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India’s Response to COVID

by Keerat

by Supriyo Chaudhuri – Trustee of Bridge India, a progressive public policy think tank based in London.

 

 

 

 

 

The world’s fastest and deepest lockdown from 25 March led commentators within the country and outside remark in unison that Narendra Modi once again showed he was a Prime Minister not to shy away from bold decisions. India had only recorded 360 active cases of COVID-19 at that stage, yet India was quicker than others like the UK and US in implementing strict social distancing policies. On the same day on the other side of the world, Brazilian President Jair Bolsonaro railed against Coronavirus measures being taken in his country.

India’s challenge was always one of scale. Smaller countries like Vietnam, Korea, Germany (at least until the second wave hit) and others have been successful in curtailing the spread of the pandemic. But the threat of a communicable contagion in India spreading as rapidly amongst a high density of population, lack of a social safety net, high burden of communicable diseases, and weak public healthcare provision was unprecedented.

One of the early successes of the government was a broad public health awareness campaign, led by the Prime Minister. For example, cellular networks contained a “coronavirus awareness ring tone” that played each time the owner receives a call. Unsurprisingly, social media and WhatsApp were loaded with misinformation and miracle “cures”.

For example, the founder of India’s largest homeopathic remedy manufacturer Patanjali Ayurveda, guru Baba Ramdev, made sponsored appearances on several TV shows in quick succession in June to extol the virtues of Coronil. The relevant Ministry quickly restricted Patanjali from selling the tincture as a cure, allowing it instead to be sold only as an immunity booster, but sales skyrocketed nevertheless.

While the lockdown was in place, cases in India were at a trickle. No doubt strict curfew rules helped, but testing was patchy. The lockdown was later extended as cases grew past 10,000, with two further extensions thereafter. On the provision of PPE, India has an impressive record. India went from having no meaningful PPE industry to having the second largest in the world in the space of a few months. As exports of PPE were banned, the gowns and other equipment were often not to US FDA or European CE standards, but it was India’s biggest pandemic success story.

The biggest win for India globally may yet be in the areas of vaccines. Five candidates are in clinical trials in India already, with the Pune-based Serum Institute of India (SRI) leading the way. Founded in 1966, SRI is the world’s largest vaccine supplier by number of doses produced (1.3 billion annually). On testing, India suffered from multiple flipflops, although so did many other more developed and better funded public healthcare systems like the UK. The Ministry of Health and Family Welfare (MoHFW) took responsibility for monitoring the spread of the virus and designated the Indian Institute of Medical Research (ICMR) and the National Institute of Virology (NIV) for the accreditation and development of diagnostic tools.

India relied heavily on Chinese-made antibody test kits initially, with nearly 100 import licenses granted. Once import duties were reduced to zero and Chinese ports returned to normal, India was able to import these on a regular basis. But India found itself amidst the perfect storm of a Delhi High Court decision to cap test kit sale prices to Rs 400 (£4.30), reports of irregular test results and rising geopolitical tensions with China.

The ICMR cancelled several of these licenses virtually overnight, leaving some Indian distributors holding stock that was worthless. Instead, India approved rapid antigen tests on 14 June, just as early adopters Belgium and Korea scaled down their usage due to reliability issues. Testing with the more expensive, gold-standard PCR kits still lags where public the ICMR would ideally like it to be.

The biggest impact was felt on the economy. India recorded the largest fall in GDP amongst major economies in the world, of a more than 10% year-on-year GDP fall. Nowhere was this impact felt more than on migrant workers. These make up the majority of workers in cities, coming from rural areas in search of cash-in-hand and irregular employment. Overnight, many lost their jobs. With strict curfews, they had no savings and no way of getting home.

At the time of writing, India’s reported Covid cases have fallen from their peak, which hit nearly 100,000 in one stage September. Economic life has stuttered back to normalcy – recent campaign rallies for both the ruling BJP and opposition parties in the state of Bihar showed no meaningful social distancing in the crowds.

India’s Covid statistics compare favourably with the UK and others in terms of infections and deaths per head of population. But lower mortality after adjusting for the country’s younger population, lower testing and incomplete death reporting especially in rural and economically less developed areas like Bihar mean the true number of Covid deaths is unlikely to ever be known. Given the scale of the challenge in a country of 1.3 billion people, India’s Covid story is probably one of a glass half-full.

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