Public lockdown discipline fast eroding, India risks becoming lax in Covid fight

India is in a crucial and especially dangerous phase of the coronavirus pandemic. With the relaxation of the national lockdown, public attention, media focus and the priorities of political leaders have shifted to other things. There is a sense — strengthened by Prime Minister Narendra Modi’s statement — that the lifting of the lockdown is progressive and linear, and Unlock 2 is sure to follow Unlock 1.

Cases are rising almost everywhere in the country, and the doubling rate is back to 18 days. Now, lifting the lockdown was necessary for reasons of survival, but it demanded that the administrative focus expand to ensure adequate physical and social distancing, hygiene, and contact traceability. It also demanded that people be put on notice that in case the course of the pandemic worsens, we should expect more containment zones and lockdowns. These did not happen. So while an admirably large number of people and businesses are acting responsibly, our encounters with non-mask-wearing people and crowded public places are increasing. The public discipline of the lockdown period is fast eroding and way too prematurely.

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Price controls are a terrible idea to tackle private-public healthcare gap in India

Even before the advent of the Covid-19 pandemic, sticker shock with respect to private hospital charges was commonplace in India. The perception and fear of being overcharged by private hospitals, especially through ‘unnecessary’ diagnostic tests and treatments, is widespread. Adverse health outcomes are frequently attributed to negligence or malpractice, and violent attacks on medical personnel by distraught relatives were common enough to warrant special legislation. In India, there is an environment of mutual distrust among the government, hospitals, and patients.

The novel coronavirus has entered the scene in this backdrop. No wonder that it has sharpened the sense of distrust to a breaking point. Last week, the Supreme Court heard a PIL filed by advocate Sachin Jain who argued that private hospitals, which have been given land free of cost, should not charge for Covid-19 treatment. In response to the petition demanding price regulations on private hospitals, the Court asked if private hospitals “were ready to charge Covid patients the rates fixed under the Narendra Modi government’s Ayushman Bharat scheme for their treatment.” Lawyers then submitted that private hospitals are in a poor financial position as a result of the Covid-crisis and that there was “no business left” as there was a drop in people visiting hospitals for treatments and this could lead to the closure of hospitals. The Court’s retort to this was surreal. “That is good,” the Bench said “You are doing it for a good cause.” It is yet to rule on the matter, but this exchange exemplifies the problem we have with the governance of our healthcare sector

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India is being forced to unlock during pandemic. But it’s no green zone yet

Unlike many other countries, India is gradually lifting the lockdown before the coronavirus curve has flattened. Covid-19 positive cases are now doubling every 17 days, a little slower than a week ago. With several state governments relaxing the lockdown, we should expect that the picture will worsen and that — at least initially — we will see faster growth in the number of cases.

Is the lockdown being relaxed too early? From a purely epidemiological perspective, yes. Yet, from an overall perspective, we have little choice but to reopen the economy and allow people to earn their livelihoods. With the Narendra Modi government unable or unwilling to provide income support and direct cash transfers to compensate people for the loss of income, the only option is to shift the balance towards greater economic activity at the cost of higher epidemiological risk.

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Some out-of-the-box ideas for a fiscal stimulus

The pandemic and lockdown have deeply hurt the economy. This year the world’s economy will shrink by 3 percent, something that we have not witnessed in our lifetimes. India too may shrink as much if not more, since our lockdown has been more stringent than other nations. During April more than 120 million people lost jobs, and some of them permanently. More than ten million urban workers and their families reverse migrated to their villages or home towns, partly because they had lost their livelihoods. These workers will return to cities and factories after the re-opening of the economy, but also when there is an assurance of jobs. Else the rural areas are a better bet during the recession. There has been a bumper rabi crop (spring harvest). The procurement of wheat in Punjab, Haryana, and U.P. has been very successful, meaning farmers have received the minimum support price. Even Madhya Pradesh procurement is at record levels. Besides this income, the PM-KISAN scheme launched last year has been putting some money in farm households. Additionally, the small payment to rural women has helped, and so has the PDS foodgrain allocation through the ration shops, again benefiting the rural areas. Finally, there is the rural employment guarantee scheme (MNREGS) whose allocation has gone up to 1 lakh crore rupees, and which will certainly act as an additional income buffer for many families in rural areasRead more 

