The Burden of COVID 19
Its been three weeks since the WHO declared a Covid2019
pandemic. It is not the world's first coronavirus. We have had SARS, MERS,
H1N1, swine flu and the like, some with much higher case fatality.
But this is unique in its sweeping virulence. The Centers for Disease Control
(CDC) says the annual percentage of the U.S. population infected with the flu
is about 8%, which translates to 26 million people a year. Of these, the CDC
estimates that up to 60,000 persons die. It stands to reason that many more in
India get afflicted by flus and influenzas each year, possibly with larger
Given this knowledge and some very recent hindsight, it is time to sit back and
objectively reconsider the draconian policy measures unleashed in India. The
four hours to midnight order for a nationwide "curfew" to enforce social
distancing has caught our public and public administration woefully unprepared.
The consequences of Covid2019 to the Indian economy and consequent loss of
lives and longevity, seems very likely to exceed the loss due to any mass
spread of the virus.
Epidemiological studies put out at several well regarded institutions such as
MIT and the Global Virus Network (GVN) seem to suggest that this particular
coronavirus is endemic in populated areas falling in temperature band of 3-17C
with a humidity between 51 -79%. These initial findings suggesting a
correlation between latitude and incidence have the powerful endorsement of Dr.
Robert Gallo, the famed virologist and GVN head.
Mind you it has been just a few months Covid2019 jumped species by finding home
in human beings. Covid2019's natural reservoir, seems to be bats, like the
earlier coronaviruses SARS and MERS. But the fact remains the spread of
Covid2019 has been faster in areas with colder climes.
The essential facts about Covid2019 is that while it is virulent, its fatality
is around 1% and this is principally concentrated among the elderly and already
ailing. Its symptoms are mostly akin to common seasonal flus often attributed
to change of season etc.
Covid2019 can only be confirmed by testing and the cheapest test costs about
Rs.5000 each. Clearly we cannot afford to test enough which simply means we
wont ever know how many are truly afflicted by Covid2019.
The average life expectancy of Indians is 68.7 years. The above 65 years cohort
accounts for only about 6% of India, which suggests that the incidence of
fatality here will be lower.
Bubonic plague has a mortality of over 80%, while even diphtheria has a
mortality rate of 32%. Covid2019 is not a killer virus.
In the developed countries like USA, Italy and elsewhere with substantially
higher life expectancy, the 70+ years cohorts are much bigger. The mortality
rate due has been the highest in Italy with about 9%. Almost 86% of the
Italians who died were over 70 years. Italy has the second oldest population in
the world after Japan, with over 23% over 65 years. Experts believe this was
the determining factor in its high fatality rate.
The goal of social distancing is a hugely unfulfilled aspiration. The poor in
India live cheek by jowl, with densities often exceeding 60000 per sq.miles.
India has over 410 million workers in the unorganized sector, the vast majority
of whom are daily wagers making a little more than the prescribed official wages
and often much below that.
This working age cohort is mostly made up of younger Indians. The youthful age
group (14-35 years) accounts for about 34% of India's population. This cohort
is about as much as the 35-65 years cohorts. Thus, even if the pandemic is real
for India, the fatality due to it will be very low. The vast majority of
Indians who might get infected by Covid2019 virus wont even know it.
Now assume that the Covid2019 pandemic will overwhelm India, and consider
India's abysmal health care scene. We have 6 physicians; 9 hospital beds and 13
nurses per 10,000 people. Nationwide we have less than 40000 ventilators and
only 70000 intensive care beds (ICU). This calls for a policy that will help
stagger the load and allow immunity to build up without overwhelming the
critical care system.
Harvard's Yonatan Grad, Professor of Immunology and Infectious Diseases, and
colleagues conducted research on how to prevent overwhelming the U.S. health
care system during the pandemic. This indicates the only possible method for
dealing with the epidemic may be multiple "intermittent" social-distancing
periods that ease up when cases fall to a certain level and then are reimposed
when they rise past a key threshold.
As time passes and more of the population gains immunity, they said, the
restrictive episodes could be shorter, with longer intervals between them.
Clearly the nationwide simultaneous social distancing imposition was not only
but also ill conceived.
The IMF has now announced a global recession due to disrupted supply chains and
contraction of consumption. In India, consumption (C) accounts for 63% of GDP.
Given GDP is = C + I + G + (X - M) or GDP = private consumption (C) + gross
investment (I)+ government investment + government spending (G) + (exports - imports), the impact of the collapse of private consumption of the economy can
be easily understood.
Many respected analysts are agreed that it will be no less than 20-30% in Q1.
The government pledged to step up its spending by Rs.1.7 lakh crores. We wont
go into how this was arrived at now, but just consider how inadequate it is
compared to the hit taken by consumption? The government clearly needs to do
more. It needs to pull out all stops to do this.
Where is the money is the question? Even if it sequestered 20% of the cash
reserves with our to 100 corporations, it will be substantial.
The top 10 corporations alone have a hoard of over Rs.10 lakh crores. (Reliance
has cash reserves of Rs.398,000 crs. TCS has almost Rs.100,000 crs, ITC has
Rs.60,000 crs.) Our government wage and pensions bill accounts for 11.4% of
GDP. Holding back only 10% of this or just the annual LTC will fetch the state
and central governments over Rs.2 lakh crores.
It only calls for will and vision to accumulate the cash to begin
reconstruction of a devastated economy. The pain cannot and must not be borne
by the poorest alone. Modi has formidable communication skills and he must use