The seven-day rolling average of cases in India has been rising every day since December 27 or for 18 days. From 6,780 on December 27 (the lowest this number has dropped since May 2020), it went to 193,418 on January 13. While average deaths were not rising initially, they have started inching upwards since January 4 in states excluding Kerala (more on this later). Does this mean we are headed for a crisis like the one seen during the second
The low CFR is not simply because daily infections are low. Average cases outside of Kerala are already at 52% of the peak of the Delta wave, while average deaths are still at 3.3% of the peak of the Delta wave. Both these percentages will likely increase in the coming days as a rise in deaths generally sees a two-week lag from cases, but if the CFR is comparatively much lower, it is most likely that deaths in absolute numbers will also considerably low even if the current wave’s peak matches the Delta wave.
Caution is still needed as hospitalisations can wreck finances of poor
To be sure, governments are correct in advising caution despite the chances of lower fatalities in this wave. This is because hospitalisations, especially expensive ones, can put huge pressure on the finances of Indian households. The bottom 60% of the population pays for about 30% of the most expensive cases of hospitalisation (excluding childbirth) through borrowings or sale of physical assets, according to a 2017-18 survey by the National Statistical Office (NSO). The top 20% of the population does this in only 15% of cases.
But caution need not mean panic
However, advising or practicing caution does not mean that people need to be locked inside homes, and businesses shut down. This is because while hospitalisations are expensive, only a small number of people have needed it in the current wave. As CFR suggests, the share of infected people who reach that stage is likely to be small. In Delhi, for instance, where the current wave began on December 16, the seven-day average is already at 93% of the peak seen during last year’s wave. The number of people in hospitals or dedicated Covid-19 centres on January 13, at 2,969, was only 14% of the peak number of 21,154 during last year’s wave. Locking down indiscriminately in such a scenario can possibly hurt the state exchequer – if businesses don’t make money, there will be less taxes to collect -- more than paying for a small number of poor people’s hospitalisation.
So, how can governments tide over this wave?
To be sure, even if the current wave does not result in a rush to hospitals, it can affect poor households disproportionately. This is because the poorest households depend disproportionately on casual work, where wages are negotiated on a daily basis and are too low for savings. If they isolate because of an infection for two weeks, they will likely need to borrow to survive. Even most self-employed people, who earn better, work without employing other people. Their businesses will suffer if they have to isolate. That’s why it makes sense to not enforce lockdowns and, instead, insist on social distancing measures and masking.
There are around a quarter of a million causal workers and close to 2 million self-employed people who do not employ others in the city-state, according to population projections for 2021 from the National Commission on Population and workers’ proportions from the Periodic Labour Force Survey conducted in 2019-20. A lockdown will affect almost all of them.
