2 May 2020: The Indian Express Editorial Analysis
1) Get on right track-
A day after the Union Home Ministry allowed the inter-state movement of migrant workers, a train carrying about 1,000 labourers took off from Lingampally in Telangana for Hatia in Jharkhand on Friday morning.
The home ministry had initially allowed the movement of these workers in buses. But several states had questioned the feasibility of the move and demanded that the railways run special trains to ferry(transport) the stranded(trapped) migrants.
SPECIAL SHRAMIK TRAINS:
The Centre has done well to accede to their request. The railways has outlined plans to run special Shramik Trains to move migrant workers, tourists, students, and pilgrims back to their homes.
It has asked the state governments to make sure that the Centre’s COVID-19-related guidelines on the screening of inter-state travellers are scrupulously(strictly) followed. It’s now up to these(state) governments to draw up plans and protocols(rules) for this purpose. They must hold regular conversations with the railway authorities to ensure transparency in running the special trains.
FEELINGS OF DESPERATION AND ANXIETY:
By all accounts, about 10 million migrant workers have been stranded in different parts of the country after Prime Minister Narendra Modi announced a nation-wide lockdown on March 24. Having lived on charity(donations) in cramped(congested) shelters arranged by state governments, NGOs and some business outfits, these workers are yearning(desiring) to go back to the familiarity and comfort of their villages.
The prospect of a train back home is bound to kindle their hopes. But such situations are also rife(common) with feelings of desperation and anxiety. This was evident in Mumbai, about three weeks ago, when distressed migrants swarmed(assembled) the Bandra railway station, anticipating(looking forward) a relaxing of the lockdown.
When their hope turned to disappointment, the hapless workers took to the streets. To prevent such a situation from recurring, the railways and the state governments must engage and inform the migrants while planning special trains. Decisions on who gets to be on the trains must be fair and must be seen to be so too. The state must keep all channels of communications open with those who might temporarily be left out.
The railways has said that the passengers on the Lingampally-Hatia train were screened and social distancing protocols followed during the journey. Given that several studies have shown that most coronavirus carriers are asymptomatic(not showing symptoms), the imperative(need) of following such protocols on future journeys cannot be overstated.
The state governments and railway officials should make sure that these operations are conducted without burdening the migrants but at the same time, care should be taken to ensure that the virus does not spread to the country’s rural areas.
All this may pose logistical(involving organization and planning) challenges for the railways and the state governments. It will require them to cooperate and coordinate on matters such as making lists of the travelling migrants, ensuring screening facilities for them, and arranging transport to, and from, the railway stations.
This is an opportunity for these authorities to get the first steps towards the opening up right. For that reason, they will be closely watched. Special trains for migrants are welcome, must be informed by sensitivity and fair play, and guided by medical protocols.
It is almost two decades after liberalisation, when private enterprise took the initiative from state enterprises. In that time, privately-owned and for-profit hospitals took the burden of disease over from a moribund( at the point of death) system of publicly-funded hospitals.
But the Rs 2.4 lakh crore private health care sector is faltering(failing) in the face of a public health crisis, whose burden is being borne(faced) by government hospitals, their doctors and nurses.
APATHY OF PRIVATE HOSPITALS:
Private enterprise owns almost three out of every four hospital beds in India, and almost eight out of 10 ventilators, but they are handling less that 10 per cent of those critically ill with novel coronavirus. States like Bihar, where private capital owns about twice as many beds as government hospitals, have seen the private sector in complete rout(defeat).
The reluctance to engage is so great that they have been turning away coronavirus patients and other patients in need of aid. In Delhi and Maharashtra, the state government has had to issue orders so that they do not turn any more away.
FACTORS AT PLAY:
As a series of reports in this newspaper showed, numerous factors have been at play in this failure — pay cuts, employee reluctance(unwillingness), the fear of sealing, the future consequences to brand value of hospitals identified with the pandemic, the lack of established protocols(rules) and protective gear, and bureaucratic instructions, like those issued in Telangana, to refer viral patients to government facilities.
Underlying all this is the economic reality of falling revenues and footfalls(number of people entering an area), accompanied by new expenses and risk.
ABDICATING PUBLIC RESPONSIBILITY:
While the central and state governments should offer to underwrite(take) the risk, the fact remains that a sector which has benefited hugely from government concessions and encouragements, and which has tried to take over healthcare in India, has abdicated(given up) its public responsibility and remains isolated from the national effort.
The pandemic offers an opportunity to policymakers to revalue the virtues(qualities) of public versus private healthcare, and those of free facilities versus insurance-backed care. But both must continue to exist and the present system, however flawed(fundamental weakness or imperfection), must carry the nation through the crisis.
To retain its perceived value, it is imperative(needful) for the private sector to do its public duty now, and be seen to be doing so. In a crisis in which every citizen is pulling together according to ability, financial excuses for withdrawing appear to be pusillanimous(lack of courage or determination) and morally wrong.
In their long-term interest, abstaining(those not treating the patients) private hospitals must reconsider this divestment(action or process of selling off subsidiary business interests or investments) from the national effort. In national interest, and in their own interest, private hospitals must reconsider their divestment from fight against pandemic.
3) Though stringent, lockdown was timely-
While the OECD countries are reeling(suffering) under the COVID-19 impact, India is clearly ahead of the curve. This is not merely in terms of the confirmed cases in the country but is also strongly reflected in very low mortality(death) numbers (8.5 deaths per lakh population) compared to other nations (4,040 in the UK and 1,930 in the US).
