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The Past, Present And Future Of COVID-19 In India

The lockdown has largely helped contain the Covid-19 infection till now. But due to bus, train, and upcoming flight movements, the cases are going to increase. It would not be wrong to say that the actual war against Covid-19 in India has just begun. As of 20th May 2020, the total number of infections due to the Covid-19 has crossed the 2.5 lakh mark in India and 50 lakhs globally. With the death of almost 8000 infected people, the infection rate in India is also increasing significantly. According to health experts and ICMR, with the easing of lockdown guidelines, cases are likely to see a sharp rise in the coming days.

Fighting against the global pandemic, we all are on the same boat, and we will only survive if we are as concerned for others as for ourselves. With the recent remark of WHO, “Coronavirus may never go away”, it is certain that we have to fight against COVID-19 for at least 12 to 18 months until the vaccines and medicines become available.

Who Has Covid-19 Hit The Hardest?

The direct and indirect impact of the virus can be noticed in almost all sectors like economy, agriculture, health, education, society, employment, migration, etc. The worst hits are the MSMEs (Micro, Small and Medium Enterprises) automobiles, tourism, aviation sector, and local industries. The clear picture can be realized through the recent IMF projection of 1.9% growth rate for the FY 2021, as compared to the earlier projection (January 2020) of 5.8% for India.

According to another report of OXFAM, half a billion people could be pushed into poverty due to coronavirus. According to data from the CMIE (Centre for Monitoring Indian Economy) 27 million youth in the age group, 20-30 years lost their jobs in April. Due to this, India’s unemployment rate soars to 27.11% for the week ended 3 May, up from the under 7% level before the start of the pandemic in mid-March.

Shocking statistics revealed that domestic violence has surged since the start of the coronavirus lockdown worldwide. The National Commission for Women (NCW), which receives complaints of domestic violence from across the country, recorded a more than twofold rise in gender-based violence during the initial lockdown period. Recent surveys suggest that COVID-19 can also cause psychiatric problems like Delirium and PTSD (Post Traumatic Stress Disorder).

With no availability of vaccines and medicines to tackle the pandemic, most of the countries are following the solutions provided by WHO which includes sanitization, maintaining physical distancing, frequently washing hands with soaps and use of alcohol-based sanitizer, restriction of movement, home quarantine, immediate medical checkup if any symptoms appear, etc. India has also been following these guidelines along with its efforts.

India has shown remarkable perception and alacrity in tackling the pandemic: from conducting screenings at airports to visa restrictions and imposing lockdown as early as possible. The recently announced 20 lakh crore economic package is said to be a huge relief in this direction. The Indian Express reports that out of it, Rs 8.04 lakh crore, is additional liquidity injected by RBI through various measures in February, March, and April and 1.7 lakh crore already announced at the end of March.

A similar argument is also given by the Fitch Solutions that India’s COVID-19 package is much smaller than it seems. It will be interesting to see the impact of remaining Rs 10 lakh crore (approx) at the grassroots level. Reports say that, out of it, almost Rs 2 lakh crore will be given directly to the migrant labourers in the form of essential needs like food items and remaining in the form of loans.

Indian railway has started Shramik Special Trains to provide relief to stranded labourers to go to their states. But the government has also been criticized for not being able to implement timely migrant-friendly measures due to which there are still thousands of labourers returning home on foot. As reported, till now more than 20 workers have died returning home since the lockdown started. The Vande Bharat Mission to evacuate Indians stranded abroad is a commendable step to mention here. The State governments are also doing their best to bring back the workers home safely. Some of the state governments also provided cash to the people living below the poverty line through direct bank transfer.

