Tuesday night the Indian Prime Minister Sh. Narendra Modi decreed “There will be a total ban of coming out of your homes… Every state, every district, every lane, every village will be under lock-down.”
An estimated 1.3 billion people are ordered to stay in their homes for 21 days except if you’re an essential worker, the largest and swiftest action taken against COVID-19 in the world. The television announcement was so sudden that people found themselves with just four hours before they were under lockdown. There are reports that police are taking drastic action against anyone who breaks the lockdown. Modi’s announcement promised essential services would continue and people would receive food, water, and necessary supplies but made little mention of how these policies would be implemented.
“If you can’t handle these 21 days, this country and your family will go back 21 years,” Sh. Modi said. “The only option is social distancing, to remain away from each other. There is no way out to escape from coronavirus besides this.”
This is a stark contrast to just a week ago when India seemingly miraculously escaped the worst of COVID-19. While other nations had outbreaks numbering in the thousands, India to this day has 500 confirmed cases with no community transmission. All known infections came from tourists or citizens that traveled abroad.
Before the Lockdown
India just a couple weeks ago seemingly was untouched by COVID-19 as the world scrambled to contain outbreaks. Even now, there are less than 600 confirmed cases in the entirety of India all of them appear to be from direct contact with tourists or traveling abroad.
As it turns out, despite having a poor health care infrastructure, India has had a good track record with effectively handling influenza outbreaks in the past. When COVID-19 first began to spread, India was one of the first countries to restrict travel and limit social gatherings. The government was also very vigilant in tracking potentially infected people. Using GPS, CCTV, and mobile phone records they were able to track down a family coming from Italy believed to be the first infections in India and were able to contain almost 1,000 people who came in contact with them very swiftly.
Other advantages of India include being the largest manufacturer of generic medicine in the world accounting for about 1/5th of the world’s volume. As we now know, COVID-19 also disproportionately affects elderly people. India’s median age is 28 which very young compared to other countries like Italy where the median age is 45.
India’s Only Hope
While the situation is currently holding steady, India knows the situation is extremely precarious. As the second densest populated country in the world, disease can spread rapidly. India also has the largest slums in Asia, home to millions of destitute and millions more who live in unhygienic areas. But most dangerously is the density, it is common for families in impoverished areas to sleep 6-8 people per room. Many believe that they will likely starve to death waiting out COVID-19.
Enforcement on such a huge scale will also prove to be a challenge. There are already reports where police are taking drastic action, beating and humiliating anyone breaking the lockdown to serve as examples. Many businesses like grocery stores and pharmacies which are supposed to remain open as essential services are being closed down by police despite government guidelines. One chief minister, in Telangana State, threatened to issue “shoot on sight” orders if people disobeyed the lockdown orders.
Though these measures seem extreme for a nation with just a few hundred confirmed cases, it would not be an exaggeration to say these extreme measures may be India’s only hope to have any kind of control over this pandemic. India’s public health sector is woefully ill-prepared even in ideal conditions. There are an estimated 0.5 hospital beds per 1,000 people compared to Italy with 3.2 and China with 4.3. Both China and Italy’s healthcare system has been ravaged by COVID-19 with far more resources than India. There is simply not enough infrastructure or resources to handle this without suffering.
There is no easy way out for India. At this point, the few advantages they have are few and meager but they are making the hard choices that other countries were hesitant to make until it was too late. Hopefully, the personal initiatives laid out by the Prime Minster Sh. Narendra Modi to take these measures on war footing are going to work to prevent the worst-case scenario.