Not vultures but watchdogs

The Supreme Court of India finally took up the issue of the plight of migrant workers and their families. It took up this issue suo moto. Meaning it was not in response to any public interest litigation. But surely it was affected by the extensive media coverage. And also by that sharp letter written by 20 senior lawyers from Delhi and Mumbai. That letter almost chastised the court for failing to protect the rights of the hapless migrants. It said that the court was showing undue deference to the government, and complete indifference to an enormous humanitarian crisis. Taking care of the migrants was not just a "policy issue" beyond the purview of the court but in fact, a constitutional issue to render justice. Whatever the influence, the court has taken notice, and asked governments, both the centre and states, what they are doing. It has also instructed that whether by bus or train, no fare should be charged to the travellers going home, and arrangements should be made for food and water, especially in this deadly heat.Read more 

Advertising a tax on the poor, pandemic going to exacerbate it

Supply of endless addictive content is a feature and a bug of the attention economy. However, much like its traditional counterpart, the attention economy is harsher on the poor than on the rich. And the pandemic is likely going to make it worse. Your attention has a monetary value for streaming platforms. Given by the current monthly prices, Netflix values your time at ₹26.2/day, Prime Video at ₹4.2/day, Hotstar at ₹9.8 a day, and YouTube (Premium) at ₹4.2/day. Roughly the per capita income of an Indian is ₹1,35,048. A yearly subscription to Netflix would cost 7.1% of that figure; Prime Video would be 1.1%, Hotstar at 2.65%, and YouTube at 1.14%.Read more.

Lockdown Is Choking The Economy

When the national lockdown was imposed, with four hours notice, the country had less than 200 positive cases and a two percent fatality rate. The world marvelled at India’s determination in imposing such a strict control on a billion people.  Two months later, the number of virus positive cases is nearing 1.5 lakh and the fatality rate has inched up to 3 percent. Now the world is not so sure whether the strict lockdown has achieved what it set out to do.The stated goal was to “flatten the curve”, that is decrease the upward slope of the spread of the virus. Since the virus mainly spreads from people to people contact, the method was to isolate people in their own homes, observe social distancing, restrict movement.Three fourth of the economy was shut down. It was as if collectively the nation was holding its breath. But after holding our breath for two months, we are feeling breathless, the economy is choking, having run out of its oxygen. The four-hour notice given on March 24, also meant that people did not have any time to plan their own lockdown. Many families suddenly found themselves separated, since one or two members were stuck in a different city due to office duty.Read more

India should prepare itself for realpolitik over a covid vaccine

The first country to have full immunity to the coronavirus will enjoy a tremendous economic and geopolitical advantage, a once-in-a-century window of opportunity till other countries catch up. As much as the covid-19 pandemic is accepted as a challenge for all humanity, realism— that dismal but unfortunately accurate way of reading international relations—suggests that countries which acquire the vaccine first will be tempted to use this relative advantage to promote their national interests.

So it matters who gets to the vaccine first. India cannot afford to be a have-not, both for reasons of public health and to safeguard its strategic interests.If there was ever a clear and present danger that confronted the human species as a whole, it is now. It should follow then that the world should set aside political differences and work together to defeat the virus. Vaccines and drugs should be made universally available as soon as they are invented. Yet, there is no sign that this would be the case.Read more

Will We Really Find Out Where the Novel Coronavirus Came From?

This article first appeared in Science The Wire.The origin of the SARS-CoV-2 virus remains mired in controversy. The virus was initially thought to have originated in a wet market in China’s Wuhan. But as it spread around the world, it fuelled many conspiracy theories in its wake. In the public imagination, the virus has often transformed (baselessly) into a bioweapon, a scientific experiment leaked from a laboratory and spread through the 5G network. Scientists have downplayed these ideas, quoting genomic analyses that clearly show the virus is of natural origin and jumped from some animal species to humans.Yet its origin remains unsettled and this ambiguity needs to be resolved soon – not to settle political agendas or conspiracy theories but simply and importantly in the larger interest of public health. Settling the question of the virus’s origins once and for all is key to take appropriate measures to prevent it from happening again, and to focus our efforts on the right things.This said, who can comprehensively investigate the origin of SARS-CoV-2?Read the full op-ed here.

