India: The new global epicentre for COVID-19  

India’s case growth rate is still accelerating seven months after the reporting of its first Coronavirus case on January 30. Gone in the wind are assertions by successive BJP ministers as to how Prime Minister Narendra Modi’s ‘deft handling’ of the crisis has saved India from a worse situation. Experts now feel that there is every reason to believe that COVID19 is still only getting started in India. The pathogen has only just penetrated the vast rural hinterland where the bulk of country’s 1.3 billion people lives, after racing through its dense mega-cities. India is fast becoming the world’s new virus epicentre, setting a record for the biggest single-day rise in cases, and beating Brazil. Experts predict that it’ll surpass the US as the worst hit country globally in a few weeks. India saw a significant spike in confirmed virus cases on September 7, Monday, adding over 90,000 confirmed infections, more than that of US and Brazil put together.

An early nationwide lockdown imposed from March-end onwards has resulted in a record 23.9% contraction in Apr-June quarter’s GDP, the first GDP contraction in more than 40 years. Yet it has not succeeded to bring in any contraction in the virus spread rate. An early lockdown has not saved jaan, but ruined jahan. Shutting down the economy has not helped the country so far. While the pandemic impact is dwindling gradually in the US and Brazil, India’s case load continues to grow.

“As the world’s second-largest country, and one with a relatively poor public health system, it’s inevitable that India’s outbreak becomes the world’s biggest,” said Naman Shah, an adjunct faculty member at the country’s National Institute of Epidemiology and a member of the Indian government’s COVID-19 task force, while speaking to Bloomberg.

“What we’ve done is delayed infections, but we haven’t been able to curtail the transmission,” said Ramanan Laxminarayan, director of the New Delhi and Washington, D.C.-based Centre for Disease Dynamics Economics and Policy (CDDEP).

“And that was never going to be possible in a country the size of India and with the health infrastructure India has. What has played out is almost exactly what one should have expected,” he said.

The Novel Coronavirus poses a unique problem to low-income countries like India. The densely packed slums where millions of its citizens live present ideal conditions for the virus to spread. Low testing, lack of public awareness and poor health infrastructure make it difficult to control the virus spread in the rural hinterland. Shortage of testing and clinical help in rural areas suggest that the number of infections and fatalities are going to be unreported or unnoticed.

The economic precariousness of low-income countries means that the shutdowns necessary to contain the pathogen are intolerable. Across the developing countries including India, economies have been forced to open up even while the virus is still running rampant. The pandemic has now shifted from the rich countries to the poor countries, as it races around the world. Till a few months back, rich countries like Italy, Spain and the UK were the epicentres of case load and deaths. Trump’s USA is the only advanced economy now in the top ten of worst affected countries. Developing nations like India, Mexico, Philippines, Peru and South Africa are the new emerging epicentres.Compared to smaller nations, large nations are at a relative disadvantage to pin down the virus. Smaller nations such as New Zealand or Vietnam can manage the flow of cases by shutting down their international borders. But large nations like India cannot indefinitely close down their porous internal borders. Large nations have big, inter-dependent and diverse internal makets. Consequently, they can ill afford to have those supply chains broken for long.

Unlike a large nation like China which has displayed ruthless efficiency in capping the spread of virus, India’s state machinery has not exhibited similar efficiency or effective strategies. When the state has insufficient capacity, it needs to strike alliances with players in the private sector and non-profit organisations. Indian government was not proactive in striking such ‘win-win’ alliances.

“In fact, it’s a standard joke among policy analysts in India that any conversation about what needs to be done ends with the statement, ‘But we can’t do that anyway.’ The state, at every level, is chronically short of managerial resources, of talent, of resources and of time”, wrote columnist Mihir Sharma in an article

As evidence that the country is managing the virus’ spread, even if not containing it, the government has pointed to India’s official low death rate of around 1.8%. However, to a large extent, fatalities are underreported as well as distorted by the nation’s disproportionately young populace.

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