Moving Towards Solutions

Nagaon, India/ Photo: Anuwar Ali Hazarika / Barcroft Studios / Future Publishing (Photo credit should read Anuwar Ali Hazarika/Barcroft Media via Getty Images)

From the worst COVID-19 affected countries like Italy, the USA, and Russia, we can say that India is not sufficiently prepared to fight against the pandemic. The density of the Indian population is much higher than the above-mentioned countries and health infrastructure is much lower compared to these countries. They have far more developed and well-equipped healthcare systems than India. India’s healthcare sector is not even in the top 100 in the world rankings while Italy comes second in the world. Due to this reason, India has to take extra care while handling the cases.

There is no alternative to testing, tracing, and isolating. India has to increase the number of rapid COVID-19 tests. WHO recommends a test positivity rate of 10%, i.e., 1 positive for 10 tests conducted, as a good benchmark. India’s test positivity rate on April 29 stood at 4.28%. The strike rate in India is one positive among 24 tested, whereas in other countries the rate is higher — such as one COVID positive per 12 or even 10 tests.

But still, there is a large variation between the Indian state’s rapid testing. Therefore, all the COVID-19 infected states must test cases more rigorously. Moreover, our current testing rate at 1,744 tests per million population is one of the lowest in the world. We should deploy both antibody tests and confirmatory PCR tests.

India has to increase the number of COVID-19 test labs at least temporarily. After ICMR (Indian Council of Medical Research) approving private labs for Covid-19 testing, the number of labs certainly has increased but is not sufficient. Moreover, there have been instances where COVID-19 tests are delayed as private labs struggle to cope with the respective states.

We have fewer hospital beds and doctors per 1,000 people than countries like China, Italy, Japan, and the USA. It has 0.7 hospital beds and a similar number of physicians per 1,000 people. As compared to India, Italy and China have a five-fold higher availability of hospital beds per lakh population. They also have, respectively, two and five times higher availability of physicians per lakh population as compared to India.

Therefore, at least temporary quarantine centres with isolated beds and proper sanitization facility are the need of the hour. Excess capacity in private healthcare must be strategically used by the government and emergency plans of setting up hospital beds in army camps should be executed as soon as possible.

Shortage and unequal distribution of Standard Protective Equipment such as PPE (personal protection equipment) kits, N-95, and surgical masks is another concern raised by the health workers across the nation. The shortage has put India’s frontline fighters at grave risk against the virus. Till now, more than 500 health workers have been exposed to the disease due to the lack of standard protective equipment. Such lapses aren’t merely a health risk; they severely deplete the staff strength at hospitals. We should not forget that they are the ones who are at high risk of getting infected and it is our prime duty to protect them at any possible circumstances.

Hand washing is one of the recommended ways of avoiding COVID-19. Data shows that 50.7% of the rural population does not have basic hand-washing facilities, including soap and water (2017). It was 20.2% in urban areas, around 40.5% for the population overall. During this crucial hour, it is the moral duty of the local panchayats, municipalities, and elected representatives to make the people aware and provide them with basic sanitization facilities. As public health and sanitization come under the state subject in the Indian constitution, the state government should provide them with the basic facilities in this regard and make the local leaders responsible for the distribution of services.

It has also been suggested that the government must restore the elements of economic and social life as soon as possible, to avoid disastrous and lasting consequences, including for other aspects of health, education, food security, and livelihood. During the lockdown, the government should focus on the expansion of agricultural storage infrastructure and make sure the agricultural produce is conserved under the direct surveillance of the government so that each farmer gets its due. By doing this, we can achieve long term food security and farmers remain profitable.

Kerala is being praised for its commendable performance for tackling COVID-19 successfully across the world.

Kerala is being praised for its commendable performance for tackling COVID-19 successfully across the world. During the time of the global pandemic, things should be seen beyond political affiliation. All the COVID-19 infected states should take inspiration from the Kerala model and implement it before it gets too late. Moreover, before the Covid-19 pandemic, Kerala was able to successfully eliminate deadly diseases like the Nipah virus. From this, it can be observed that the healthcare system in Kerala is advanced than most of the states in India. This fact has been supported by NITI Aayog’s Health Index.

