COVID-19 in India: Issues, Challenges and Lessons
COVID-19 has not left any part of the world untouched and India is one of the worst affected countries in the world. The cases in India are rising steadily with each passing day. As of August 10th 2020, India has over 2.3 million (the second million coming in exactly three weeks since the country hit a million infections on July 16, with 42 percent of the new cases coming from Andhra Pradesh, Karnataka, Uttar Pradesh, West Bengal and Bihar) confirmed COVID-19 cases and 46,188 reported deaths. The worst affected states of India include Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi and Uttar Pradesh. Another growing concern is that interior parts of the country are emerging as new hotspots. Four states in eastern India, namely, Odisha, Bihar, Assam and West Bengal are increasingly reporting positive cases. The two main reasons being reported for this surge in cases in rural areas are the returning migrants from major cities who did not undergo screening or were asymptomatic and the poor healthcare infrastructure in the rural settings. Out of a total of 739 districts in India, 13 districts (across 8 states and a union territory) account for 1 in seven Covid-19 deaths. The 13 districts are: Kamrup Metro in Assam, Patna in Bihar, Ranchi in Jharkhand; Alappuzha and Thiruvananthapuram in Kerala, Ganjam in Odisha, Lucknow in UP; North 24 Paraganas, Hooghly, Howrah, Kolkata and Maldah in West Bengal, and Delhi. These districts account for nearly 9 percent of India’s active cases and about 14 percent of COVID-19 deaths. Over the spring and summer, the COVID-19 situation in India has really deteriorated and could get much worse on the current trajectory with around 60,000 cases being reported per day and around 900 daily deaths.
Lockdown and travel bans due to COVID-19 have impacted almost every sector including tourism, hospitality, and education. To deal with the coronavirus crisis, the central government has undertaken various initiatives like monetary relief package under Pradhan Mantri Garib Kalyan Yojana, Uttar Pradesh Rojgar Abhiyaan, Atma Nirbhar Abhiyaan etc. The state governments have also undertaken various initiatives like Operation SHIELD, 5T Plan, Mission Fateh, Snehar Paras etc. We describe these briefly. Some regions in India have successfully contained COVID-19 like the state of Kerala, the district of Bhilwara in Rajasthan and the slums of Dharavi in Mumbai. In order for a strategy of containment and recovery to succeed, it is vital to keep using public health measures to suppress the epidemic, that is to drive R < 1. Besides the infection rate, it is vital to closely monitor the positivity rate and the case fatality ratio (death rate) and rely not so much on the recovery rate which is what seems to be happening currently. Eventually, in all likelihood, as the pandemic subsides, close to 97 plus percent cases are likely to recover implying a 2 or 3 percent death rate. India needs a epidemic control strategy to be developed and put in place to control and contain the spread of the infection in the country, something that is not being done currently. Due to COVID-19, while most countries are facing the twin crises of public health and the consequent economic downturn, India has an additional challenge to deal with, namely a massive migrant workers crisis. While it is hard to say what long-term impact this home migration might have, but some trends were quite clear so we made a few recommendations to the government in May that we list along with some lessons for India to learn from elsewhere. On the economic front, a deep and prolonged economic slowdown is inevitable.
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