the big story

The great dilemma of unlocking India

The TLDR: India’s covid count is soaring, and we are facing a critical shortage of medical staff and hospital beds. Yet, today most of us will rush out the door, and get right back to business. WTF is going on? The short answer: The Indian government forgot that a lockdown only buys time—at a very high price—but it cannot buy us immunity. We explain where we went wrong, and took the off-ramp from the path of rationality.

First, tell me how bad it is

At 257,486, India is now the fifth worst-hit country in the world, having edged past Spain. We added 9,971 new cases yesterday. Our death toll is now 7,202—which is still low, but likely an underestimate. Given the severe backlog in testing (see: our explainer here), it is likely many Covid deaths have not been logged. 

Also misleading: our R number—or the rate of infection. 

• Before the lockdown, our R number was 1.83—i.e. a 100 infected people were spreading the disease to 183 others on average. 
• Now, our R number is 1.22. But that’s only because Maharashtra—which accounts for the greatest number of cases—has slowed the spread in recent weeks. 
• However, other states are speeding up: Uttarakhand now has the highest R-value in the country: a sky-high 2! Assam is at 1.7, while Haryana is 1.9.

The main takeaway: National totals—be it for recovery rates or death counts—matter little in a country as vast as India. The vast backlog in testing and reporting test results suggests that the current count is way lower than in reality.

So the lockdown failed, right?

Yes, but not because the lockdown was a bad idea per se. Remember the ‘flatten the curve’ chart that went viral back in March. Created by scientists, it explained why a lockdown was necessary—and what it was intended to achieve. 

The lockdown was never aimed at stopping the spread of the disease—nor can it do so. While social distancing keeps us safe, it also prevents a great many of us from developing immunity. So the moment we relax the rules, the virus starts to spread again. Until we get a vaccine, most of us will be infected by the virus over the course of the year—as Indian experts make very clear.

So what’s the point of flattening the curve?

One, it buys us time to bulk up on healthcare resources. Two, it prevents serious spikes that overwhelm our healthcare system. Therefore—according to a widely circulated Imperial College study—what we need is a series of short lockdowns that will hit the brakes every time we start to surge.  

So the lockdown failed because…?

We didn’t use it as intended. Here’s what we did fairly well at the outset, and through the lockdown. 

• Trace, test and isolate international passengers and their contacts. 
• Implement the most severe lockdown in the world to limit the spread of the virus. 
• Use our resources to set up quarantine facilities to isolate Covid cases.

What did we fail to do?

Strengthen our healthcare resources. Scientists have repeatedly warned that infections will surge when a lockdown ends. And we need to use that time to bulk up on medical supplies, staff and—most importantly—hospital beds. 

We went into lockdown on March 24. But the worst-hit cities did not move towards increasing hospital beds until late May. Consider the example of Delhi—where the story  of a man dying because he couldn’t get a hospital bed went viral last week. 

The Kejriwal government gave the order to convert five luxury hotels into makeshift hospitals on May 29. It still has not been implemented because the hotels are just plain refusing to obey this “ridiculous” order. The reason: “There will be a huge stigma attached to these properties and guests will not consider staying there.” Making the situation even more effed up: Hotels are set to reopen today as per the central government’s Unlock 1.0 directive. 

In the case of Mumbai—where Covid patients are sharing beds, and being treated alongside dead bodies—the government is only now racing to convert stadiums, planetariums and other centres into hospitals.

Point to note: The order to reserve private hospital beds for Covid patients in Delhi and Mumbai was only issued in the third week of May.

So what were we doing for the past 76 days?

We gave up entirely on contact tracing as per the government’s own data. And we went into denial over ‘community transmission’—despite clear evidence that the virus is now freely circulating across the country. 

From obsessing over the travel history of international passengers, the government moved to blaming the ‘travel history’ of migrant workers—millions of whom are now moving back to rural areas. 

The migrants are causing the surge, right?

Yes, in the states where they have returned. The spike in the number of cases is anywhere between 30-80% in states like Odisha, Bihar, Chhattisgarh, Bengal etc. This is hardly surprising. We stuffed lakhs of people into quarantine facilities with zero social distancing, which triggered protests by desperate mobs of workers, and then transported them home in the worst way possible. 

But here’s the kicker: now we are doing our best to woo them back.

Wait, what do you mean?

The grand unlock plan requires the workers to return en masse—especially the construction industry. In Maharashtra, real estate developers are working with the state government to bring workers back to Mumbai, Pune etc via trains. In Chennai, these companies are chartering flights for the same purpose. Others like Raheja are adding incentives like Air coolers, bedding, and bunk beds. No more shanties for our worker! This is Shramik 2.0 for Unlock 1.0.

Point to note: These cities have just about gotten their Covid curves under control. 

So we shouldn’t be unlocking the country?

We have no choice now. The economy will be damaged beyond reprieve if we don’t find a way to restart it. But we paid a high price for a very necessary but very badly executed lockdown—and it may all be for nought. Now, we have to do our best to stay safe in a highly unsafe environment created by those choices—at least, those of us who have the luxury of making that choice. More mini-lockdowns in certain regions will likely be necessary in the months to come, but let’s hope next time they are based on reliable testing data, and not just governmental panic or whims.

The bottomline: is best summed up in a series of images.

Rahul Gandhi tweeted out a series of Oxford University charts on the effect of the lockdown in various countries. Ours looks damningly like this:

This is Marine Drive in Mumbai:

This is social distancing on our planes:

 And finally, this is what our hospitals look like:

The reading list

• Mint and Times of India detail the plans to woo migrants back to the city.
• This older Telegraph piece shows why we need evidence-based lockdowns—i.e. those based on reliable testing data, which remains poor.
• New York Times explains what it means to flatten the curve.
• This Huffington Post  first-person essay details the death of the author’s father-in-law—denied a bed in Delhi—in heartbreaking detail.
• The Guardian and Time have an overview of the shortage of hospital beds.
• This Times of India op-ed explains how the PM’s war-like rhetoric led Indians to believe that the virus would be defeated by the lockdown.
• Both this doctor in Scroll and the leading doctor at Bangalore’s Nimhans explain why most of us will be inevitably infected with the virus.
• Read our explainers on the Shramik trains, the nightmare of being a Covid patient, and our soaring Covid tally.