The coronavirus pandemic has created an unprecedented crisis. It has spread rapidly, catching governments, local administrations and public health systems unprepared. All countries — rich or poor — have been adversely affected.
For India — a country of 1.3 billion with socio-economic disparities, and hundreds of millions of poor, unemployed and underemployed labourers — the virus has posed critical challenges. The country has been under a total lockdown since March 25, which has now been extended to May 17. But the virus is still spreading and the lockdown restrictions have to be extended further. On March 25, India had only 627 confirmed cases spread over 130 districts. On May 3 — the last day of phase II of the lockdown — the number of affected districts stood at 401 with 42,836 confirmed cases, now rising by over 2,000 a day. Though the mortality rate for India at 3.2 per cent is lower compared to the US, the UK and other European countries, more than 1,389 people have died and infections are doubling every 11 days.
India’s lockdown has been arguably the harshest. It was supported by all major political parties, and elected state governments of which 11 are controlled by the opposition. This bipartisan consensus was made possible as containment of the virus was considered necessary.
The lockdown has helped in slowing the spread and flattening the curve. Tracking suspected cases, their contacts and testing them has been relentlessly pursued. This period has also provided space for the Centre and state governments to ramp up testing facilities, and strengthen a fragile public health system for a possible post-lockdown surge.
The pandemic has brought to fore the glaring shortcomings of the public health system and the over-dependence on private hospitals. Over the years, there has been a tendency to favour an insurance-based private hospital model and not opt for increasing government spending to expand public healthcare facilities. Two-thirds of hospital beds in India and almost 80 per cent of available ventilator-equipped ICU beds are in private hospitals. They are handling only 10 per cent of the COVID load. For a country with a large number of poor and socially vulnerable citizens, private healthcare is neither accessible nor affordable. Ironically, in this time of crisis, it is the government hospitals that are taking on the burden.
This pandemic should be a wake-up call for the government to allocate more resources for public healthcare infrastructure. Unfortunately, the government’s priorities are misplaced. It is persisting with the controversial Central Vista Project which costs Rs 20,000 crore. This will also be a criminal waste of public money when there is already a paucity of resources to fight the pandemic. The government is withholding DA installments and accepting loans from the World Bank to fight the pandemic. India needs well-equipped government hospitals and not grand buildings which will serve no public purpose.
The shutdown of the economy has inflicted unbearable social and economic costs. An estimated 122 million jobs in the formal and informal sectors have been lost. The informal sector which employs 90 per cent of the workforce and the MSME’s are worst hit.
The lockdown was hastily imposed by the Central government without any advance preparation or coordination. There were no consultations with the state governments. Abrupt cancellations of trains, buses and bans on movement of all vehicles led to confusion and despair. Millions were stranded without food and money. Untold suffering was inflicted on them.
The fallout on the large number of casual workers and migrant construction and farm labourers has been severe. Migrant labour desperate to return to their native villages were stranded and trapped in harsh conditions. Thousands of migrant workers deprived of their livelihoods were forced to walk back to their villages. The images of men and women — many pregnant, carrying their belongings and children, the elderly and young ones, starving and crying — will remain forever frozen in our memory.
The enforcement of the first lockdown without consultation with the states raises fundamental questions. India has a federal structure and in the constitutional scheme of things, healthcare is a State subject and contagious diseases is on Concurrent list. Also, trade and commerce within the state and industry are State subjects. But all decisions were arbitrarily taken by the Centre under the National Disaster Management Authority Act of 2005. This approach has long-term implications on Centre-state relations.
India is staring at a prolonged recession and massive unemployment. The financial package provided by the government is very small to make any meaningful impact. A financial package of 5 per cent of GDP is a must to revive the economy. The government has directed industry to pay full wages to their workers. MSME’s should be given government-guaranteed finance at zero interest to enable them to pay their workers. The fiscal deficit and inflation issues can be put in abeyance until April 2021.
For the poor — 75 per cent of rural and 50 per cent of urban households — food security has to be guaranteed. Fortunately, the granaries are full with 77.5 million tonnes of buffer food grain stocks.
A phased exit from the lockdown has started. Industrial activity, movement of cargo and limited retail trade has resumed. This will help to balance the twin objectives of saving lives and livelihoods. It will also save the economy as the collateral damage is bound to be far greater if the lockdown is extended.
The lockdown has definitely slowed the spread of the virus. It will resurface once the restrictions are eased. The virus spread, it appears now is beyond the ability of state to contain by quarantining. Ensuring personal protective equipment for doctors and healthcare workers and providing required resources and logistical support to government hospitals is essential to prepare for the next wave.
India has to be prepared for a long haul. A pragmatic approach is the need of the hour.
This article first appeared in the print edition dated May 7, 2020 under the title “Prepare for long haul”. The writer is deputy leader of Congress parliamentary party and former union cabinet minister.
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