Expert Speak Health Express
Published on Apr 15, 2020
#Covid19: For now, lives over livelihoods Feasting and festivities mark the onset of Baisakh across India. Families merge into communities to celebrate the annual pre-summer festival of renewal and rejuvenation as farmers bring home the Rabi harvest. This year’s Baisakhi celebrations, spread over 13-14 April, were supposed to be special. It was widely expected that Prime Minister Narendra Modi would announce the lifting of the national lockdown, if not in entirety at least in parts, thus allowing a homebound nation of 1.4 billion people forced into ‘social distancing’ to step back into the world from which they had been sequestered for the last three weeks to checkmate and rollback the Covid19 pandemic. That was not to happen. The Prime Minister thanked the people for their cooperation in making the lockdown successful, noted how India had performed well in comparison with other countries in the war on the pandemic. And then asked people to stay home till 3 May. In between, he acknowledged that the blow to the underprivileged sections of society, whose livelihoods have been disrupted, needs to be mitigated, appealed to employers left with dwindling capital and stuck with idle machines not to sack labour, and admitted that the impact on the national economy would be unsettling. It was a call that the Prime Minister took on the basis of assessment by Central health authorities, the views of Chief Ministers, many of whom have already extended the lockdown till 30 April and indefinitely sealed ‘hot spots’ in their States, and the cost differential between endangering lives on the one hand and risking livelihoods on the other. For the moment, the economy has taken a back seat as the political leadership, both at the Centre and in the States, has placed a huge, possibly unprecedented, premium on lives. This is not usually the case in India where human life is proverbially cheap. The decision to extend the lockdown, effectively by another three weeks, came on a day when the virus from Wuhan showed no signs of relenting in its ruthless hunt for human lives around the world. The global numbers look grimmer by the moment: 1,946,386 confirmed cases of Covid19 so far with 121,704 deaths caused by the virus. In India, after what now appears to be a false slow start, the numbers are beginning to look bigger by the day: 10,542 confirmed cases and 358 deaths. Maharashtra, Delhi and Tamil Nadu continue to log alarming numbers. The decision to extend the lockdown, effectively by another three weeks, came on a day when the virus from Wuhan showed no signs of relenting in its ruthless hunt for human lives around the world. There is cold comfort in the fact that India trails the US, Spain, Italy, France, Germany, Britain and other developed countries by several miles and more. Nor is there any percentage in stating the obvious: that despite inadequate funding by State Governments for a moth-eaten health infrastructure, our public sector doctors and healthcare staff have performed remarkably in holding back the tide of death and misery unleashed by the pandemic. The sudden disruption caused by Tablighi Jamaat activists has pumped up India’s numbers to levels that were not anticipated. That the controversial religious gathering was allowed merits a full investigation to pin accountability at a later date. This then is the backdrop to the lockdown extension announced by the Prime Minister. It is anybody’s guess as to whether Government hopes to flatten the curve irrevocably in the next three weeks or extraordinary hopes are being placed on the early summer heat overwhelming the virus and curbing its spread. Nor should we place needless emphasis on World Health Organization Director-General Tedros Adhanom Ghebreyesus’s sudden realisation that the “SARS-CoV2 virus is at least 10 times deadlier than the Swine flu virus” and that “Governments should not lose control over lockdowns and take strict measures to flatten the Covid19 curve”. Three months after the world got to know about the Wuhan outbreak, this is common sense and not special knowledge. It would be facetious to suggest that the economic impact of the lockdown is not weighing heavily on the Prime Minister’s mind – or the mind of any head of government around the world. The early warnings have begun to pour in. The IMF, which has said that Covid19’s impact on the global economy would be “worse than that of the Great Depression in the 1930s”, has been the least harsh in its prediction for India, suggesting that the country’s GDP would grow by 1.9 per cent and India would be the “fastest growing emerging economy”. China would clock in second at 1.2 per cent GDP growth. Predictions, obviously, are just that and no more. There is a spurt of wildly swinging, possibly totally inaccurate, estimates of how much India stands to lose on the economic front with nearly 70 per cent of its economy shut down since 25 March. Barclays has predicted zero per cent growth and a loss “close to $234.4 billion or 8.15 per cent of the GDP”. Most of the losses would be on account of the pandemic’s impact on industry in Maharashtra, Delhi, Tamil Nadu and Punjab. And it’s still too early to figure out with any certitude whether this year’s monsoon would play truant or stand by India. A bad monsoon, needless to add, would worsen India’s economic woes and pile further pressure on the Government. Industrial units (micro, small, medium and big) which had just about begun to show signs of recovery after a prolonged downturn are now clamouring and lobbying for relaxing the lockdown norms to enable them to start functioning, even if in a truncated manner. That’s easier said than done. Many of these industries are located in States badly hit by