Behind the Apparent Success of India's COVID-19 Response

When the novel Coronavirus first erupted in China during the final months of last year, many suspected that neighboring India, with its high population density and urban squalor, would be the next massive hotspot for the disease. However, as of the end of April 2020, India has only reported around 40,000 cases of Coronavirus (less than 0.1 percent of the population), with approximately 1,000 of those cases proving fatal. While this number is certainly nowhere near zero, it is surprisingly less than the number of cases currently being endured in many, more developed countries such as the United States, which has about a third of India’s population, but over 1 million COVID-19 cases and over 60,000 resulting deaths. How exactly is a country of over 1.3 billion people, over 60% of whom live in poverty, doing relatively well against one of the worst global public health crises in modern history? The Indian government’s drastic nation-wide lockdown and contagion surveillance policies appear to be having positive effects. However, it is also possible that India simply has not identified the true size of the COVID-19 threat within its borders as testing is not nearly as widespread per capita as in other countries.

On March 24, Indian Prime Minister Narendra Modi announced a 21 day lockdown (now extended to May 3), meaning that virtually all activity, economic and social, in the country effectively stopped. India’s policy is far more restrictive than anything that has been implemented yet in the United States. In short, nobody can leave their place of residence unless they have a valid reason and proof to support it (e.g. law enforcement badge, evidence of medical profession, prescription for medication, etc.). The punishment for disobeying the lockdown is quite harsh. There are videos of police officers beating violators with sticks in public. Many question the results of such strictness, specifically on how it marginalizes migrant workers and Muslims. There is some truth behind these concerns, as Hindu nationalists, many of them members of Prime Minister Modi’s Bharatiya Janaya (BJP) political party, have falsely accused Muslims of intentionally trying to spread COVID-19 claiming they are trying to wage jihad against Hindus. Additionally, many migrant laborers are now not only forcibly unemployed by the lockdown, but also trapped in places often far away from their homes and families without a way to return. However, recent scientific research suggests that the lockdown’s public health benefits seem to outweigh its negative consequences. A paper published by faculty at the University of Michigan Department of Public Health concludes that a 21 day lockdown like the one India did has a significant chance “to reduce the number of COVID-19 cases in the short term” due to social distancing. This will buy the Indian healthcare system much-needed time to prepare testing and disease growth monitoring to help combat the virus in the long-term.

Regarding such testing, is it important to remember that India’s aforementioned success against the Coronavirus, despite the promising scientific developments, could still be little more than an illusion. As of April 19, 2020, only around 400,000 people had been tested for the disease. When viewed through the context of India’s large population, this puts testing per capita at less than 1 person per 1,000, far lower than the United States (approx. 14 tested per 1,000). India definitely needs to ramp up its testing program and fast, but a multitude of obstacles, including oppressively high temperatures in certain areas and the high cost of tests (about $59 each), are hampering the effort to do so. Additionally, even where testing is prevalent, many testing kits, especially those imported from China, are delivering unreliable results, thus forcing many clinics and other testing facilities to throw out their equipment when it is needed most. Whether or not the total number of Indian COVID-19 cases will rise after more people are tested remains to be seen.

Even if this lockdown policy turns out to be less effective than it currently appears, at least India’s response to COVID-19 shows that the country is taking the pandemic very seriously. This is more than what can be said about countries like Brazil, where president Jair Balsonaro recently fired his health minister for suggesting stay-at-home orders because they conflicted with Balsonaro’s “desire to resume business,” and China, where many wet markets considered to be the origin of COVID-19 are still open. Even some in the United States could learn from India, since officials like Georgia governor Brian Kemp are irresponsibly advocating for nonessential businesses like gyms and bowling alleys to re-open despite threats of a second wave of COVID-19 cases. Therefore, although there may be drawbacks to India’s approach against COVID-19, the country continues to pursue one of the most effective strategies to fighting the pandemic by prohibiting unnecessary physical contact in any way possible.

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