What did Narendra Modi do to curb
COVID spread in India?
Narendra Modi created a
template of decision making which can serve as an useful model
Published: October
06, 2020 09:56Akhilesh Mishra, Special to Gulf News
Prime Minister Narendra Modi interacts with chief
ministers of states on the COVID-19 situation through video conferencing, in
New Delhi
Image Credit: ANI
US president Donald Trump’s rather dramatic
COVID-19 infection has put the global spotlight back on the coronavirus and how
countries have dealt which the pandemic that has bedevilled the world since the
beginning of this year. At the heart of the debate are essentially two
questions. First, whether the measures taken by the governments of respective
countries have been effective in containing the spread of the virus and second,
what has been the effect of these measures on the economy of the country?
Any attempt to answer such a question for
the purposes of evaluating a replicable model must also factor in the following
parameters. First, whether the country is free and democratic or not, for
totalitarian measures adopted by autocratic regimes are really not replicable
models for the rest of the world. Second, is the country large enough in terms
of both population and area. Finally, is the country globally connected and
diverse, for relatively remote countries with little global traffic may have
managed to isolate themselves in a way which is again not replicable for much
of the world.
With these caveats in place, let us look at
the performance of India and assess whether India offers a model or not?
As of 6 October 2020, the worldometers.info
website reports total cases in India at 6.68 million and total deaths at
103,600. This puts India as the second most infected country, just after USA,
and the third in list with most deaths, after USA and Brazil. So, should we
just stop here and declare India is a failed case? Or is there more to the
story?
While many countries are
yet to resolve lives versus livelihood debate to any degree of certainty, India
got both ends of the spectrum broadly right. The “Jaan Bhi, Jahaan Bhi” (life
as well as livelihood) paradigm of India saw among the strictest early lockdowns
which broke the initial exponential chain, while the economy is also on
recovery track much earlier than predicted
-
Akhilesh Mishra
Let’s look at another data. Total combined
population of the Top 15 most infected countries (minus India) as of 6 October,
is 1.49 billion. India’s population is in the same ballpark range at 1.38
billion. How does the combined data of the Top 15 most infected countries
compare with India? Total 21.4 million cases in the Top 15 and total deaths at
721,598. For India the equivalent numbers are 6.68 million and 103,600. Total
combined cases per million in Top 15 infected countries is 14,316 while that
for India is just 4,830. For total deaths, the equivalent numbers are 481.8 and
75. The Top 15 include such countries as the USA, UK, France and Spain — all
countries with much more advanced health systems than India!
Comparing India with the
world
Let’s consider another data set based on
when countries first achieved their highest score on Oxford University COVID-19
Government Response Stringency Index.
On 21 March, when the USA first achieved
its highest score (72.69), it had 16.24 daily confirmed COVID cases per
million.
On 26 March UK (75.93) already had 21.39
daily confirmed COVID cases per million population, 2.74 daily deaths per
million population and 10.22 total COVID deaths per million population.
On 30 March, Spain (85.19) already had
123.33 daily confirmed COVID cases per million population, 17.92 daily deaths
per million population and 139.62 total COVID deaths per million population.
Similarly, on 12th April, Italy (93.52)
already had 77.64 daily confirmed COVID cases per million population, 10 daily
deaths per million population and 322 total COVID deaths per million
population.
On 6 May, Brazil (81.02) already had 32.63
daily confirmed COVID cases per million population, 2.82 daily deaths per million
population and 37.27 total COVID deaths per million population.
In contrast to all these examples, when
India first achieved its highest score (100%) on the Stringency Index on 25
March, it had only 0.04 daily confirmed COVID cases per million population, 0
daily deaths per million population and less than 0.01 total COVID deaths per
million population.
What has been the result of this
extraordinarily quick decision making by India?
As of 6 October, UK has 7,584 total cases
per million population, Spain is 18,239, Italy is 5,420, Brazil is 23,138 and
the USA is 23,135, compared to India’s just 4,830 total cases per million
population. Similarly, with respect to COVID deaths, as of 6 October, UK has
623 total deaths per million population, Spain is 689, Italy is 596, Brazil is
689 and the US is 648, in contrast to India’s just 75 total deaths per million
population.
India's size and
demographic
Let’s look at a third data set. With almost
equivalent combined population, Europe (740 million) and North America (540
million) together have 14.6 million cases and 542,311 deaths despite having
much stronger health systems, as compared to India — 6.68 million cases and
103,600 deaths.
Consider Sweden, which adopted a model
different from much of the democratic world — no lockdown and more reliance on
herd immunity. Sweden has 5,895 COVID deaths, i.e. 584 deaths per million
population. If we extrapolate Sweden’s deaths per million number to India’s
population, it would equal 805,920 deaths. This is despite the fact that Sweden
is 30 times richer than India and with a much lower population density. It has
one of the best public health care systems in the world and a highly aware
population.
