Unlocking India: Covid-19 exit strategies

India is now in the unlocking phase and central government directed states to evolve their own unlocking strategies to minimise restrictions to boost economic activity. The strategy for unlocking has to keep a balance between loss of lives through infection and loss of livelihoods due to economic slowdown.

A strategy needs to be adopted which separate, segregate and protect the vulnerable (mostly old aged, suffering from diabetic and heart related patients) to Covid and simultaneously opening the economy to others to ensure livelihoods. The segregation strategy should note the fact that the peoples whose lives are vulnerable due to Covid are different from those whose livelihoods are at risk from lockdown, although there are some overlaps.

The recent relaxation of lockdown provided much needed breather space for the poor, but it appears that corona cases have been increased steeply as a result. Many state governments are now weighing the options of second round of lockdown to keep a balance between direct loss to lives and indirect loss to livelihoods.

It is important to count the people who are vulnerable to Covid and who are at risk of loss of livelihoods due to lockdown to evolve a balanced and calibrated strategy.

Counting vulnerable to Covid

Many studies shows that old-aged with diabetic, heart and lung related ailments are at risk to Covid. A recent Lancet paper finds that 1 in 5 people (22 per cent of global population) worldwide are at risk of severe Covid-19.

The study came with this number by counting individuals with underlying health conditions, such as diabetes and diseases that affect the heart and lungs, who are more vulnerable. In India there are about 17.4 crore people (5.5 crore heart, 6.5 crore diabetic and 5.5 core lung disease patients) are at risk to Covid.

In just six months, there was about one crore confirmed cases with Covid-19 with at least 5,10,000 have died and world economy plunge by more than 6 per cent. In India confirmed cases are 5.67 lakh, while deaths were 16,893. It indicates fatality rates (deaths as a percent of total people infected) were double in the world (5 per cent) then in India (3 per cent).

Given that the testing rate in India is low at 4,000 tests per million, compared to about 75,000 tests/million in Spain or Italy; our actual fatality rates are overestimation of real figures. The more we test, the more we will find cases and the denominator in fatality rate increases, which reduces the fatality rate.

Indian Council of Medical Research (ICMR) survey shows that the ratio between reported cases and true infections is about 1 in 20. It indicates that the actual fatality rates may be quite low (0.15 per cent only) and many cases are asymptotic or with mild symptom and don't require hospitalization. The low fatality rates in India are due to a combination of genetics and tropical climate.

Counting risk of livelihoods

The main defence against Covid is lockdown, but lockdown induces loss of livelihoods; increase hunger, poverty and unemployment among the poor, who cannot survive long without employment. Many people lose their livelihoods, jobs, savings and assets and may not be able to recover from that.

The negative effect of the reduction in GDP was real; it will not be visible immediately but have long-lasting effects especially in developing countries like India. The World Bank anticipates up to 6 crore people could be pushed below the extreme poverty line because of income losses due to the pandemic.

In India, being a developing country, we can consider bottom 40 per cent of people, that is 54 crore people out of 135 crore population are at risk of going in to poverty, hunger and food insecurity, if lockdown is prolonged.

Once we protect the lives of vulnerable, the next priority is ensuring livelihoods, employment and income opportunities for poor. They are mostly migrant workers, casual labourer, small and marginal farmers, urban home less etc. The Times magazine claimed that an economic crisis resulting from an extended period of lockdown could claim more lives than the coronavirus itself due to hunger and poverty.

World Bank and IMF reported that global GDP will fall by 4.9 per cent and Indian economy fall by 4.5 per cent in this fiscal year. Fitch Ratings predicted that Indian GDP will drop by 13.8 per cent in July-September 2020 quarter. Data from other countries are also showing imminent recession.

The World Bank reported that, in developing countries including India, economic contraction may leads to increase in extreme poverty. It forecasted that the Covid-19 will push 70 crore people into extreme poverty worldwide, measured at the international poverty line of $1.90 per day.

The post-COVID scenario assumes that the outbreak remains at levels currently expected and that activity recovers later this year. Under post-Covid scenario vulnerable private sector would exit markets, vulnerable households would sharply reduce consumption, and several developing countries would see heightened financial stress.

Some studies pointed that economic contraction may also lead to an increase in hunger, distress and fatality rate among younger age people. Implying a greater loss in human-life years in case of economic contraction compared to pandemic.

Considering the life expectancy in India is 69 years, the loss in human life due to the death of a 29-year-old translates into a decline in human-life years by 40 years (69-29=40), whereas a death of 65 year old translated to loss of only 4 years.

Segregation strategy

Separating and segregating 17.4 crore vulnerable people will help in targeting them to ensure to stay at home, focused health care facilities and prioritize them for probable vaccination to reduce the infections and death rate.

Even among this vulnerable category, many don't require hospitalization even if they are infected with the coronavirus. Only a small fraction needs to be hospitalised, still a small fraction actually needed to be on ventilation.

If state evolves strategies to protect this vulnerable category by arranging ventilators, there will be little problems in opening up of the economy and alleviate fear among the non-vulnerable people to go for work.

The one-size-fits-all approach may not be suitable to achieve two goals of maximize saved lives and keeping economy going. The more precision we can get at who's at risk of hospitalization, the better we can work with those people and tailor our response appropriately with little harm to the economy.

Policy choices

Overall, India's Covid strategy should prioritize for protective measures to elderly with diabetic, heart and lung related ailments, who comprise about 17.4 crore population. Special safeguards for vulnerable people like paid leave can work. On the other hand, It needs to prioritize ensuring employment and income opportunities for families of 54 crore population who are at risk of loss of livelihoods.

In spite of unlocking, we cannot expect the economy will recover to 100 per cent, many lose jobs permanently, past experience shows that only 60 per cent of the workers who lost jobs fill find jobs and the remaining needs to find alternate employment sources.

Until they find alternate employment, government has to continue to provide free food grain and cash support through Direct Benefit Transfers (DBT) and similar other schemes to compensate subdued economic activity.

(The author is Principal Scientist, ICAR-Centre Research Institute for Dryland Agriculture, Hyderabad. Views expressed are personal)