When first cases were reported in most hotspot countries and India around the same time (last week of January), today, the outbreak is far more manageable in India than in most other countries.
(The Organisation for Economic Co-operation and Development is an intergovernmental economic organisation with 37 member countries, founded in 1961 to stimulate economic progress and world trade)
MUCH NEEDED LOCKDOWN:
It was pragmatic(practical) for a resource-poor country to be pre-emptive(intended to pre-empt or forestall something, especially to prevent attack by disabling the enemy) and declare a national lockdown when the total number of cases were still low at 500. The subsequent growth of the pandemic clearly shows a perceptible(noticeable) decline in the number of cases due to the lockdown.
Though stringent(strict), this was much-needed and a timely policy intervention by the government. It is important, however, to appreciate the high and growing opportunity costs(the loss of other alternatives when one alternative is chosen) that are involved during a lockdown. We must brace(ready) ourselves for long-term pandemic management (18 to 24 months) with significant economic impact on our lives. The immediate costs of the lockdown are borne(faced) by the most economically vulnerable people in society.
The immediate costs of the lockdown are borne by the most economically vulnerable people in society. This perhaps was the rationale behind the first round of economic policy interventions announced by the finance minister within a few days of the lockdown.
They targeted front-loading of cash transfers through PM-Kisan, support to construction workers, self-help groups, food distribution through the public distribution system, among others. Beyond welfare concerns, there are significant growth concerns that are mounting(increasing) with every day of economic inactivity in the country.
Companies are struggling to honour payroll( list of a company's employees and the amount of money they are to be paid) and maintain their workforce against cancelling orders and declining demand for their goods and services. These in turn will lead to greater delays and defaults in loan repayments, thereby further weakening the fragile(weak) banking sector and struggling credit markets.
The Reserve Bank of India stepped in for some timely monetary interventions, however, the longstanding climate of risk aversion(avoidance) within the banking sector will mean that transmission of these monetary interventions is unlikely to be timely or adequate(enough). All eyes are set expectantly in one direction.
Historically, when economies are faced with major calamities(disasters), governments step in to stabilise the environment and boost confidence within the business community who are the creators of wealth and employment. We have seen this response from all major economies disrupted by COVID-19 over the last several weeks.
India will not be an exception to this as the government fine tunes its strategy to support and kickstart our immobilised economy. The opportunity cost of time, however, is ballooning(increasing) with each passing day. Just like the spread of the virus, we are up against the full force and power of compounding. Mindful policy interventions, when timed well, can cut growing losses and the misfortune of many.
India is a large country and the current crisis keeps reminding us of that reality every day. While we have succeeded in slowing the growth of the virus at the national level, the true gains and pains are at the state and local level.
IMPROVING CONTACT TRACING EFFORTS:
As the data reveals, currently we have three states that have made remarkable gains and “flattened the curve” of COVID cases. These are Kerala, Haryana and Tamil Nadu where recoveries are growing and active cases are rapidly declining.
States like Karnataka and Telangana are improving their recovery rates consistently, despite fluctuations. While every state and local administration has to keep eternal(endless) vigil(watch) and double down on containment and testing, they have to aggressively improve their contact tracing efforts with the help of their police who are trained in debriefing, call record mapping and have more manpower than public health departments of local administrations.
Given the scale and variation in infection control across the country, our national strategy needs to be informed and calibrated(measured). Currently, there are more than 300 districts in the country which have reported zero COVID-19 cases. This can be confirmed quickly with some random testing (we do have the capabilities to conduct these meaningfully) and the lockdown can be lifted effective immediately.
Then there are about 225 districts which have reported less than 10 cases each. With adequate ring fencing at the level of the block where these cases are reported, these districts too can afford to lift their lockdowns.
There are, however, approximately 30 districts across the country which have reported large numbers of confirmed cases and are identified as “hotspots(place of significant activity, danger, or violence)”. The lockdown in these places needs to continue with some relaxations for basic trade and essential services. Not surprisingly, these “hotspots” are also important economic centres of the country.
The capacity of the local administration to develop and enforce appropriate strategies of containment, contact tracing and testing, should determine their decisions to ring-fence and isolate(separate) blocks while allowing other parts of the district/city to resume economic activity.
Over the last month, India has developed significant capacity to test and treat COVID-19 patients across the country by creating a large number of specialised fever clinics and identifying COVID hospitals across every state. Our disaggregated(separate (something) into its component part) data analysis, however, suggests that there is no hospital rush of patients with symptoms of acute respiratory ailments like in the US, the UK, and Europe.
Given the uncertainty of the virus, we seem prepared for large hospitalisation and care if the need arises. The efforts now must be to further contain the growth of the infection. If the current rate persists(continues), we will reach over a lakh cases within three weeks. That is the power of compounding we are against.
Beyond knowledge sharing across states and adopting successful containment strategies from each other, there is a role for the central government in providing “NSG-like” public health support teams to states that need them.
On the economy front similarly, the central government’s timely economic package should flatten the curve of exponentially rising opportunity costs across the sectors.
Given the relative scale and virulence(severity or harmfulness of a disease) of the COVID-19 virus in India, the odds seem stacked(loaded) in favour of a calibrated(measured) opening of the economy.