(CNN) – Millions of Indians live under a mix of locally imposed coronavirus restrictions, as the central government resists calls from leading medical experts for a nationwide lockdown.
The Indian Medical Association said earlier this month that a “comprehensive, well-planned and pre-announced national lockdown” for 10 to 15 days would give the country’s overburdened health system time to “recover and replenish both the material and manpower “that it needs.
And on May 9, top US coronavirus adviser Dr Anthony Fauci said of India: “You have to shut down … you have to break the chain of transmission.”
However, the government of Prime Minister Narendra Modi has already done this and learned a very painful lesson. Experts say shutting down the nation again is unrealistic.
When the first wave of the virus hit India in March 2020, Modi announced a sweeping national lockdown hours before it went into effect, closing state borders, suspending interstate travel, shutting down businesses and forcing people to stay home.
This lockdown, which ultimately lasted nearly four months, helped India control the spread of the coronavirus, but it has come at a cost, leaving the country’s poorest and most vulnerable without income or food, and often stranded far from at their home.
This time around, Modi says a nationwide lockdown would be a “last option.”
“We have to save the country from lockdown,” Modi said in an address to the nation on April 20. “We must do our best to avoid lockdowns.”
Since then, the leaders of 35 of India’s 36 states and union territories have imposed their own restrictions, including nighttime curfews, partial closures and weeklong lockouts. These kinds of short-term localized measures are radically different from the approach taken the last time India faced a wave of coronavirus.
Some experts believe this makes perfect sense, as it gives regional leaders the freedom to tailor restrictions to the size of the local outbreak and the needs of their residents.
A single lockdown for a country of 1.3 billion people does not work, they say.
India’s poor have been hit hardest
Since the start of the pandemic, India has recorded more than 24 million cases, just behind the United States. Over 270,000 people have died.
According to a projection model from the Indian Institute of Science, at the current rate of spread, the number of cases in India could reach 50 million by June 11, with 400,000 deaths.
The model indicates that a 15-day nationwide lockdown could save around 100,000 lives and prevent some 20 million people from catching the virus. The longer the lockout, the lower the number of cases should be, depending on the model.
But a nationwide lockdown comes with its own health risks, especially for India’s poor.
About 100 million Indians are migrant workers, mostly from rural areas, who have settled in cities for work. During the first lockdown, many found themselves stranded without jobs or food, causing a mass exodus from cities.
With the national rail system suspended and internal borders closed, hundreds of people tried to walk home for several weeks and thousands of kilometers. Many did not survive, dying of exhaustion, dehydration, hunger or traffic accidents
“The experience of the past year has shown us that economic shutdowns are the most disruptive to the poorest segments of society,” said an April report from the Indian Covid-19 Commission task force of the Lancet. “In urban areas, day laborers, informal sector workers and low-skilled workers are most likely to be impoverished due to disruptions to economic activities.”
Ajnesh Prasad, professor and Canada Research Chair at Royal Roads University School of Business, said that only a “certain category of people” had the luxury of staying at home and maintaining a healthy life. social distance.
“If we are talking about the urban poor, it is impossible for them to follow these guidelines,” said Prasad. “They will tell you that following these guidelines would be tantamount to starving.”
Population density further complicates matters – around 35% of India’s urban population live in slums, where households lack sufficient living space and adequate sanitation facilities, according to the World Bank .
In densely populated slums, an entire family often lives in a small room and shares a bathroom with other families. It’s impossible to get away from others – and it’s unrealistic to expect a movement without the risk of virus transmission.
The things that make a lockdown both feasible and effective – staying indoors, working and attending school remotely, social distancing – require access to a stable internet connection and resources like a laptop and electricity. These luxuries are simply not available to the vast majority of Indians, most of whom do not even have access to doctors or oxygen as the second wave overwhelms major cities.
Millions thrown into poverty
India’s struggling economy is also making it much more difficult for the government to impose a second national lockdown.
The first lockdown plunged much of the country into poverty – the number of people earning $ 2 a day or less in India is believed to have increased by 75 million due to the Covid recession, according to the Pew Research Center.
“The lockdown has come at a huge economic and social cost,” said Chandrika Bahadur, chairman of the Indian Lancet Covid-19 Commission task force. “The suddenness of the announcement meant … that the vast majority of the country was unprepared for the implications on income, food, security of tenure and safety.” And in turn, central and state governments were not prepared for the migrant. crisis.”
The economic disruption of the first lockdown also left the Indian government “less political leeway,” Bahadur added.
India has a weaker financial system than countries like the United States or the United Kingdom, for example. There are less money and fewer systems to send it to those who need it most.
Some parts of the country saw ration kits distributed to the poor during the first lockdown, but it was not enough to keep people at home. They still needed to earn a salary to feed their families.
“Without a government establishing a strong system of social support through public policies, which would take the form of social assistance programs such as allowances or grants, foreclosure is not possible,” said Prasad, of Royal Roads University.
A localized approach
In early April, as cases began to rise in the capital, New Delhi, many migrant workers returned to their home villages even before restrictions were imposed. Many feared that a surprise lockdown would leave them stranded again.
India’s varied topography means that its population density is concentrated in specific centers – and although the virus can spread anywhere, its effects are most felt in cities like Delhi, Mumbai and Bangalore. Each state also has a different level of resource availability, including health care capacity.
A nationwide lockdown would leave little room for state and local governments to respond to the pandemic in a way suited to their local circumstances. Currently, some states are enforcing nighttime curfews, restrictions on public transportation, and localized measures in certain neighborhoods.
In its April report, the Indian Lancet Covid-19 Commission task force recommended not to “totally lock down the country or the state”.
Instead, he supported measures such as closing venues for large gatherings and encouraging white-collar workers to work from home – but urged the government to minimize restrictions for the rural and urban poor.
Bahadur said the task force is now calling for localized but synchronized closures based on two variables – the spread of disease and medical preparedness.
Modi echoed these recommendations in his April speech, asking heads of state to focus on “micro-containment zones” instead of full lockdowns.
States and union territories are now taking this approach – for example, Delhi imposed several consecutive lockdowns for short periods such as seven or ten days, with exceptions for many categories of essential workers – unlike the first lockout. last year.
“The basic point is that there are no simple yes or no answers to a series of very complicated questions,” Bahadur said.
“In a country with such diversity, localized decisions, guided by a common science and evidence-based approach, with a strong coordinated response, are our best bet for success.”
This story first appeared on CNN.com, “Calls are mounting for another nationwide lockdown of India. This is unrealistic.”