Why India could not contain Coronavirus in spite of prolonged lockdowns

Italy in July! Its hospitals are basically rid of COVID-19 patients. Daily deaths attributed to the virus in Lombardy, the northern region that bore the brunt of the pandemic, hover around zero. Rewind to March…Italy was the nightmarish epicentre of Coronavirus.

“The streets of Bergamo are empty. As in all of Italy, people can leave their homes only for food and medicines and work. The factories and shops and schools are closed. There is no more chatting on the corners or in the coffee bars.”

“But what won’t stop are the sirens.”

“While the world’s attention now shifts to its own centres of contagion, the sirens keep sounding. Like the air raid sirens of the Second World War, they are the ambulance sirens that many survivors of this war will remember. They blare louder as they get closer, coming to collect the parents and grandparents, the keepers of Italy’s memory.”

The New York Times  published an article in March, describing Italy as "The Bleak Heart of the World’s Deadliest Outbreak".

Once seen as the world's worst hotspot, Italy has now managed to bring the virus to its heels. Italy has had more than 34,000 deaths, with nearly half of them in the Lombardy region, of which Milan is the capital. Italy's first case of Coronavirus was identified in Codogno, a town of 16,000 people about an hour's drive from Milan on February, 21. Within a short period of one month, Italy has been hit by nothing short of a tsunami of unprecedented force, punctuated by an incessant stream of deaths.

In a matter of four weeks (from February 21 to March 22), Italy went from the discovery of the first official COVID-19 case to a government decree that essentially prohibited all movements of people within the whole country, and the closure of all non-essential business activities. As the virus threatened to spread uncontrollably, Italian officials decided to put lives ahead of the economy. Italian officials think now in retrospect, that the best of the cure came in one single dose — the painful lockdown — and that the country is now safe to resume normal life, albeit with necessary precautions.

Even now in the Lombardy region, masks must be worn at all times while in public. Schools and universities remain closed. Bars and restaurants are open, but with social distancing rules in place. Some experts attribute Italy's success to surprisingly high levels of compliance with social distancing measures from the Italian people.

Italy and Spain have been singled out by the head of the World Health Organization (WHO) as good examples of how to successfully contain the Coronavirus. "In March, Italy and Spain were the epicenter of the pandemic" - Tedros said - "At the peak of its epidemic, Spain had almost 10,000 cases a day, and Italy had more than 6,500 cases. However, both countries managed to bring their epidemics under control with a combination of leadership, humility, active participation by every member of society, and implementing a comprehensive approach. Both countries faced a daunting situation, but turned it around."

How Italy has turned around from being a global pariah to a model of virus containment is worth understanding. It holds lessons for the rest of the world, including the United States, Brazil and India where the virus now rages on.

Like Italy, India also went for an early nationwide lockdown in March. While Italy’s outbreak has dramatically ebbed from its mid-March peak, India’s new cases keep climbing and remain more intimidating than Italy's worst day. India's single-day spike of 57,117 COVID-19 positive cases on July 31 was the biggest one-day jump in cases.

It seems that the nationwide lockdown in India did not have the same effect of decreasing the volume of virus circulating in society, as in the case of Italy. There are reasons. Italy's proportion of old and vulnerable population is very high, requiring an urgent and strict lockdown. India has a high proportion of young population and Indian people have relatively higher immunity. Italy does not have issues like migrant workers and hence the lockdown could be implemented perfectly to the written script. The chaotic return of nearly 10 million migrant workers to their home villages has defeated the essence of a nationwide lockdown in India. Only a few states like Maharashtra, Tamil Nadu, Delhi and Karnataka account for a lion's share of positive cases in India and not all states have same intensity of spread. The time line for emergence or explosion of cases is also different for different states. For example, Andhra Pradesh is lately emerging as a new hotspot, while Maharashtra has been a hotspot for the last two-three months. In a vast and diverse country like India, one solution does not fit all. Localised solutions would be better. In a low-income country, high levels of compliance to sweeping lockdowns is difficult and has grave implications in terms of livelihoods.

In a country like India, lockdowns and social distancing measures need to be calibrated and localised to be effective. Lockdowns and social distancing measures need to be complimented with higher testing, more hospital beds, free universal health cover for Coronavirus treatment, free supply of masks to all households, subsidised supply of soaps and sanitisers, transfer of minimum income to all BPL families etc. However, none of them seems to be on the mind of our policy makers

(V Venkateswara Rao is a retired corporate professional and a freelance writer)