According to the IMF, the government should proceed with proper pre-planning and security so that the impact can be minimized. It should do its best to help the worst affected financial institutions and institutions related to day to day financing. It also suggests that maximum capital should be spent on emergency services and for the direct benefit of the migrant labourers and people living below the poverty line.

During the lockdown, the printing media has been severely disrupted across the country. The printing media houses must be facilitated with the required support/assistance for the continued dissemination of appropriate information. We are aware of the circulation of fake news in digital as well as in broadcasting media. Therefore, people still rely on print media for their credible and accurate information. Moreover, the local newspapers keep the spirit of vernacular languages and help them expand among the masses.

Therefore, the government should urgently provide a strong stimulus package to the domestic newspaper industry. And if possible, the government should increase advertising rates in print media by 50% as requested by INS (Indian Newspaper Society) and settle all outstanding advertising dues of the central and state government’s forthwith. The readers are also requested to help the newspaper agencies through crowdfunding.

The last but not the least is to make the buses and trains virus free by using sanitizers frequently. We know that an infected person can infect hundreds through direct or indirect contact. So to avoid mostly indirect infection transport vehicles must be cleaned frequently.

The Way Forward

Image used for representation purposes only/ India’s healthcare sector needs to be reformed and revamped.

At the end of the day, we all know that we will succeed against the deadly virus in the upcoming months or years. From the beginning of human civilization, we have been facing several regional and global pandemics and natural disasters. In the end, humans are always the winners. And this time as well, in the era of scientific and technological development, there is not a single doubt that we are going to defeat coronavirus.

But the question remains, what after the COVID-19 is gone? What has the coronavirus taught ‘us’, the humans, till now? How the system is exposed due to coronavirus? How India along with the world, would be prepared for future pandemics like COVID-19 or even worse? What should be the priority of citizens and the government in post coronavirus India?

Nature and science are the two most predominant aspects of the survival of human civilization. And for this, India should focus on the protection and expansion of the natural biodiversity along with technological and scientific development. We still spend only 0.85% of the country’s GDP in Scientific Research and Development, which is much lower than the BRIC nation.

This is far lower compared to China (2.1%), Israel (4.3%), South Korea (4.2%), USA (2.8%), France, UK, Japan, and Canada. In this regard, WIPO (World Intellectual Property Organization) has suggested some measures to improve math and cognitive skills at the school level, encourage investigator-led research, link national labs to universities, and create new knowledge Eco-systems to improve science and R&D in the country.

Furthermore, scientific experiments and researches should put more emphasis on actual ‘needs’ instead of researches related to ‘curiosity’ and ‘global dominance’. The prime objective of capital intensive researches should mostly be for the betterment of human civilization, and not just for the ‘curiosity’.

The onset of Covid-19 has completely exposed India’s healthcare sector. The lack of adequate ventilators, PPE kits, N-95 and surgical masks, and shortage of healthcare professionals, prove that India’s health facility indicators are below par in any global parameter. In Assam, for example, 36 out of 200 ventilators being used in government hospitals were found to be non-functional.

Even though India’s expenditure on healthcare has increased in the past few years, it remains very low globally.  According to the Ministry of Health and Family Welfare, the public expenditure on health as a percentage of GDP for 2017-18 was a mere 1.29% of GDP. India’s neighbours, such as Sri Lanka (1.68%), Indonesia (1.40%), Nepal (1.17%), and Myanmar (1.02%) are spending far more than India on healthcare.

Comparative international figures are available for 2016 with the World Bank, which shows that India spent 3.14% of general government expenditure on health, compared to China’s 9.05%, Italy’s 13.47%, and Iran’s 22.6%. Moreover, till now India has 8.5 hospital beds and 8 physicians per 10,000 people, much below the level prescribed by WHO. All these suggest that post-COVID-19, India must increase the yearly expenditure to encourage research in medical fields and face similar or even worse future pandemic situations.