Cities, both paradise and hell for migrants

Till the end of March, the world was marvelling at the success of Singapore for having controlled the spread of the pandemic. Its lockdown was not as severe as India, and yet with a combination of sanitising, social distancing, movement restrictions, testing and tracing protocols, it had managed to keep its numbers relatively low. It was flattening the curve. Even its schools and colleges were running.Then over the month of April, its numbers went up from around 1,000 to 15,000 and by the third week of May it has doubled further to 30,000. Singapore's population is about 5.6 million, so if the same infection rate would have happened in India, we would have 70 lakh virus positive patients. Today we barely have 1.2 lakh.But this is not about trumpeting our record. India needs to scale up its testing in any case. What is remarkable that even with relatively strict protocols, Singapore numbers have skyrocketed. Unlike countries of the West, Singaporeans do not mind strict controls, and curtailment of their personal liberties, if it is for their own safety, health or national interest. It is also one of the world's richest countries in terms of per capita income, and has a world class health care system and infrastructure. And yet the infection numbers have risen so dramatically? Why?Read more

Direct cash transfer best way to help poor in Covid crisis. If Modi govt can’t do it, let us

During as deep and as unprecedented a crisis as the coronavirus pandemic, the best way to help the largest number of people is to put money in their pockets. In most cases, cash allows people to purchase what they want: whether it is food grain, oil, medicine, a recharge on the mobile phone or a railway ticket home. Cash in hand also gives vulnerable people a little more confidence to deal with the many uncertainties of life during a crisis. Yes, in a country as large as India, there will be instances where cash won’t help, but for hundreds of millions of people, money is the single-most important helpful thing today.

And thanks to Unified Payments Interface (UPI) and Jan Dhan, Aadhaar and Mobile (JAM), India today can process direct cash transfers to hundreds of millions quickly and efficiently.

So, it is disappointing that direct cash transfers do not form a significant part of the Narendra Modi government’s economic package announced last week. Towards the end of March, it re-assigned around Rs 62,000 crore for transfers to women Jan Dhan account holders, farmers and construction workers, but did not widen cash transfers after that. It is unclear if the PM CARES Fund will be used for the purpose either.Read more

Don’t let your dislike of Yogi Adityanath get in the way. Labour reform is a good idea

Unless you belong to the ideological Left — and even if you do — it is impossible to argue that India’s complex web of labour regulations serve the public interest.

Simply put, they are part of the reason why 90 per cent of India’s labour force is “informal”, without the basic protections that law ought to have given them. Our labour laws are part of the reason why we have failed our migrant workers, millions of whom have not been paid their wages, have been prevented from going home, were killed on the rails and are trying to walk the long distance home. Over the past few decades, both employers and workers have found a working optimum outside the Kafkaesque labour regime, which more or less worked during normal times, but showed its failings during the coronavirus pandemic-triggered lockdown.

Consider the counterfactual — if a greater proportion of our workforce had enjoyed the basic protections of employment, the migrant crisis might have been less acute.So, when Uttar Pradesh and Madhya Pradesh, two Indian states that acutely need new economic engines, surprisingly announce that they intend to do away with a substantial chunk of their labour laws, they deserve the right kind of support.Read More

Crowds at booze stores reveal an addled approach to policy

The long queues outside liquor stores last week attracted a lot of attention, commentary and government reaction. Many people were dismayed that among the first things their compatriots did after the relaxation of the lockdown was to make a beeline for the liquor store. In an unusual demonstration of alacrity, the Delhi government immediately imposed an additional 70% tax on retail liquor sales, ostensibly to put some brakes on demand and reduce coronavirus outbreak risks. The sense of moral outrage was compounded after a Bangalorean customer triumphantly shared a ₹52,000 liquor store receipt on social media. This too caused the Karnataka excise department to rapidly rise to the occasion and come down hard on the retailer concerned for exceeding the maximum quantity that can be sold to a person at a time.