Covid19 – Maharashtra, Tamil Nadu and Delhi, to mention some – and there is no guarantee that factory floors would not turn into virus incubators. But turning on the switches in factories is the easiest part; keeping the machines running is far more difficult. Supply lines have been disrupted with trucks off the roads. Units that are dependent on imported material (a lot of it from China and south-east Asia) or on export of finished goods cannot simply start operating again. As the CEO of a car parts manufacturing giant said, “Even if we produce, to whom do we supply?” A globalised economy has come to mean a tangled web, an inseparable mesh, of global supply lines. Those lines are not going to get unclogged any time soon. There is also that other aspect which often does not figure in the dominant discourse on industry: migrant labour. They are the mainstay of most micro, small and medium industries; big industry depends on migrant labour directly or indirectly via their downstream suppliers. Much of India’s migrant labour has gone back to the villages where they came from; those that remain in urban areas are desperate to get out. This is not about food and shelter alone. Migrants tend to see their ‘gaon’ as a safe harbour in times of trouble. It is immaterial that there does not exist the idyllic village of plenitude and caring, compassionate villagers as seen in films. It is cultural. Convincing migrant labour to stay on would not be easy; convincing them to return immediately would be next to impossible. There is also that other aspect which often does not figure in the dominant discourse on industry: migrant labour. They are the mainstay of most micro, small and medium industries; big industry depends on migrant labour directly or indirectly via their downstream suppliers. Even if they would want to return to their jobs and urban squalor, organising dedicated, labour-only transport would be a Herculean task. On top of that, many State Governments would be reluctant to allow inter-State travel. The political cost of Covid19 running amok is too high for any politician to stake his or her Government on. The bipartisan support for the national lockdown we see now would rapidly dissipate the moment things begin to go wrong and spin out of control. Many, if not all, of those cavilling against a total shutdown would not get the import of this reality. Yet, as Samir Saran has powerfully argued in his commentary ‘Coexisting with #Covid19: Saving lives and the economy’, something has to give. Locking down India for a prolonged period may work to the advantage of the Government in its battle against Covid19 – statistics indicate that it has – but shutting down the economy, restarting which will take less time than its recovery, will ultimately work to the Government’s disadvantage. A low or zero rate of growth is the least of concerns in political terms. What carries greater clout at polling booths is livelihood – jobs, or more specifically the loss of jobs, cannot be glossed over. The host of social welfare measures that have been rolled out, admittedly with remarkable speed, to mitigate the misery of those living on the margins, will serve a limited purpose over three months. After that, what? Which brings us to the window of flickering hope left open by the Prime Minister who said between now and 20 April, the performance of every State Government and district administration in containing the spread of the virus would be scrutinised. If ‘hot spots’ are managed well, if there are no fresh cases of infection and if districts can demonstrate they have held the preventive line, exemptions would be made. The point is, how many such places have industrial units or contribute in a significant manner to the national economy? That said, incentivising performance by the State Governments – health is a State List subject and hence entirely the domain of respective State Governments; the Centre can goad but cannot enforce – is a good idea. It would encourage a competitive environment to carry forward the Union Government’s national purpose. But what if State Governments fudge figures or under-report the incidence and spread of Covid19 to show they have performed well? What about States where the administration has visibly, demonstrably failed to match intent with action? West Bengal is an example. Maharashtra’s performance has been below par as is evident from the galloping numbers in that State, placing it on the top of the most threatened list. Yes, increased testing still remains an excellent option. But that raises the question: Who does the testing? The Centre, through the Ministry of Health and Family Welfare and ICMR, can advise State Governments, not force their hand. What if State Governments refuse to toe the Centre’s line on increased testing? There are systemic flaws – some which run very deep – in the much-vaunted constitutional scheme of things. The Constitution, we must remember, is more than just the Preamble. If there is one key takeaway from the Covid19 crisis, it is that strong, decisive political leadership at the Centre and a spirited, supportive citizenry are not enough to lead the nation out of the quicksand of a pandemic. The constitutional instruments of governance have to change to enable policy-making that is nimble-footed and equally applicable from Kashmir to Kanyakumari. There is little or no scope for ‘diversity’ and ‘native sentiments’ to play a role in times of looming disaster. We do not need to glorify ‘resistance’ to disease control as was done during British colonial era. A first step towards that would be to shift health from the State List to the Concurrent List. That’s a separate debate but not necessarily for a different time.
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