End lockdown or not?

Extending the lockdown could lead to more deaths

The current three-week nationwide lockdown because of Covid-19 is slated to end at midnight of April 14. Sometime before then, the government will have to announce its decision between three possible choices: (a) extension of the lockdown by a few more weeks; (b) a phased or staggered lifting of the lockdown; and (c) a complete and immediate end to the lockdown. Media reports of last week’s interaction between the prime minister and state chief ministers indicate that the latter were consulted for suggestions about how to have a phased or staggered lifting of the lockdown restrictions. Other reports suggest that extension of the lockdown by a few more weeks remains a live possibility. Here I want to argue that this option would be a bad choice for India.

In the global “war” against Covid-19, lockdowns have become a weapon of choice in China, the United States, and most major European nations. (Interestingly, it has not been implemented in either Germany or South Korea, two countries with the lowest fatality rates, defined as the ratio of deaths to Covid-confirmed cases). There are at least four important differences between India and these countries, which makes a prolonged recourse to lockdown a much less desirable approach for India.

First, India is a much poorer country, with average incomes a fifth of even China’s and more than 20 times less than in the US or Europe; and with 20 per cent of households living below a minimally defined poverty line, while another 20-30 per cent have incomes only modestly higher. What this means is that nearly half the population is close to subsistence standards of living, with little reserves to ride out fluctuations in incomes, caused by sudden shocks like the current lockdown. They have little alternative to reducing already low levels of consumption of even basic items like food if the lockdown is prolonged.

Illustration by Binay Sinha

 

Second, about 80 per cent of India’s labour force is in the informal/unorganised sector, comprising casual labour and the self-employed, typically with low average earnings, often below recommended minimum wage levels. In a lockdown situation, where at least half of all economic activity has come to a grinding halt, they are the workers who are taking the biggest hit in terms of job losses and earnings. The hundreds of thousands of migrant daily wagers, seen on TV sets, trudging many scores of miles to their distant homes vividly demonstrated this. The latest survey data from the Centre for Monitoring the Indian Economy shows massive loss of jobs and declines in labour force participation rates in the last week of March. And precisely because this vast labour force is in the unorganised sector, it is difficult to protect or compensate them significantly through ramping up of government income/consumption support programmes.

Third, as in other poor countries, India’s patchwork of welfare programmes fall far short of European style national welfare safety nets like unemployment insurance and universal public health service provision.

Fourth, our extant availability of health infrastructure and services is incomparably worse than in the countries mentioned above. In those nations, the basic logic of a lockdown has been to provide a breathing space during which key medical facilities (such as critical care hospital beds, ventilators and personal protection equipment for medical staff) is procured, manufactured and organised to step up capacity to meet the anticipated peak, or near-peak, requirements of Covid-19 patients needing hospitalisation and critical care. (As reported currently, that seems to have averaged around 10 per cent of those who have tested positive in these countries). This is the so-called “flattening the curve” strategy, while waiting for that time in the future (12-18 months?) when reliable anti-viral medicines or vaccines against Covid-19 become widely available. In the Indian context, the goal of ramping up available facilities to meet likely peak Covid hospitalisation needs is probably an impossible dream, whether the lockdown is maintained for three weeks or three months. What has not been achieved in 70 years simply cannot be done in a few weeks.

So what is the current lockdown achieving, other than the pervasive shutdown of economic activity and massive job losses, especially among poorer segments? Well, a few things. First, by slowing the transmission of the disease, the lockdown is buying some time to enhance and organise the availability of hospital facilities and critical medical equipment (though starting from a very low and inadequate base), and to increase capacities for screening, testing and quarantining. Second, it has brought home to the general public, in a dramatic manner, the seriousness of the pandemic crisis and the associated need for public action to minimise the perils and costs. This should increase adherence in the post-lockdown phase to non-lockdown norms such as “social distancing”, frequent hand-washing, mask-wearing as needed and proscription of large social/religious gatherings. (Of course, most of this is not possible in India’s densely populated and poor urban slums, which house nearly 100 million people. Nor in many thousands of poor villages without running water). However, these gains are being achieved at enormous economic and human cost.

In rich countries suffering lockdown, the debate on costs and benefits of prolonging lockdowns is active. Often, this debate is cast in binary terms: The weighing of likely Covid deaths avoided by “flattening the curve” versus the economic costs of shutdowns. For India, such a binary discussion is too simplistic. This is so for the simple reason that prolonged lockdowns will also lead to higher (than normal) rates of morbidity and death (especially among the poorer half of the population) as the loss of incomes and reduced consumption of nutrients and other essentials render people vulnerable to a wide array of disease vectors such as tuberculosis, diarrheal diseases, respiratory ailments, cardiovascular diseases, diabetes and so on, not to mention Covid-19 itself, as well as sheer starvation deaths.

So, it’s not just about GDP foregone in lockdowns. There are human deaths on both sides of the balance: Those Covid ones saved versus the other extra ones caused by prolonged lockdowns (mostly among the poorer half of the population). No one knows the numbers on either side. It will be a matter of “informed” judgement. Mine is clear: There should be no extension of the current nationwide lockdown beyond April 14. 

And let’s hope that the Covid-19 virus weakens in the summer heat andour virus/bacteria-rich environment, as many have speculated!

The writer  is honorary professor at ICRIER and former chief economic adviser to the Government of India. 

Views are personal