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Why govt must address the question of access inequity before making mobile apps mandatory during COVID-19

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The Issues

Several concerns have been raised about the implications on multiple fronts. Privacy, and the risk of its evolution into a vehicle for mass surveillance. Security, and the potential information security risks to individual users as well as a large centralised database of citizen data. Legal - whether the National Disaster Management Act confers the necessary powers to do so, as well as the absence of Data Protection legislation. Technological - efficacy of contact tracing apps/algorithmic risk detection and the associated issues with false positives and false negatives. Transparency - opaque processes and the fact that the code has not been open-source yet. Some reports suggest that this may happen when the app is considered to be 'stable'. It is unclear, though, how stability is defined.The Ada Lovelace Institute has published a rapid review titled "Exit through the App Store" which warns of the risks of 'rushed deployment of technological solutions without credible supporting evidence and independent oversight'.

On Equity

An aspect which is under explored is Equity, or the lack of it. In designing public policy, Equity is a crucial part of policy design. It deals with the social allocation of benefits and deals with the questions of 'who pays' and 'who benefits'. In the book 'Policy Paradox', Deborah Stone lists 3 dimensions and 8 issues and associated dilemmas with each distribution method. Ultimately, this is a complex undertaking and no matter what criteria is for distribution, some group or the other will feel that they have been left-behind by the policy.Read more

Amid COVID-19 Crisis, How Can Telemedicine Be Harnessed in India?

The Medical Council of India, in partnership with NITI Aayog, recently released guidelines for practice of telemedicine. Considering the current COVID-19 outbreak, the guidelines could not have been released at a more apt time. Using telemedicine is a safe way of screening and treating patients in times of infectious outbreaks. It ensures safety of doctors, as they do not need to be in the physical vicinity of the patient. Besides outbreak situations, telemedicine is also of great help where healthcare facilities are not easily available or accessible. It saves patient the time of going long distances for minor illnesses. While the telemedicine practice guidelines have paved the way for more efficient practices in healthcare, it is imperative to have the infrastructure and the funding in place, for their implementation on ground.Read more

Like an MEA to help NRIs in crisis, India needs a system for its internal migrants too

India’s treatment of its migrant population has been a disgrace. We must redeem ourselves by admitting our failures and devising policy approaches that are sensitive, humane and respectful of individual freedom and dignity.

Much of the blame on this issue that was directed at the Narendra Modi government immediately after the lockdown was unfair. The nationwide lockdown had to be imposed quickly and not every scenario could have been catered for. Sure, the government’s antennae failed to pick up the risk that millions of migrants would make a beeline for their homes. But as far as one can tell, few outside experts, activists or mediapersons had flagged it as an important factor ahead of the lockdown. So the Union and state governments had to react to the unfolding human tragedy, which they did to the level their administrative capacities allowed.

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Stay safe and go back to the newspaper this pandemic

This article was first published in Deccan Chronicle. Views are personal.It is arguably easier to deal with the coronavirus than it is to deal with misinformation about it. The key difference is that when dealing with the former, you have your work cut out for you. Maintain social distancing, close borders, flatten the curve, and build capacity in the national healthcare system. When it comes to dealing with misinformation there is no one set of steps you can take to definitively win the battle.We did not need a global pandemic to realise how big a challenge misinformation is, but it helps. In India and abroad, we have seen some spectacular consequences of spreading misinformation. In the UK and Netherlands, conspiracy theorists spread misinformation claiming that 5G cell towers were spreading coronavirus. As a result of which, some 50 towers were burnt in the UK and 16 in the Netherlands.