So, the question then is, what did India do
right that has kept it per million total cases and more importantly per million
total deaths significantly below peers, despite having much greater population
density than the richer countries of Europe and USA and relatively weaker
health systems?
First, India was among the quickest to react
at the government and institutional level. China notified the world on 7
January about the Wuhan virus. India had a mission meeting on 8 January itself
and started screening passengers from 17 January, among the first countries in
the world to do so. First case in India was detected on 30 January and
aggressive containment and screening measures were instituted then and there.
On the other end of the spectrum, India was among the first to introduce Rapid
Antigen Tests along with RT-PCR tests. India was criticised initially for this
strategy but now the WHO itself has adopted this model and promoting it the
world over. Similarly, large parts of India made masks mandatory way back in
April itself, with Modi himself wearing masks in public since early April,
while the WHO waited till June before recommending it the world over.
Decisive national
lockdown
Second, India set the template by imposing
firm and decisive national lockdown at a very early stage of the virus spread.
When India imposed a complete lockdown on 24 March, it had just about 500 total
country wide cases. India could have waited or delayed imposing a lockdown and
risked going down the European or USA trajectory. At the time of lockdown in
third week of March, India was just about entering into the exponential phase.
The growth rate of new cases had increased from 10.9% to 19.6% in just one week
and the doubling time was just over 3 days. That is when Prime Minister
Narendra Modi took the decision to impose a national lockdown, which till then
no other country had taken so early. This one decision changed India’s
trajectory. As of today, the doubling rate in India is 51.4 days. As per
various estimates, the lockdown prevented approximately 2 million cases and
60,000 deaths that were projected to happen by May end itself. If that had
happened, the cumulative growth numbers by now on India’s population size would
have been catastrophic.
According a paper recently published in the
globally respected Science journal, the Rt=Effective Reproductive number i.e.
the number of contacts a positive case would infect, was 4 to 5 persons before
the lockdown in two states (Tamil Nadu and Andhra Pradesh) where the research
was done. But after lockdown, it declined dramatically, and notwithstanding
fluctuations, ultimately this rate is only between 1 to 1.5 (Rt=1-1.5). The
spread of COVID-19 infection was thus dealt a permanent blow during the
lockdown.
Third, Prime Minister Modi built a national
and voluntary model of participatory compliance. The behavioural change
required to deal with the pandemic, at such a large population scale in a
democratic society, was not easy. Modi understood it could only be done through
a participative model. From the Janta curfew (people’s curfew)
before the lockdown to periodic national addresses to Modi himself wearing
masks in all his public appearances — the responsible leadership template was
set at the highest executive level itself.
Relatively very low death
count
Fourth, the lockdown was not wasted but
utilised to build capacities. As an example, India before the lockdown
manufactured zero PPE kits — everything was imported. Today it manufactures
almost a half-a-million PPE kits per day! As of today, there are almost 1.5
million dedicated isolation beds, almost 250,000 oxygen supported beds and more
than 60,000 ICU beds. In January 2020, India had only one testing lab. Today
India has 1869 labs. In January 2020, per day testing capacity was less than
500 tests. Today it is 1.5 million tests per day! It is this kind of ramping up
of facilities during the lockdown that prevented hospital facilities from being
overwhelmed when the lockdown was eased and has kept India’s death count
relatively very low as compared to peer countries.
Fifth, India timed its unlock process just
about right. The first quarter of India’s fiscal year (April-June 2020) was a
washout as is the case with almost every other country. However, latest data
available for the month of September is indicative of a recovery much sharper
and widespread than anyone previously imagined. Manufacturing PMI was at 56.8,
which is the highest after 2012! Exports in September were up 5.27% YoY;
Railway freight loading was at 102.12 MT, which is up 15% YoY and the highest
ever; Petrol sales are back to January 2020 levels; power demand is up 4.6%
YoY; GST collections are almost back to pre-COVID period; India’s biggest
car-maker (Maruti) saw a 30.8% increase in sales YoY while India’s biggest two
wheeler manufacturer registered a 16.9% sales increase YoY.
The real estate benchmark market of
Maharashtra registered similar trends. Daily average property registrations
were the highest in September 2020 after May 2019! E-Way bills generated in
September was the highest ever, pointing towards a healthy road traffic as
well.
What this has meant is that while many
countries are yet to resolve lives versus livelihood debate to any degree of
certainty, India got both ends of the spectrum broadly right. The “Jaan Bhi,
Jahaan Bhi” (life as well as livelihood) paradigm of India saw among the
strictest early lockdowns which broke the initial exponential chain, while the
economy is also on recovery track much earlier than predicted.
Prime Minister Narendra Modi has had to
make some very difficult calls at various points of time during the course of
what is still an ongoing pandemic. Till now, he has been on the mark and for a
country of such diversity and scale as India, Modi has created a template of
decision making which can serve as an useful model for the democratic world.
