BENGALURU: For a country with limited resources, a huge population and economic constraints, India is faring better than many other countries in slowing down the doubling rate of COVID-19, analysis of data suggests. In an interview to The New Indian Express,
Professor Shamika Ravi, former member of the Prime Minister’s Economic Advisory Council and senior fellow at US-based research giant Brookings Institution, said that the lockdown has helped the country bring down the growth rate of COVID-19, but a prolonged lockdown may have a devastating economic impact. Edited excerpts:
You have suggested that without the lockdown, India could have seen 1254% more cases. Where does India stand on containing COVID-19 now?
When the first few cases of COVID-19 were reported from Europe and the US in January, we were quite pro-active in terms of airlifting students, sending people to quarantine, screening at airports, etc.
Notwithstanding scores of people who jumped quarantine, a lot of big measures were taken early on, which resulted in bucking the growth rate in the very beginning. We were doubling at every 3 days initially, but slowed that down to every 5 days, two weeks into the lockdown.
It was a drastic measure for a country of 1.3 billion people, but in a resource-poor country like India, this becomes a preemptive necessary step. Even if we went by statistics globally that only 5% of cases would require hospitalisation, ventilators etc, we don’t have that kind of infrastructure.
Lockdown was required and two weeks into it, from April 6, we see a perceptible decline in growth rate. It is, however, important to note that we are still in the growth phase, and total numbers will accumulate and continue to grow for some time, but the rate at which we are growing has slowed tremendously. That is essentially what flattening the curve means. It tells you that we have bought considerable time and what we do with that time remains to be seen. The growth rate has now fallen to doubling of cases every 11 days.
Is the sudden spurt in the number of cases over the last week a matt e r of concern?
Day-to-day fluctuations will happen, and that’s why we need to study trends. Initial predictions of EpiModels suggesting 400 million to 600 million cases have been discredited or need updating because they are based on parameter estimates from other countries, and don’t take into account Indian circumstances. Instead of projection, we chose existing stats to analyse data using Johns Hopkins Data and COVID-19 crowdsourced data that give us insights into s t ate and district-level statistics.
All-India numbers are being driven up by Maharashtra, Delhi, and of late, Gujarat. We are seeing the outcome of actions we took two weeks ago, considering the incubation period of the virus.
The confinement strategy is not working in hotspots like Mumbai and Gujarat, while despite the slight increase in the number of cases in Karnataka, it is still under control.
The escalation in cases means some aspect of lockdown isn’t being followed, or local authorities are failing in contact tracing or surveillance measures.
Testing is only one part, but local administration has to focus on plugging leakages. The Kasaragod case study is a fine example which the country can emulate.
In the beginning of April, Mumbai and Kasaragod both had a similar number of cases, but now we see the drastic difference in magnitude. Since we are a resource-poor country, we need to rely on planning and be smart about it. It is a health outbreak, but a lot is about policing. It is an establishment efficiency story as much as public cooperation.
Are we doing enough tests in India? Is the spike in numbers a result of ramping up testing?
There is nothing called enough testing. We need to continue testing simply because testing, with all its false negatives and positives, is still information and knowledge. There is no way to tell whether there is community spread, whether there are new cases in new blocks without testing. We also need repeat testing of individuals.
We have the constraint of not having enough resources but that isn’t limited only to test kits. Logistics, HR in terms of people handling samples, transportation of samples in real-time, storage and refrigeration -- all are concerns. Testing has been ramped up since March 27 and we need to increase it. We are indeed seeing a slight increase in the number of cases because of increased testing, but the number of positive cases/100 tests is still hovering around 4 per cent.
That is very low compared to the US, with 20 positives /100 tests, and Italy with 24/100 tests. Even with conservative testing protocols like testing only those with symptoms, travel history or contact history, the numbers are still lower than in other countries. Hospital data shows us that the trend in the number of cases of acute respiratory illness this year is similar to last year, and the year before. That means there is no great rush of respiratory illness cases in hospitals, but regardless, testing is the only way to confirm if cases are spiking. We also need to see recovery, and the number of recoveries in India is also rising and it is good.
How intense is the economic fallout going to be?
This will be a resetting of how relationships are structured and production is set up in society. There could be greater automation and a lot of churn in terms of reorganising by firms to understand which way their respective industries will move. With the economy at a complete standstill, we have to realise that we are in a recession.
For an economy of $2000 per annum per capita GDP, India is a low-income country. To not generate wealth means many many people will fall below the poverty line. Of course, there is likely to be greater state support -- with economic packages and monetary policies that will hopefully lead to percolation at the household and firm-level, where the total impact of economic fallout will be assuaged. Hopefully, the landing will be soft.
The economy, as a whole, can’t afford to be in a state of shutdown for a very long time. That’s where testing becomes strategically important. If we are saying that 325 districts are untouched by COVID, then we should open them up. The more we are in lockdown, the more we are eating into our savings, and aren’t creating wealth.
That holds good for a household, for society and GDP as a whole. The longer we stay indoors, we effectively shrink the pie, causing economic depression. We have to prevent that from happening. That’s where calibrated moves of geographically opening up sectors come in handy. Hotspots aren’t even an entire district, but blocks.
Let’s isolate them and contain the spread, and go back to wealth creation as soon as possible. First, we will need to step up because the production cost will rise. They have to put in place mechanisms of screening, protective equipment, social distancing until the entire country is COVID-free, which right now no country is. Even China, Singapore, Japan are witnessing second waves of infections and are declaring emergencies.
We are talking either herd immunity or vaccines, but other than these options, we are going to see continued uncertainty and costs mounting. It is important to make it possible for economic activity to happen with preemptive measures. It won’t be a matter of just costs for some sectors. Demand has shrunk and is unlikely to go up for a long time for sectors like travel, hotels etc.
Do you see research gaining prominence post-COVID-19 in India?
Every crisis is a great opportunity for India, and this could be a window of opportunity. Health should be recognised not as a social sector, but a strategic sector. With the global economy growing and ageing, the demand for healthcare only grows.
The health sector doesn’t shrink, and demand is only going to rise. Strategically for us, it could become an engine of growth in the next 50 years. India should focus and think of this as a healthcare-focused investment strategy for future growth. The strategy would require doubling of doctors, paramedics, pharmaceuticals.
India is one of the biggest exporters of generic drugs and we need to reduce reliance on China and increase our share in global trade. India has great scope to become the world leader in generic pharmaceuticals sector, but we have to invest in R&D.
It is high time we invest in research not just from the government’s end or policy matters, but also from the private sector for product development.
Research is important because functioning in uncertainty isn’t a good thing. Countries that research more have more knowledge, and hence, are better equipped to handle any kind of crisis.