 Closer to home, when PM Modi asked citizens to light candles and make noise for 10 minutes, WhatsApp was rife with networks of misinformation. People claimed that the rise in temperatures or the chance in decibel levels would kill the virus. Even if you have not been subject to any of these messages, you have likely heard that Indore locals or Muslim mobs attacked health staff and attacked doctors who went to treat them.  To put it mildly, it does not make any sense to attack doctors during a pandemic. Until you read Indian Express’ report that fake WhatsApp videos were circulated in localities claiming that healthy Muslims are being taken away and injected with the virus were doing the rounds of Tatpatti Bakhal and adjoining localities.Misinformation is so potent because social media is an excellent tool to spread narratives and reinforce beliefs, as opposed to television. Imagine a scenario when you are viewing protests live through news on a television screen. In all likelihood, all you can see is a hoard of people fighting with the police or marching down an aisle with slogans printed on charts.  The information you take in is largely what is visible on the charts or what the anchor at the time is saying.Compare that to how you observe a protest on social media. On Twitter, when you follow a trending hashtag, it will show you the video of the protestors or the slogans they carry. In addition, you will also be able to look at what most people are saying or thinking about during the protests. This helps absorb a narrative a lot more quickly than a news anchor would.In times of panic, like protests or a pandemic, the narratives thrive and get a larger audience. This leads to more engagement and more content. It is a vicious cycle that reinforces itself. That’s how it becomes easy to believe that 5G towers are spreading the virus or that doctors have come to inject you with the virus and not to treat you.It’s hard to say whether most misinformation is a result of malice or stupidity. But when it comes to tackling the infodemic, there are not a lot of generally accepted truths in the area.  The broad goal is clear. We need to re-evaluate the importance we afford to social media in our news diet. To anyone who hasn’t been living under a rock, it is evident that WhatsApp is not a credible source of information.In that spirit, it is easy to go to news sources that are free and convenient to access, such as Twitter and Facebook. It is even better when the news comes to you through push notifications on WhatsApp. However, when we rely on these sources for the news, there is no assurance that we actually get the news.Quality journalism and information that comes as a result of it is a commodity. Like most commodities, it might make sense to pay for it with money (not with privacy). Paying for the news is inherently not a foreign concept. We have paid for newspapers before, and a significant number of us still do so. It may not make sense to physically hold a newspaper everyday right now, but paid digital access is a more convenient and ironically, a more natural alternative.The trade-off is worth it. There is no end in sight to the lockdown and the pandemic. In times such as these, the value we attribute to information will increase on average. You may have a gripe with the editor about the stories s/he curates for you, but in a good news agency, there is genuine effort involved in fact checking and ensuring that consumers get both sides of a story. Any person who sends you a forward on WhatsApp will not go through any of these pains.So this lockdown, consider paying for the news or be critical of what you consume for free.As 5G towers in the UK and injured doctors in Indore will tell you, it is worth it. 

Dear young IRS officers, taxing the rich in Covid times is bad economics

The Narendra Modi government did well to promptly dismiss a proposal put up by a group of young Indian Revenue Service officers that recommended raising a number of taxes to make up for the government’s revenue shortfall amid higher spending requirements as a result of the Covid-19 pandemic. A prompt and public rejection of the proposal was warranted because even the whiff of an increase in taxes can deepen the crisis and prolong the recovery, because the already-mauled individuals and businesses will choose to play it safe by holding back on spending and investment.

That said, the government should not have gone further and taken disciplinary action against the intrepid officers. They were clearly acting in good faith. Barking up the wrong tree is not an offence and should not be penalised. A crisis is an especially important time for top leaders and civil servants to keep ears and minds open, and encourage fresh thinking within the government’s ranks.

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Get India back at work to secure the economy and employment

As we near the end of an extended national lockdown, our policy discourse must broaden from containing the outbreak to addressing the three ‘R’s for the economy as well: of relief, revival and reconstruction. While the pandemic will haunt us for a few years, it is also true that complete lockdowns will harm Indian society as much—if not more—than the disease.

Unlike rich countries, India’s government simply does not have the resources to pay people to stay at home. Most businesses are staring at insolvency after having to keep and pay employees over the past four weeks. Even if they manage to stay afloat, their distress will compound our unemployment crisis. According to Mahesh Vyas of the Centre for Monitoring Indian Economy, 140 million people, or 14% of India’s working age population, have lost their jobs during the lockdown. Both urban and rural India have been hit hard.