The global impact of Coronavirus is immense as educational institutes all over the world are shut down completely. This disruption impacts our readiness for the future and also has huge economic and lifestyle costs. The pandemic has made us realize the potential of digital education and demonstrated that we should start shifting (not completely, but partially) from the traditional educational system to a technologically driven modern education system.

The sudden shift to online or digital learning is not possible in countries like India where television, internet, or smartphone cannot be accessed by most of the rural students and where the teachers are not trained enough. But the gradual shift to a model of blended learning is needed for situations like this. This can be achieved with the help of the power supply, digital skills of teachers and students, and internet connectivity. For this, proper implementation of government initiatives such as Saubhagya or Pradhan Mantri Sahaj Bijli Har Ghar Yojana, National Optical Fibre Network (NOFN), and BharatNet will prove beneficial.

The sudden shift to online or digital learning is not possible in countries like India where television, internet, or smartphone cannot be accessed by most of the rural students and where the teachers are not trained enough.

The guidelines prescribed by the WHO for the prevention of COVID-19 are basic hygienic guidelines. We should make the rules into habits even after post-COVID-19 life. The use of sanitizer, frequently washing hands and the use of masks help us prevent possible viral or bacterial infection. Hygiene should be our topmost priority in day to day life.

After almost 2 months of lockdown, the global pandemic has taught us that taking care of the environment is not that difficult. Due to less industrial activities, the pollution level is reduced drastically. The rivers and oceans have become cleaner. For example, the lockdown has made the Ganga river water significantly cleaner and air pollution levels in Delhi drop by 49% post-lockdown.

According to a study conducted by the IIT Delhi, the country has witnessed 43, 31, 10, and 18% decrease in PM 2.5, PM 10, CO, and NO2 levels during the lockdown period compared to previous years. This shows us that we should decrease our reliance on conventional energy sources and focus more on alternatives like solar, biomass, geothermal and wind energy, small hydroelectric power, etc for sustainable growth.

In our busy lives, we often forget to take care of our health and hence neglect the importance of body immunity. Research reports suggest that patients with good immunity levels can fight the infection better. With the ongoing pandemic, strengthening our immune system is our first line of defence. To boost body immunity, some of the suggested measures are getting enough sleep, drinking water, regular exercise, yoga, and maintaining a healthy diet.

Covid-19 has shown a path for educated youth that it is not necessary to move to the other states or countries seeking better job opportunities. Rather they can be self-employed locally or can be involved in agricultural activities, animal husbandry, or MSMEs. It also made us realize the value and importance of farmers; that the farmers are the backbone of our economy and we should put efforts into the development of agriculture.

We should make sure that the farmers are getting basic facilities like drainage, irrigation, cold storage, credit facilities, high-quality seeds, insurance, scientific modern agricultural tools, and most importantly not exploited by middlemen or local moneylenders.

This pandemic has displayed that humanity is still alive in the world. Thousands of people came forward to help the people living below the poverty line and the migrant workers effected due to the nationwide lockdown. They are helping both financially and by providing them essentials like sanitizer, food, and shelter irrespective of one’s caste, language, religion, or locality.

Most importantly, we should be careful about our food habits and intervention in the environment. At present, it is unknown whether the virus is man-made, or it already existed in the physical environment and erupted due to human intervention, whether deliberate or accidental. Most of the recent diseases, like Nipah, Hantavirus, and Covid-19 (as claimed) are said to be originated due to the consumption of animals like Pangolins, rodents, and bats, etc.

Especially in China (a hotspot of diseases like COVID-19 and Hantavirus), the illegal wildlife trade and their consumption should be abandoned. Punitive actions should be taken against the violators. People should be made aware of the consequences of zoonotic diseases and how a simple change in our food habitat can make the world better for living.

We have faced several pandemics in the past, and as earlier, we are confident that, this time also, the victory will be ours. The researchers and scientists around the world are busy in developing vaccines and medicines. Already some of the prestigious institutes have claimed that the vaccines are in the trial phase and soon it will be made available to the world.

Let us hope for the best, but prepare for the worst.

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