Triage of choices as corona kills
It is day 89. Since December 31 2019, which is when WHO and the world were officially notified about the Wuhan Virus, the number of cases has shot up from 40 to over 650,000 and the pandemic has claimed over 300 lives every day. It is as if the events are cued to the script and phraseology of Contagion, and the storyline is yet to approach intermission.
Two days after China declared its march to normalcy, on March 27, the Xi Jinping regime shutdown all theatres. The fear of the second wave raised its ugly head in south-east Asia and countries scampered to acquire critical drugs and devices. In Britain, where the thesis of ‘herd immunity’ found its headline moment, Prime Minister Boris Johnson tested positive and isolated himself from the herd, to be counted among the afflicted 660,000 cases.
The virus may well be dubbed an invisible enemy but the social-political-economic manifestations of the disease are tragically all too visible – the most tragic being the fate of those stranded in the gap between supply and demand, between life and livelihoods. In the decisions unrolled, governments have unveiled an unstated triage, a triage of choices which renders many vulnerable.
On the social and political front, the consequences of these decisions have wrenched open faultlines and triggered confusion and chaos. Accepted wisdom suggests social distancing is the way to flatten the curve of transmission and infection and this calls for a shutdown/ lockdown. Ergo, the playbook of lockdown has been adopted almost universally but without customisation of the playbook for context and circumstance.
In the US and UK and elsewhere in Europe shutdowns have left thousands without access to income and health care. In India, 21-day lockdown has triggered a parade of tragic images — caravans of migrant workers left without transport walking home on the highways, in the outskirts of Delhi to villages in Uttar Pradesh and from Mumbai to neighbouring states. Over 80 per cent of the workforce comprises daily wage earners who are engaged in the informal economy. Without wages, they cannot sustain rent or living costs.
The shutdown compelled the long march, the trek back home. Their deprivation and vulnerability represent a threat to society at large, with medical, economic and political implications. The numbers tell the magnitude of the crisis better — Economic Survey of 2016-17 cites studies which estimate the size of migrants in the workforce in 2016 at over 100 million or 20% of the workforce.
The management of the twin crises can be broadly defined under three silos — rescue, relief and recovery. Rescue is primarily about access to health care and capacity is critical. While in the US, stadiums are being prepared for eventualities, in India, the Railways is converting idle trains and coaches to create capacity for treatment. Governments are scrambling to know the extent of the transmission of the virus and make available critical inputs ranging from masks to drugs to ventilators — and stories, denied but believed, of 65-plus victims in Spain being refused access to ventilators have worsened virulent fears.
Relief is about sustenance, calming the fears of tomorrow. The management of the health emergency has exacerbated existing conditions and installed economic emergency. US, Britain, Canada et al have unleashed a wave dole and payroll bailouts. Arguably India, with pre-existing conditions or comorbidity in the economy, is constrained. But surely the relief package could be better imagined.
The measures announced by the government of India are a mix of the sublime and the convoluted. Insurance coverage for corona warriors is inspired but the rest of the package is poorly imagined. The doubling of food grain allocation reeks of ‘buy-to-get-free’ approach – this, when government granaries are overflowing with food stock.
What matters most in an emergency — health and economic — is cash in hand. India has over a billion people registered with the biometric Aadhaar identity and millions on a direct benefit transfer system for rural employment, pension, scholarships and subsidies. Why not design a temporary allowance, a la Friedman negative tax, to deliver succour. The packages announced thus far are akin to prescribing paracetamol to treat the symptoms. Hopefully, more will follow and will be better designed.
The triage, and determination of choices continues. This week, as cases doubled in the US, across the world, as anxiety widened and morphed into a fear of the unknown, the IMF declared that the world has entered recession and rating agencies slashed India’s GDP growth forecast to sub 2.5 per cent. Central banks are cutting interest rates and offering backstop credit for bailouts just to enable stability and employment continuity.
The script of the narrative fights shy to mention recovery, and when mentioned it is punctuated with questions about when and shadowed by if! Recovery is the grand challenge, the hope the world is fighting for and it demands the return of calm and a modicum of certainty.
The future is determined by the decisions we take and the choices we make — and on these choices rest the grand hope of recovery and what normalcy will look like.
(Shankkar Aiyar, the Author of Aadhaar: A Biometric History of India’s 12 Digit Revolution, and Accidental India can be contacted at email@example.com)