January 20, 2020. A 35-year-old Chinese woman, a visitor from Wuhan, became South Korea’s first COVID-19 case. As of April 3, South Korea had registered just over 10,000 cases and 174 deaths. That very day, on January 20, albeit a few time zones later, a 35-year-old American, returning from travels in China, became the first case of COVID-19 case in the US. By April 3, the US recorded over 2.7 lakh cases and over 6,500 deaths.
The seemingly mystifying difference in cases and fatalities, on a similar timeline, and rhetoric on who to blame, is a viral narrative across time zones. Indeed, January 20, 2020 has acquired a presence in the riveting rhetoric on the spread of COVID-19 and strategies to contain the pandemic. Propelling intrigue and innuendo is the fact that the US toll is rising despite the fact that over 40 states in the US are under varying definitions of lockdown, and by one estimate over 300 million are under ‘shelter-at- home’ guidelines. In contrast, Korea did not witness large-scale shutdown of businesses.
Factoids, on ratios of cases per million of populace, are whizzing across the cyberspace, to and from, countries and multilateral agencies. The US has registered over 800 cases and 21 deaths per million persons. South Korea, in contrast, has recorded just over 190 cases and 3 deaths per million persons. China, which is the font of the pandemic, has recorded just over 55 cases and 2 deaths per million persons. Japan is just above 21 cases per million persons.
Context is critical in any analysis of the spread of COVID-19 pandemic and containment strategies. The determining factors range from demography to state of health care sector, cultural landscape to architecture of administration and most critically approach. Korea scaled up national alert level quickly, adopted aggressive tracking, testing, isolation and monitoring of vulnerable using data and technology. In Germany, the consistent investment in upgradation of health care systems, use of capacity for widespread testing helped to keep the death count low. Hong Kong did better as awareness was high and post SARS practices of using masks, sanitisation and social distancing persisted.
The questions being debated have acquired a sense of urgency as more than two billion people, or over a third of the world population is under lockdown. Large populations corralled and enclosed like animals in a zoo are looking for answers about normalcy and end of uncertainty. There is the contagion and then there is the contagiosity of issues – of life and livelihoods.
India recorded its first COVID- 19 case on January 30. As cases spiraled, the Narendra Modi government ordered a complete lockdown on March 24, effectively asking the population of 1,350 million persons to stay at home. By April 3, India had over 3,000 cases and 70 deaths. India is yet to get into double digits at under 3 cases per million persons. This week, the government indicated a staggered exit from the lockdown. This has triggered questions of readiness.
There is the general lament about when this will end but, more importantly, there is the unstated concern on how long systems can enforce and sustain lockdowns. Maintenance of order in society demands sustenance of supply chains. And above all this is the political and economic cost of shutdowns. Fear enabled the lockdown. The question is how to propel faith and return to normalcy.
The virus defies the definitive. Ordinarily data should spell an equation. There is no single fatality rate. Yes, age is a good surrogate for frailty but existing conditions like diabetes, asthma, cardiac issues make even the young vulnerable. Death could also be caused by lack of access to care or to a ventilator. Then there are warts in data – some countries which only test those with symptoms, some test all but register only those with symptoms leaving asymptomatic carriers out. Transmission depends on social behaviour, policies and environment and is open to questions. What about the second wave? Are those infected and recovered immune?
The plan to test, track, identify, isolate and quarantine will form the foundation of the road ahead. This demands boosting capacities across sectors. What is essential and how to manage mobility will be determined by how we navigate issues. Food security is critical and necessitates the restoration of access to labour and markets. Production of essentials requires restoration of supply chain and, therefore, availability of factors of productivity. Most importantly income support and access to credit — forbearance on debt, zero interest loans for SMEs — for operating capital are essential.
For sure, the answers for many of the questions will depend on the experiential and evolution of processes in India and elsewhere. This demands accelerated engagement with the society, with civil society groups at every level of government – to design solutions which are driven by bottom up experienced realizations, rather than top down group-think.
The history of free men, Dwight D Eisenhower said, is never written by chance but by choice – their choice. Leaders face the ultimate challenge, to design and define choice to script history – theirs and that of their nation.
shankkar.aiyar@gmail.com
SHANKKAR AIYAR
Author of Aadhaar: A Biometric
History of India’s 12 Digit Revolution,
and Accidental India