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Monday, October 25, 2021

What India needs: Pandemic response that combines ethics and economics

Covid crisis has made it clear that cooperation and coordination will serve both society and economy

Written by Sarjan Shah |
Updated: May 16, 2020 4:36:29 pm
finance minister nirmala sitharaman economic package, migrant labourers nirmala sitharaman speech, migrant labourers special train, India still has its bottlenecks in terms of trained ER doctors and nurses, but there is a certain rate of growth and acceleration.

In some of the more balanced and nuanced conversations over the last many weeks, I have been struck by an oft-recurring argument: The urgent need felt by people to “re-open” the Indian economy, virus be damned. Pressed a little further, there is a plaintive cry of the “economy” becoming permanently “cratered” if the “lockdown” were to be extended much further. Next, concessions are made towards protecting only the most vulnerable, while allowing the rest of the population to get on with the business of getting India out of poverty (that is, capitalism as it has operated in India since liberalisation). In response, I’ve often found myself explaining what seemed to me, at first, to be an obvious priority: The fact that the public health battle to contain, curtail and manage the virus has to, a priori, come before any considerations of the economic impact of locking down the whole or parts of the country.

At first, when I met with stiff resistance on this point from those intent on “opening up” as soon as possible, learning to “live with the virus” and protecting only the most vulnerable, I assumed that my fundamental priorities and theirs were somehow different. But I quickly realised that all that was missing from our otherwise intelligent conversation was critical data and numbers. There is, after all, no ideological debate to be had here between more “socialist” or “capitalist”-minded folk: There is only a set of hard realities, the important duty to fully understand those quantifiable realities, and the true nature of the “gut-wrenching trade-offs” that we are considering when evaluating policy options.

India has total “public health” capacity — hospitals, clinics, centres, doctors, nurses, diagnosticians, trainee medical students, the medical college facilities themselves, etc. India, now, also has a certain rate of growth and acceleration in its total “public health capacity” as the government has moved over the period between March 15 and May 15 to invest in, solicit and coordinate not merely a national lockdown, but also a vast purchasing programme for the necessary elements of a COVID-19 medical response. India still has its bottlenecks in terms of trained ER doctors and nurses, but there is a certain rate of growth and acceleration.

This capacity, and its growth rates, are the only two factors that need to be considered, in conjunction with the geographical mapping of COVID-19 by ward and district, and finally, the rate of spread or ‘R-number’ of the virus — during the almost-total national lockdown. Given this data — based on the last 60 days or so — it is entirely possible to map geographically, and value economically (by weighting districts by productivity/ capacity) the percentage of India’s GDP that can, at any given moment in time, be “opened” without ever risking coming close to 100 per cent utilisation in the total public health capacity of the system. (A slightly more nuanced approach would, in actuality, also need to track sub-systems to ensure there are no bottlenecks that hold up the line, as it were.)

In other words, my friends and I truly had no disagreement, so long as we agreed that the one unacceptable, morally reprehensible outcome that must be avoided at all costs is fellow Indians dying by the numbers, literally on the streets, once our total public health capacity is exhausted and we’ve lost control of the situation. No amount of economic growth, development or time is worth the kind of COVID-19 patient “run rate” that would threaten to overwhelm our capacity to effectively deal with infected patients.

What this drives home for me is an important principle: So long as fundamental human dignity is still an arbitrary value that we continue to hold sacred, crises often bring tremendous clarity to otherwise very murky and ideologically-charged waters.

In the status quo ante, my friends and I would often debate the issues of fairness, justice, merit, growth and development and across the socio-political spectrum. Often, the issues would resolve into the same question again and again: Is it, in the ultimate analysis, “me” or some conception of “everyone” that comes first? This seems, unfortunately, to be an irreducible difference: A seemingly “rational”, self-invested human agent versus a partly “sub-rational” or “non-rational” human agent who somewhat compromises his interests in favour of constructs like friends, family, community, nation-state, or even “humanity” as a whole.

The crisis on the other hand, flips this on its head: The irrationality of pursuing a narrow self-interest becomes apparent and obvious. The cost of this includes possible systemic collapse in the face of whatever crisis has occurred. Figuring out a holistic solution to maximise the survival of as much of the system as possible becomes the clear mandate. And, in such an environment, seemingly “ideological” discussions are often mere mathematical problems and operational models that need proper elucidation. Our politicians, commentators and business leaders are all well-placed with the aid of proper experts, to build a national consensus around prioritisation, sequencing, sizing and calculation of the problem and its solutions, and to accordingly embark on a truly cooperative and coordinated effort at building the nation with renewed energy primarily due to the newfound “clarity” that the crisis has brought.

Unlike the usual “kill or be killed”, or in other words, evolutionary pressures operating within India in the form of corporate and individual competition, the scale and stage of the evolutionary struggle has moved up to the level of our nation as a whole, which is engaged in a struggle with the novel coronavirus. In sum, developing, nurturing and championing a deep ethic of cooperation is not only India’s best ethical answer, it is also its best economic answer.

The writer is an alumnus of the London School of Economics, Cambridge and Harvard, and lives and works in Mumbai

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