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Countries head toward crisis as pandemic devastates fitness and livelihoods
India’s monsoon season is in full swing, flooding the streets of Mumbai and flooding the plains of Bihar. But dark clouds of another kind are also gathering: sickness, starvation and death.
India is now ahead of all other countries in terms of the number of new COVID-19 instances recorded according to the day: almost 70,000 in mid-August. This represents about a quarter of new instances worldwide. Only two countries are close: Brazil and the United States; and India has lagged behind those two countries in reducing the number of daily instances.
Furthermore, the recorded cases in India constitute only a small fraction of all COVID-19 infections. This may be true in many countries, however the ratio of infections to registered cases turns out to be the best in India – at least 20: 1, judging by two recent serological surveys, in Delhi and Mumbai, respectively. That would mean that India already had more than 50 million COVID-19 infections, up from a recorded figure of 2. 5 million.
The bright side is that, for reasons that are not yet clear, COVID-19 mortality in India appears to be relatively low. The same surveys recommend that the death rate from infection (IFR) possibly be as low as one in a thousand. If so, India may not be heading towards a primary mortality crisis, or a primary mortality crisis from COVID-19, at least compared to overall mortality rates. So far, COVID-19 deaths make up less than 1% of annual deaths for all reasons in India. Per million people, there have been only 38 so far, compared to more than 500 in the United States.
However, overall mortality would possibly increase for two reasons. First, mainstream fitness facilities have been massively displaced through COVID-19. Until now, COVID-19 infections have been largely concentrated in major cities located in the filthiest and richest states in India – Delhi, Mumbai, Chennai, among others. The preparation of the fitness formula is much greater there than in other places. But the reported cases are expanding in the poorest states of India, where fitness facilities are very fragile. As the COVID-19 crisis absorbs their scarce resources, many public gyms have stopped offering regimen facilities. Even formative years immunizations have been suspended for months in many states.
Consider the state of Bihar. If Bihar were a separate country, it would be one of the poorest countries in the world, with a population of over a hundred million. About a part of all young people in Bihar are stunted. COVID-19 has been slow to succeed in Bihar, however recently registered cases exceeded 100,000 and are now expanding by 3-4% steadily. The state has fewer than 40 doctors, which is equivalent to 100,000 inhabitants, 90 in India and more than 250 in the United States. First-hand accounts of life in Bihar’s public hospitals paint a grim picture of missing doctors, neglected patients, damaged gadgets and stray dogs. Where are other people with non-unusual physical disorders supposed to go?
The other explanation for why an imaginable increase in deaths is that India’s extended national lockdown (from last March to the start of the unlocking stages in June) has destroyed the livelihoods of millions of other people. Local lockdowns continue in many states and their peak is likely to persist for months. Unlike rich countries, India has very little to show for the social security formula, except for food subsidies and some relief paintings under the National Rural Employment Guarantee Act. The jobs crisis has already hit poor families very hard: Recent surveys through Dalberg, Azim Premji University, the Center for the Study of Developing Societies (CSDS) and others reveal an excessive lack of confidence in food during and after blocking. To call just one, 78% of the other 25,000 people interviewed as part of the CSDS national survey said they found it “quite difficult” or “very difficult” to feed their families while locked up. Acute lack of confidence in food will likely result in maximum mortality. For children, it also means lasting damage from malnutrition.
To invoke Bihar again, more than one part of the workforce is made up of informal workers living on the fringes of subsistence at the most productive time. A recent survey of some 20,000 returning migrant employees found that 60% could not provide two square meals for all members of the family circle. With the local economy in decline, with the exception of agriculture, the informal workforce is heading into a prolonged era of underemployment and hunger. As a smart measure, Bihar is hit by devastating floods, as is the case at this time of year. However, the state government is more involved in the upcoming legislative elections than in those multiple crises.
The scenario is not much greater in other poverty-stricken Indian states such as Jharkhand, Uttar Pradesh and West Bengal. With tax revenues not exceeding general levels, state governments are struggling to offer more than token relief. Unfortunately, the central government doesn’t do much to help them. It introduced limited relief measures during the national lockdown, such as five kilogram loose food rations by user for the month for two-thirds of India’s population. But now it turns out that he lost interest and let the state governments deal with the crisis.
In this area, as in other areas, the Indian government seems to be more concerned with public relations than with informed action. For a long time, he vigorously denied any “community transmission” of COVID-19, even when the registered instances number in the millions. When an initial investigation of official knowledge revealed the interruption of regimen fitness services, the central government withdrew the knowledge. Doctors and nurses who criticize the government’s reaction to the crisis have been gagged or harassed, as have many journalists. Confusing statistics are used to assure the public that all is well: The Health Department recently boasted, for example, that COVID-19 recoveries had “surpassed the all-time peak of 1. 5 million – a meaningless achievement since COVID-19 has recovered rates of more than 99% in India.
In its rush to turn India into a viswaguru (world leader), the Modi government appears to have little patience in the face of a humanitarian crisis. However, denying a crisis is the surest way to make it worse.
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