Health

COVID-19 is an opportunity

It provides a chance to work towards strengthening public health systems and better disaster resilience

 
By Praharsh Patel, Ishani Palandurkar
Last Updated: Tuesday 31 March 2020

The novel coronavirus disease (COVID-19) pandemic has infected almost 800,000 people globally. The uniqueness of this pandemic is that it has brought the whole world under quarantine and forced country-wide lockdowns in almost all the large economies of the world.

Additionally, unlike Ebola or HIV, COVID-19 has spread mostly through internationally traveling passengers who were infected from the source city and further went on to infect others, thus, primarily infecting people from higher income strata.

India is in the second phase where the infection has majorly spread through people travelling from abroad. With the difficulty in tracing the arrived passengers and further difficulty in contact tracing of these people, the infection picked up the momentum and started transmitting at an exponential rate.

In view of this limitation, the strict imposition of the 21-day nationwide lockdown by the government is a welcoming step and has certainly put India under better condition as compared to many other countries. Although COVID-19 has still not infected a large population according to government sources, it has affected the poor far more intensely.

For the lockdown to be effective, all sections of Indian society will have to be equally active in maintaining social distancing and hygiene. As India is on the verge of phase three, millions of poor are extremely vulnerable, with their livelihoods lost, resulting in severe financial and social stress for them.

Among 276 million people living under poverty according to some estimates, around 62 million people are broadly engaged as domestic helps in construction work, transport services (autos / rickshaws), waste-picking, etc in urban India whereas in rural areas, they are engaged as small farmers and farm labourers.

Here we are highlighting some peculiar constraints and situations associated with these people who may not be able to follow the quarantine.

Infection implosion in slums and lack of information

Lower-income groups are usually engaged as helps to higher-income ones. Unlike the privileged class, they have limited access to awareness through social media or news.

Since the symptoms of the infection are broadly fever, dry cough and difficulty in breathing, these can very easily be taken for common flu or fatigue. Additionally, these communities live in small, overcrowded spaces and expose a lot many people to the infection if they are the carrier.

In a recent case in Mumbai, a 68-year-old house help contracted the virus from her employer and went on to infect another 25-year-old in her slum.

As of the 2011 census, 68 million people resided in slums in India (now even more) indicating the risk at which lower-income groups are at if they are exposed to even a single person carrying the virus. Not only will they be unable to identify the infection, they will also not be able to maintain the required hygiene and isolation.

The lost livelihood of unorganised sector workers

The lockdown has severely impacted daily wage earners.

Factories, except those under ‘essential’ category are shut, local transportation services are on hold along with the rest of the national transportation, local administrations are policing cities to prohibit anyone from stepping out and reducing human contact, fruit-vegetable vendors are allowed to function for only a few hours and much more.

This sudden halt of economic activities has put micro, small, and medium enterprises (MSME) owners and workers under great financial and resource stress. Moreover, they have also lost their means to travel back to their villages.

Special bus rides have been arranged amid the lockdown to ensure that workers reach their homes safely. While this step has been applauded by many and may come as a relief to the workers, it has also defeated the very purpose of the lockdown, with so many people coming in close proximity and traveling together.

Couldn’t the local authorities provide temporary shelter to these workers? Couldn’t the local resources be mobilised to feed them daily? Couldn’t they be organised and kept at a safe distance from each other and also be observed for the viral infection? These are some crucial questions that the state might soon need to answer.

Unwarranted exposure of waste pickers

The majority of the population is using disposable masks, gloves, etc as a ‘safer’ option as they could be thrown away immediately after use. But what goes unnoticed is the handling of these wastes.

The masks, gloves or clothes disposed by people who have stepped out or came in contact with the suspected or confirmed citizens could have the virus on them and if such waste is not handled properly, waste pickers are going to be on the frontline of danger.

Recently, the Central Pollution Control Board has released guidelines for handling medical waste from COVID-19 home quarantined facilities, which is to be collected under thorough supervision of the local authority.

However, no guidelines ensure safe waste collection from non-quarantined households that could also have infectants in their waste. While no case of contraction of infection is yet reported among waste handlers, it could, nevertheless be a ticking time bomb.

Failing farmers’ fate

Agriculture is the backbone of the Indian economy which is under severe threat this year. The last kharif season crops for most of India failed due to untimely intense rainfall. Rabi sowing this year was expected to have promising results as there was 9.5 per cent higher sowing.

The area sown with staple crops that are mostly preferred by the marginal and low-income group farmers such as rice, wheat, and pulses had increased by 23.5 per cent, 11.8 per cent, and 16.5 per cent respectively.

The season to harvest the rabi crops coincided with the lockdown period. The rural economy has been brought to a standstill, with most of the mandis shutting their operations as well as the complete blockade on goods transportation.

Additionally, many parts of western and north-western India such as Punjab, Gujarat, Rajasthan, etc experienced unanticipated hail and thunderstorms that destroyed the standing crop.

Although India currently is food-sufficient, this loss will impact the rural economy and livelihood severely and will create a great liquidity crunch for the farm sector.

What next?

The government has declared that essential goods will be provided to marginalised people through the Public Distribution System (PDS) but it may not suffice as, 1) it will create chaos at the distribution level since the last mile connectivity is lost, 2) it is difficult to expect people to maintain social distancing while venturing out to get their freebies.

There is an urgent need to deliver basic amenities in the most hygienic manner or else the distribution itself will become an agent of the infection.

A few civil society organisations have taken up the last-mile delivery of basic necessities but the severe resource crunch (manpower and money) calls for a public-private partnership where PDS works with civil society to deliver goods at the doorstep and makes the lockdown truly effective.

The crisis also calls for long-pending demands such as effective implementation of Pradhan Mantri Fasal Bima Yojana (PMFBY) to be met. PMFBY includes measures to tackle unanticipated risk to farmers and provides necessary protective gear to all sanitation workers.

The situation also calls for introspecting disaster preparedness from a public health viewpoint as the mere limiting the virus’ spread virus cannot be termed as a well-prepared system. India has shown great strength in fighting against natural calamities with the National Disaster Relief Force.

Now, similar inputs are required to build resilience in society so as to have the least impact of such health disasters, with substantial support given to maintain the economy.

COVID-19 provides a chance to work towards strengthening public health systems and better disaster resilience. Along with containing the infection, we hope we can also reduce the economic impact it may have.

Praharsh Patel is with the International Water Management Institute-Tata Water Policy Program while Ishani Palandurkar works with Chintan Environmental Research and Action Group

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