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COVID-19: Localise efforts to tackle water shortage

This article is written by Rohan Seth and Rashi Sharma, was first published in Deccan Herald. There have been plenty of debates and discussions around what is being done to manage the threat of coronavirus. A lot of that attention has been focused on using technology to deal with the problem. Apple and Google announced that they will be working on developing software to enable contact tracing in phones. In a similar vein, the Indian government has rolled out its own contact tracing application in Aarogya Setu. Prime Minister Narendra Modi, while extending the nationwide lockdown, urged the public to download the app. While most of the discourse has been focused on how technology fits into the picture, we have ended up missing more fundamental means of coping with the problem. Ubiquitous elements, particularly water, have been overlooked and taken for granted. Water is going to be an essential part of any country’s strategy when dealing with COVID-19. If you are reading this, there is a significant chance you have been told about the importance of washing hands or have watched a video of how to do so properly. Healthcare professionals, essential workers, and law enforcement have and will be subject to a higher risk of exposure to the virus. As our most important line of defence against the pandemic, they will need to sanitise themselves regularly. This involves washing their clothes and taking regular showers. Unfortunately for India, in recent years, the country has been dealing with acute water shortages. While major Indian cities have increased in size and their water consumption, villages lack water for basic sanitation, bearing witness to lowering levels of groundwater. Keeping in mind the lack of access to clean water for nearly 163 million people in 2018,  the Union Government created the Ministry of Jal Shakti in 2019 to integrate water resource management efforts. Under the Jal Shakti Abhiyan, the Ministry plans to ensure the availability of running tap water for domestic purposes in all households across the country. While the mission of the Ministry of Jal Shakti has been off to a promising start, there is only so much it has been able to accomplish in a year. Due to lack of both administrative will and centre-state politics, much of the water projects could not be successfully completed before the outbreak of the virus. COVID-19 and the water crisis A summer induced water crisis is not a new phenomenon for India. The depleted water levels and the already exploited government managed resources have made India rank 13 of the 17 water-stressed countries. Access to freshwater is now important and urgent. Without water to sanitise, villages once exposed to COVID-19, will find it harder to recover and to contain the virus. In the recent past, an inexorable rise in the population residing in clustered areas makes self-isolation a privilege that not many can afford. Given the historically limited state capacity, necessary demands for social distancing, and a time-sensitive situation, it is going to be a lot harder to ensure clean tap water reaches water-scarce areas. The lack of adequate supply, particularly during a lockdown, will prevent households from ensuring domestic sanitisation and lead to an increase in open defecation during this period. This socio-economic standing of the larger Indian community is a ticking time bomb which may be scheduled to explode at Stage 3 of social transmission of the virus. Importance of finding local solutions This brings us to what should be done to mitigate the crisis. There have been some attempts to allocate scarce resources amongst states across the world. Most notably, the Federal Government in the US created competition among states, creating a bidding war for medical equipment. As a result, it created an environment where medical equipment was not distributed based on need but on the purchasing power of states. Of course, a bidding war for medical equipment leaves open the risk for poor areas impacted by the disease not getting enough medical supplies to manage the spread. Learning from the US, and instead of turning to a market to mitigate an impending water crisis, it might make sense to take a different approach. The stakes now have abruptly been raised. What the spread of the pandemic has done is to leave the inadequacies in Indian infrastructure exposed. They needed to be fixed yesterday, and they need to be fixed now. Communities must mobilise their efforts to find solutions to the water crisis locally. The Union government cannot be expected to build adequate infrastructure overnight if doing so has not been possible in over 70 years. Given the social distancing requirements, time and capital constraints, these inadequacies cannot be fixed using a top-down approach. Instead, changes need to be made at the grassroot level so that the water available is optimised for usage. Along with local efforts, nudges towards desired behavioural changes for water optimisation might be the most viable option. Water optimisation thus, involves promoting the usage of greywater for irrigation, and when possible, collecting rainwater in previously built infrastructures. Along with revisiting traditional methods of preserving water, reusing already existing structures like dried-up ponds, reservoirs, tube-wells etc. can also be a low-cost source of clean water. At this point May 3, 2020 is a line in the sand. The pandemic will not end on May 4, neither will the need for water across India. Local efforts may not be enough to meet the surged demands, but steps taken today should contribute to a better scenario tomorrow. (Rohan Seth is a technology policy analyst at the Takshashila Institution and Rashi Sharma is a research assistant at the Observer Research Foundation)