to 15 lakh daily wage labourers and 20.37 lakh construction workers across the state via direct benefit transfer.
Even the Arvind Kejriwal led government has announced doubling of pensions for widows, old people, and the specially-abled.
Scale Up Testing
Since Day 1, the World Health Organization has been clear on how to control the pandemic. "We have a simple message to all countries - test, test, test. All countries should be able to test all suspected cases, they cannot fight this pandemic blindfolded" WHO Director-General Tedros Adhanom Ghebreyesus said in a press conference.
However, as of now, India seems to be completely ignoring the advice. India had tested some 14,175 people in 72 state-run labs as of Thursday evening - one of the lowest testing rates in the world. The rate at which the country is currently testing stands at 10.5 per million people. To give you an idea South Korea, Italy and the United States are testing at 6148, 3949, 313 people per million respectively
There seems to be a direct relationship between the scale of testing the ability of the country to control the epidemic. Test more, find more cases, deal with them effectively. Countries and regions that have so far been able to contain and mitigate the spread of COVID-19 have all done so by scaling up testing. Examples South Korea, Taiwan, Singapore, Japan and Hong Kong.
Mass testing is essential for a variety of reasons. The virus has shown cases where the patients have been asymptomatic. These patients if not tested can act as dangerous carriers of the virus, capable of spreading it to multiple people unknowingly.
South Korea’s mass testing practices revealed how even young people are getting the virus in large numbers but aren’t showing any symptoms. While these go on to recover, they pose a threat to the elderly and those already suffering from pre-existing conditions. By identifying and isolating such people, countries like South Korea have been able to contain the spread of the virus and keep their mortality rates low.
However, signs are there that the country is finally scaling up testing. The Indian Council For Medical Research recently changed its testing guidelines, to make sure more and more people are eligible for a COVID-19 test. The total number of testing facilities in the country is expected to be boosted to 122, with even private labs being asked to begin testing. India has also placed orders for a million test kits and will be possibly asking the WHO for a million more.
Improve Sanitization Facilities
By now, you surely must have seen enough about how sanitation and personal hygiene is the single most effective way to deal with the novel coronavirus. It is even listening on the official WHO website, under basic protective measures to deal against the new coronavirus.
However, sanitation is already a huge challenge in a country like India. For a disease that can be tackled by simply washing your hands, India struggles on this metric as well.
Hand washing is one of the recommended ways of avoiding COVID-19. Data shows that 50.7 per cent of the rural population does not have basic hand-washing facilities, including soap and water (2017). It was 20.2 per cent in urban areas, around 40.5 per cent for the population overall. As many as 99 million people lack access to safe water in the country.
Therefore, providing basic sanitation facilities and hygiene conditions to Indians becomes even more important during this time.
Thus while a lockdown is a step in the right direction, as has been attested by the World Health Organization. It is imperative that the country builds upon the preventive measures and takes into account other aspects as well, to prevent an impending health crisis in India.