Health

COVID-19: Challenges today and tomorrow

The choice is stark for Indians

 
By Sunita Narain
Last Updated: Wednesday 25 March 2020
Corona challenges today and tomorrow. Illustration: Ritika Bohra

I am writing this from lockdown ― India is at the cusp of coronavirus’ third and most deadly stage of community transmission and governments have now called out to citizens to stop all economic activities and isolate themselves. This is clearly crucial. Never before ― at least not in my living memory ― has something this small become so globally life-threatening and so out of control, so quickly. 

It was only in January that we got the first real news about the novel virus, which has jumped from animals to humans, and was claiming lives in China. We saw images of forced incarceration; millions of businesses and homes were shut down; hospitals were built overnight; and, it would have seemed that victory was on hand. It was a blip in the global economy and China would bounce back. Business was as usual.

But then, so quickly, the virus moved to make new homes: Italy, where things have completely gone out of control and Iran, where so little is known even today about the sheer extent of toll that this disease has extracted. Now the spread is practically universal; most of the world is in a lockdown mode. It is completely unbelievable.

As I write this, there are 415 coronavirus cases, with nine deaths in India. This pales into insignificance, when you consider that Italy has close to 60,000 cases; or that New York alone has over 16,000 confirmed cases. It is said the cases in India do not represent the true numbers, because testing is limited. But this is where the real question arises.

What should countries like India do, with limited testing facilities and even more limited public health infrastructures? All evidence now is pointing to the fact that as the pandemic reaches the community spread stage, the death count will increase because these countries cannot provide intensive care that is needed.

That’s why the choice for Indians is stark ― we cannot afford community transmission; we have to contain and to prevent further spread. Already, in my view, we have delayed the inevitable closure and not been strong enough on enforcing the rules of quarantine. And, yes, we have to increase our testing capacities, but it is also clear that we will never be able to test adequately once it spreads.

So, testing has to be done to identify and isolate. But this is where we are weak. We have seen how people ― the literate rich because they are foolish and the illiterate poor because they have no option ― have been willfully breaking the self-shutdown.

Governments must explain this logic to us. We need to know that we have to shut down so that we do not end up spreading the virus, which we have seen in other countries where the virus has been galloping exponentially to infect entire populations within days.

There is no rulebook on this virus, but what is clear is that the only way to contain it is to break the chain of transmission. This, of course, is tough as it brings economies to a grinding halt. It destroys livelihoods, particularly of the poor and the self-employed.

Here too we will need governments to step in with social security and access to essentials so that people can cope and make their way through this never-before global catastrophe.

But this is not all. We need to use this time to think about some fundamentals ― one of which is the issue of global cooperation. There is never a good time for such a pandemic to hit the world, but this is the worst time possible.

There is no global leadership or institution, which has the respect and the sagacity to take us through, what is clearly a crisis beyond national boundaries. What we have seen in the past few months has been a shameful record of self-interest and self-preservation over everything else. For most of us who work to advocate for global cooperation on another existential threat like climate change, this should not be news.

But it does shock you that even with such a crisis, which is literally bringing the most powerful countries to their knees, we are not getting together to discuss the global response to the global pandemic. Why? What more can and should we do? I want to discuss this further in the coming weeks.

Then, of course, there is the issue of public health ― what coronavirus teaches us (if we care to learn) is that we are only as strong as our weakest link. If there is no access to public healthcare or if public health services have collapsed ― as is the case in most of the emerging world (and the United States) today ― then we cannot withstand pandemics.

It is also not enough to build this capacity within countries, because if any region of any country or any country of the world is weak, then the contagion will breed there and will spread. For how long will we be able to keep our borders closed? How will this even work?

And, this then, leads to my third question about the nature of globalisation post-corona. Will we learn from the vulnerabilities of our system to make it more robust ― investing in local economies and local health systems through global partnerships? Let’s keep discussing this in these tough times.

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