Is Lockdown the Only Alternative to Respond to the Coronavirus Outbreak in India?

Academicians, economists, business personalities as well as the political parties are questioning the central government’s decision to implement a nationwide blanket lockdown in response to the coronavirus pandemic. Considering the cost associated with the lockdown, questions by these personalities are not uncalled for. In this peculiar situation when India has already spent one month in a stringent lockdown, one must ask whether the lockdown is the only alternative that India has to respond to the coronavirus outbreak. To answer this question, there is need to explore as how other countries in the world are responding to this crisis which challenges every conventional ways and means.

The reproduction rate (R0) of COVID19 is estimated to vary in the range of 1.5 to 3.5 from country to country making it highly infectious. But at the same time, the fatality rate is not very high and ranging from 1-3% (Upadhyay, 2020). At present different countries are following two broad strategies. One is lockdown coupled with testing, isolation and treatment and the other one is the path of herd immunity. Herd immunity may be effective way of responding to a disease when at least 60% of the total population is deemed to be immune to the said disease to bring the chances of person to person transmission very low. Besides Sweden, no other country with significant numbers of patients in the world has opted for the herd immunity. All the countries across the continents hit by the coronavirus outbreak are using lockdown as a strategy to break the chain of the spread so that there is no community transmission. The only difference in these countries is the level of lockdown.

Herd Immunity in Sweden

In the process of managing the coronavirus outbreak, Sweden has opted for herd immunity. The ability of herd immunity for managing coronavirus outbreak is debatable and has been questioned by a numbers of researchers because of asymptomatic carriers of the virus (Paterlini, 2020) as well as the unconfirmed characteristics and humane body response to the new virus. Sweden has a population of 10.1 million with a population density of 24.71 per square kilometer and a median age of 41 years. It is relatively a young nation in comparison to many western nations. It has one of the finest healthcare infrastructures and services in the world with 2.22 beds and 3.984 physicians per thousand of the population in 2016 (Worldbank, 2020b).

As on 24th April 2020, there were 3286.12 coronavirus patients per million in Sweden and death per million was 395.28 with a fatality rate of 12.02%. For a country like Sweden equipped with very healthcare parameters, these numbers are not small at all. Death of 3,992 citizens as on 24th April for a country with just 10.1 million of population is a very high number. Even the above graph about the daily death does not indicate a confirmed downward trend in daily deaths. So experiment of herd immunity might have saved economy from falling into a slowdown or depression like situation but with a very high cost. A large numbers of human lives have been lost in this process. And future is still uncertain.

Healthcare Infrastructure and Services in India

On the front of healthcare infrastructure and services, India is far behind the WHO recommended standards in most of the parameters. The total number of government physician are only 1,16,757 for 135 crore Indians with one physician available for 11,562 citizens. In many states like Bihar, one physician is available for 28,391. Similarly there is just 0.52 government hospital bed for 1000 citizens! However, including private physicians, there are 0.857 physicians for every thousand citizens (Worldbank, 2020a).

India is one of the most densely populated nations in the world with an average population density of more than 420 citizens in one square kilometre. Many states like Uttar Pradesh, Bihar and West Bengal have even higher population densities. It makes India one the most vulnerable places in the world for community transmission of Covid-19 or such infectious diseases. Considering the poor public healthcare system, it would never be possible for India to treat the large number of patients infected from Coronavirus if community transmission of the virus is allowed to happen.

Coronavirus in India post One Month of Lockdown

From the below graph about India, it is clear that the fatality rate as on 24th April witnessed a fall after a threefold increase. Similarly the daily positivity rate has fallen. The doubling period has increased by more than three times to 9.8 days from 3 days on 21st March 2020. The increase in doubling period is one of the most important favorable results of lockdown. If confirmed cases would have doubled every third day, as on 24th April there would have been approximately 2,10,031 confirmed cases. However, the increase in death and confirmed cases per million is natural and will keep on increasing with every single increase. So it can be conclusively said that till now the lockdown has worked in favor of India. On the basis of above the implementation of lockdown in India cannot be termed as an unproductive or irrational decision. Rather it is good decision.

Conclusion

For a small country with one of the finest healthcare parameters in the world and a small population, Sweden can provide healthcare services to a large numbers of patients but for a country like India, choosing for herd immunity is not an option at all. With very limited healthcare resources and insufficient infrastructure at disposal, India is not able to provide proper healthcare services to its citizens even in ordinary times. If the numbers of patients would have increase exponentially in absence of lockdown, it would have been impossible for India to provide healthcare services.

The world is now a changed place while it still fights against the coronavirus pandemic. India is not an exception to it. In short run, isolation, self-quarantine (lockdown) will prove very helpful and is the only alternative to contain the increase numbers of coronavirus patients. But lockdown is not a solution. It is just a tool to control the spread of virus and it must be applied carefully and a nationwide lockdown for long is not an option. Rather it should concentrate on all the specific areas with high daily positivity rate and should completely shut all the nonessential activities without compromise. But at the same time government has to keep the economy running and demand intact. It can happen only with entitlements. So the government has to do two things very sincerely; treatment and entitlement. Any lapse on account of treatment, entitlement and stringent staggered lockdown would prove very costly to the nation with very high fatality rate and a depression like situation in the economy.

Bibliography:-

• Paterlini, M. (2020, April 21). Closing borders is ridiculous’: the epidemiologist behind Sweden’s controversial coronavirus strategy. Retrieved from Nature: https://www.nature.com/articles/d41586-020-01098-x 
• Upadhyay, R. K. (2020, March 11). Coronavirus, Economy and A Fear Frenzy Behaviour . Retrieved from The Deliberation: https://www.deliberation.in/2020/03/coronavirus-economy-and-fear-frenzy.html  
• Worldbank. (2020a). Physicians (per 1,000 people). Retrieved from Worldbank: https://data.worldbank.org/indicator/SH.MED.PHYS.ZS  
• Worldbank. (2020b). Hospital beds (per 1,000 people). Retrieved from Worldbank: https://data.worldbank.org/indicator/SH.MED.BEDS.ZS

- Rajeev Kumar Upadhyay