Full lockdown or deaths: The false dichotomy
India may not experience all the health benefits of a lockdown, while being saddled with the economic costsUpdated: Apr 05, 2020 17:02 IST
It is critical for us to understand that India’s conditions are unique. We will be required to take different steps than other large countries who are following a total lockdown strategy,” wrote former president of the Congress, Rahul Gandhi, in a letter to Prime Minister (PM) Narendra Modi. Having been the first to warn the nation about the coronavirus pandemic (Covid-19), Gandhi pledged full support to the PM in the fight against it and called for a more “nuanced” strategy to counter the virus, while acknowledging India’s distinct realities. How unique is India, and why is a total lockdown not an optimum strategy?
First, comparing data of Covid-19 infections, hospitalisations, deaths and fatalities across different countries is absurd and misleading. Every nation has different testing strategies, demographics, and data integrity. To claim that the United States (US) has more Covid-19 cases than India, or that Italy has a higher fatality rate than Germany is like comparing guns, germs and steel. Such cross-country analyses have only added noise to this grave crisis.
Many developed nations such as the US, the United Kingdom (UK ), France, Italy have adopted a strategy of social distancing through lockdown to prevent the rapid spread of the virus. India too jumped on the bandwagon, but with an extreme and absolute national three-week lockdown and is likely to extend it further.
A lockdown impacts daily wage workers who must step out to work every day to feed themselves and their families. Less than a fifth of the workforce in the US, Italy and the UK are such daily wage workers. But in India, 90% of all workers are. So, the scale of the impact of a total lockdown in India is exponentially larger than in other nations.
The very idea of social distancing rests on the premise that the virus can be contained within small households of two to four people. More than 90% of all households in developed countries have less than four members. But, more than three-quarters of all households in India have more than five members. In nearly all poor households, there are more than six members, again unique to India. Social distancing through lockdown has been portrayed as a Sophie’s choice, where there is a trade-off between a massive adverse impact on the economy and stopping the spread of the virus. It is a “dollars versus lives” conundrum in western nations and in that, the case for “lives” should always win.
However, in India, it is not “rupees versus lives” but a “lives versus lives” dichotomy. There are already reports of many deaths due to hunger and hardships to migrant populations caused by the sudden and absolute lockdown. Millions of migrant workers have been left stranded amid heart-wrenching images of them being made to frog jump, squat and sprayed with chemicals.
Deaths due to hunger, homelessness and isolation are imminent. Intangible social costs of ostracisation and humiliation by local communities may claim many more lives. None of these deaths will be measured and documented in charts, as ardently as the ones caused by Covid-19. Media reports indicate that the deaths by the lockdown are already similar in the count to the deaths by the coronavirus. Shamefully, this is also unique to India. Given India’s social structure, the efficacy of an extreme lockdown will also be much lower here than in developed nations. So India may not experience the full benefits of an extreme lockdown, but will be saddled with the enormous human and economic costs of it.
It is often remarked that the government must provide a wide safety net of food, shelter and income, and, thereby, ensure that the lockdown is smooth. Yes, the government has woefully fallen short and must do more in protecting the poor and vulnerable during these tumultuous times. But it is also acknowledged that India has a weak State capacity for welfare delivery. It is then naïve to believe that a weak State can dramatically transform itself from an inefficient monster to an efficient angel overnight, and ensure that cash, food and shelter are delivered down to the last affected Indian.
India’s inordinately large share of daily wage workers, high population density in homes, a notoriously inefficient government welfare architecture and a massive humanitarian crisis from the current extreme lockdown is a given.
It is also a given that the Covid-19 epidemic is extremely infectious, fatal for the elderly, can overwhelm hospital capacity and can be highly asymptomatic. It is then imperative that we adopt a nuanced strategy to counter this complex threat.
Ninety-five per cent of India’s population is below the age of 60. Covid-19 is fatal largely for people above 60. It is then possible to look at age-specific isolations, hospitalisation and treatment, which narrows the problem down to 5% of the population. Localised lockdown measures in specific states, districts and blocks based on migration patterns can be an alternative to a national lockdown. Ubiquitous testing through the private sector and isolating positive cases can be another targeted strategy. Spreading out work timings over multiple shifts can be yet another approach. I am sure many people will have several other ideas for a more balanced approach to social distancing than the current extreme and absolute lockdown strategy.
It is important to shift from the current “extreme lockdown versus death by Covid-19” binary to a more nuanced debate. Moving from a total lockdown to a more targeted lockdown is perhaps the more viable and better option for India.
John Maynard Keynes’ “in the long run we are all dead” is often quoted in such times but for millions of Indians, the long run is about surviving today for tomorrow.