By Dr Pranay Kumar Swain
We heard the Prime Minister of India speak to the nation a couple of days ago. I do not remember any time in my memory any of our Prime Ministers coming out with folded hands asking a country of over 1.3 billion to stay home, drawing a lakshman rekha right outside the doors of all the households.
Given the size, socio-cultural diversity and socio-economic complexity of the country, it is going to be a herculean task to implement the lock-down. However, the onus is on us where each citizen has an incredibly big role to play. 21 days of lock down, call it a national curfew. In hindsight I think the janta curfew on 22nd March was just a precursor to what we were going to experience the next three weeks. Imagine over 1.3 billion people- sans our first few lines of saviours- ‘not doing anything’, I mean literally so, to save each other!
Now let’s look at few significant numbers with their respective timelines.
|Date of First reported Death||11-Jan||29-Feb||12-Mar|
|Date of Lockdown||23-Jan||22-Mar||23-Mar|
|Death at Lockdown||17||21||9|
|Cases at Lockdown||574||33300||433|
|Extent of Lockdown||Wuhan city (Later the entire Hubei province)||Partial||All India|
|Population in Lockdown||9 Million||75 Million||1300 Million|
(source: www.who.int, multiple media sources)
The numbers above tell us why the lockdown was necessary and also explains why the Prime Minister appealed to the state governments to give topmost priority to health services and to the private sector too to come forward and join hands in fighting this pandemic.
The numbers projected by data scientists from across the globe look scary, extremely scary. A report in BusinessLline estimates that India could see upto 1.3 million confirmed cases by mid-May. Researchers from Johns Hopkins University paint even a gloomier picture. Their apprehension is rooted in the fact that the number of people actually tested in India has been very small. Hence it is very difficult to quantify the extent of community transmission. Put in other words, we do not even know how many ‘infected’ people are actually outside the health care systems.
If the World Bank data are anything to go by, India has a paltry 0.7 beds per 1000 people which is way less than other countries like South Korea ( 11.5), Italy ( 3.4), US (2.8) and France (6.5). Any sudden surge in the number of cases in India will outstretch the healthcare system in the country.As I write this, the covid-19 dash board hosted by the Ministry of Health and Family Welfare of Govt. of India reads active covid-19 cases as 640 and casualties as 17 whereas 67 have been cured/discharged or migrated. All these numbers have doubled in past 72 hours. It also says 15,24,266 people have been screened at the Airport. However, this number may not actually mean anything in the absence of the exact number of people actually ‘tested’.
Another ICMR report suggests that the average number of people who are likely to be infected by an infected person ranges between 1.5 and 4.9. This is where checking ‘community spread’ becomes extremely important. The burden on India’s public health services looks humongous.
Strict social/physical distancing can only delay the spread and thereby reduce the burden on India’s existing health-care system. This can also allow more time to deal with the crisis. Having made-shift and dedicated Covid-19 hospitals across the country seems to be the only option left to reduce the burden on the healthcare infrastructure when the infected cases surge. We need to buy time. And the only way to do so is by staying away from getting infected. Some scientists have reasons to believe that about 26% of the entire population will get infected and most of the infected will come out of this as they develop the required immunity to fight the virus.
An analysis of mortality data from Europe and China reveals that people above 50-years with pre-existing conditions are the most vulnerable ones. Coordinator of the White House Corona virus taskforce was reported saying, “ In the mortality data that has been provided to us there has been no child under 15 that has succumbed to the virus in Europe. To generation Z and to my millennial colleagues who have been really at the forefront of many of these responses less than 1 per cent of all of the mortality is less than 50 and so this is I think also a very important point…That doesn’t mean that individuals will have severe disease so still 99 per cent of all of the mortality coming out of Europe in general is over 50 and with pre-existing conditions.”
A recent report from Johns Hopkins University and the Centre for Disease Dynamics, Economics & Policy (CDDEP) has predicted the COVID-19 peak arriving in April-May-June infecting over 120 million Indians in an optimistic scenario.In a pessimistic scenario (trajectory with current lockdowns but insufficient physical distancing or compliance), the total number of cases (asymptomatic, hospitalized and symptomatic) may reach massive figure of 250 Million.
As we crunch India’s numbers, the Global dash board looks more alarming than ever before. US death toll tops 1200. Spain crosses 4800 with over 750 deaths reported in past 24 hours. The only heartening news are from Italy, South Korea and China where the graphs have either flattened or plunged. Also as another report (on ndtv.com) suggests, “evidence from China indicates that higher temperature and humidity are likely to lower the transmission rates but it is unclear how this will translate to the India context”.
When we are looking at other countries for numbers, projections, trend analysis, etc. we must also look at them to see what measures they have adopted or have been adopting to arrest the pandemic. Worse, given the complexities of Indian socio-economic fabric we may actually need the basket of all those efforts.
The scenario is scary ( see the figure below), extremely scary. Remember the ‘big nations’ have not been able to come on top of the situation. The numbers are there for everyone to see. The big daddies like China, Germany, Italy, France, UK, USA, South Korea have taken big blows. In comparison to the level of (health) awareness and quality of health services in these countries, our country stands nowhere. A tiny outbreak of a contagion can actually wipe off millions. We have enough reasons to worry.
Unprecedented by any stretch of imagination, the world is almost shut down for most practical purposes. Unfortunately, all it needed was a virus to unite the entire humankind together.While all the countries are focused on the same goal- coming on top of the covid-19 crisis the soonest possible- each of them has its own unique challenges to deal with. However, countries like India which has just begun to experience the increase in number of cases, have the biggest benefit of taking a leaf out of other in terms of adopting ideas that worked and also learning from their mistakes.
As of now we have been hear8ing and talking about about containing the spread of the virus. We do not even know how much damage has already happened to us. By us, I mean entire human race. The economy has already been shaken beyond words. But yes, we will get a chance to think of measures to correct that only if we are out of this harm’s way. Schools and colleges have been closed. Months of academic curriculum needs to be compensated. Most optimistically speaking, this may need letting go the summer vacation and readjusting the academic calendar. The safety net of the poor and underprivileged needs to worked out. As we see the review of situation by the Government is happening on a daily basis and this may result in changes in strategies as and when required.
Lastly, let’s spare a thought for the first line of defence- the doctors, the nurses, the paramedics, the media, the police force, the entire food supply chain, etc that are hundreds of thousands in number, who have been relentlessly risking their lives so that we win this battle against an unseen.Also the last line that comprises the homeless, the wage-earners and the bottommost of the population pyramid. I am sure the appropriate Governments are in the process of working out several mechanisms to address these critical mass. However, that does not take much away from this ‘fear’of unprecedented magnitude. For a while, let’s keep everything else at bay and do our bit as suggested by the Government and Enforcement agencies from time to time. Ironically, by ‘doing’ I actually mean ‘not doing anything” other than maintaining personal hygiene, good cough/sneeze etiquettes and keeping social/physical distance from each other as suggested in the health advisories issued by the Government agencies.
About the Author
Dr Pranay Kumar Swain is the Chairperson, School of HSS, National Institute of Science Education and Research, Bhubaneswar. Contacts +91 674 2494010 (O), Handheld- +91 993 700 9939/943 986 1939
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