An image from Chennai, India, as the pandemic rages. Photo by V. Srinivasan.
This article first appeared in the print edition of The Indian Express on April 24, 2021 under the title ‘Coping with Covid’. The writer, Vikram Patel, is the Pershing Square Professor of Global Health at Harvard Medical School, a Steering Committee member of the Mittal Institute, and a member of the Lancet Citizen’s Commission on Re-imagining India’s Health System.
Our political class must set aside differences to act quickly and with compassion to ensure economic security and well-being of the vulnerable, as we fight back second wave of Covid-19.
Like the actor Bill Murray in the popular film Groundhog Day, I feel as if I am trapped in a parallel dimension, witnessing a recurrent nightmare. Just when I had thought that India had escaped the dreaded second wave, the sequel which makes the first hit resemble a mere trailer has well and truly landed on our shores. I was wrong, of course, as was our political class and most of our population, lulled into a smugness as we fooled ourselves into believing we were the outliers. How I wish that speculation had been true. What might explain this exponential descent into death and despair? While complacency in adhering to masks and physical distancing might have played a role, it seems increasingly likely that this second wave has been fuelled by a much more virulent strain. If that’s the case, we must all pray that the lethality of this mutant child is lesser than that of its parent and that the vaccines being rolled out will offer similar levels of protection.
No matter what the final analysis of this second wave of the epidemic will tell us, we now bear witness to unimaginable horrors unfolding across the country. It is harrowing to witness the phenomenal gains India had made in securing control over the first wave being totally squandered, leaving one with the gnawing feeling that we have learned nothing. How else can any of us explain the sheer madness of proceeding with elections and monumental religious gatherings in the midst of a deadly surge. Now, as the tsunami sweeps across the land, there is little we can do to stem its tide, other than adhering to the behaviours we have long known, and often neglected. You know the drill, but it still bears repeating: Wear a correctly fitted mask, avoid crowded situations and get vaccinated. If we must close sectors of our society down, we must do so thoughtfully to avoid the horrors which accompanied the first lockdown. And we might begin with doing away with the term “lockdown” itself, as awful as the equally terrifying term “social distancing”, and request our fellow citizens to “stay at home”. But this sleight of words doesn’t alter the fact that this policy will have a devastating effect on many groups in our country.
Foremost on this list are the hundreds of millions of people who rely on daily wages to put food on the table. For many of these people, who had just begun to see a light at the end of the dark tunnel as their livelihoods picked up with the decline of the first wave, the return of the epidemic may well be the proverbial straw that broke the camel’s back. We must remember that “deaths of despair” led to an unprecedented reduction in the life expectancy of working-age Americans after the financial crisis of 2008; the crisis facing India looks infinitely more daunting. Next on the list are our children, who have not seen the inside of a school for a year and who had ached to return to the comfort of a place where they would play, meet friends, learn and eat a nutritious meal. The damage that school and college closures have played on the learning potential and mental health of this generation is incalculable for the impacts will only become visible in the years ahead. Third, we must attend to the needs of mothers and people who struggle with other diseases to avert adding to the mounting Covid-related mortality due to reduced access to essential health care.
We know what we need to do to address the needs of each of these groups. For daily-wagers and small businesses, this is the moment for a transformative stimulus bill, on par with the visionary legislations passed by the Biden administration and other countries, to provide immediate cash transfers which can cover basic needs for at least the next three months. For our children, we must prioritise teachers and parents of school-going children to get vaccinated so that they can safely reopen schools, practising physical distancing by holding staggered classes outdoors or in well-ventilated classrooms, easy to do in our climate. The fact that we opened hotels and casinos before schools is a jarring reminder of how unthinking we have been with regards to the well-being of our children; schools must always be the last to close and the first to open.
For those who suffer other ailments, we must make sure that all emergency clinical services are kept open as before, and deploy the opportunities offered by telemedicine for continuing routine care. In my mind, the second wave offers a historic opportunity for the private sector to play a role which contributes to a national mission, as it has done for the production of vaccines, working in a coordinated manner with the public sector to cover all the healthcare needs of the communities they serve. Perhaps, this could be the first concrete step towards a mutually beneficial partnership for both sectors to realising the aspiration of universal health coverage.
This is a moment of truth for India. We must set aside recriminations and partisan thinking. The time for accountability will come in due course. For now, let’s be clear that even if all of us are fastidious about wearing a mask and the government massively increases vaccination coverage, the epidemic will take its course and there is little, short of another brutal lockdown, which will modify this likelihood in any significant way. We must remain hopeful that this wave will pass in a matter of months, thanks to its lightning spread across the country, and that our frontline workers will find every drop of superhero blood to help the sick. The immediate, most pressing, need of the hour is that we ensure the economic security and well-being of the vulnerable, whom we abjectly failed the last time. We can no longer blame our ignorance on this occasion.
The state must act quickly, purposefully and with generosity. This means not just money, but also genuine compassion. I think I speak for every Indian to pray to our leaders, across the political spectrum, to put aside their differences and stand together, in solidarity, with the powerless and vulnerable so that, when the dust has settled, they are not left fatally wounded.