The next stage of Covid

India's focus needs to move away from the feel-good metrics about recovery rate to the spike round the corner

The Covid epidemic overwhelmed Italy’s medical defences around this time two month ago. From the middle of March, daily new cases went to 4,000 a day, peaking at 6,000 a day on two days towards the end of the month. The week after that, their lockdown hit and the cases began to drop and fell back to 4,000 a day, before tapering off to a couple of hundred daily new cases.

 In Spain, equally badly hit, new cases went up to 7,000 daily in the same period and remained there for six days before beginning to fall from the first week of April. The UK had 7,000 daily new cases on one day in April, and while the epidemic appears to be in regression there now, the pace of contraction is slower and the UK registered over 3,000 positives a few days ago.

India registered 7,000 positives on Wednesday, the highest number so far, and this followed a few days when daily new cases were over 6,000. Last week, the number was 4,000 a day and the week before that it was 2,000 a day. The spread is exponential.

So far, we have tested 3.3 million of our population, which is 1/30th the scale of the European nations. It is likely that our true count of positives is much higher. But even assuming that we are even with the other nations on identifying the positives, the fact is that we stand today where those nations were at the peak of their crisis. The question is, what is to be done? The virus is going to affect us all in every part of India and will remain with us for some time even after a vaccine has been found. The instinct of some at this time will be to gloat at the helplessness of the Union government, but the crisis is national and, in many ways, it is defining for this generation and the next — and has already proved existential for thousands.

The first thing is not to be in denial. What does that mean? Our focus must move away from the metrics that are being pushed out today. One is the recovery rate, which is currently 42 per cent or so and rising. This is a meaningless number. Covid’s fatality rate is about 3 per cent and some think it is even lower. So the number of people infected who will recover will naturally rise to 97 per cent or higher on its own. No cure is at hand, so those recovering are doing so on their own. For this reason, there is little point in advertising what the current recovery rate is.

Similarly, talking about the rate of doubling having slowed by two days or three is not useful beyond a point. It marginally delays the bad news, it does nothing to stop it. The most important number is daily new cases.

We need to be prepared for what is coming down the pike for us. Three nations have registered numbers that are larger than ours. Russia had 10,000 daily new cases at the beginning of May, it has about 8,000 now but it is still in lockdown.

Illustration: Binay Sinha

 

Brazil is clocking 20,000 daily new cases and its hospital system is at breaking point. The United States peaked at 30,000 daily cases and is today still at about 20,000. These are terrifying numbers. But we need to confront them. The likelihood is that we will have to deal with them soon. At the rate at which we are going, we will be past Russia in terms of daily new cases next week, past Brazil a few days after that and past the United States by the end of June. That is only 30 days away. What is to happen then?

That will mean, at the fatality rate of 3 per cent, 1,000 daily deaths and the capture of hospitals by the elite infected. Indeed, even many of our rich will not have access to health care. Will our government hospitals even have any staff attending at that point? What will Dharavi and such places look like? Reports of people dying of hunger are increasing. Fights over food, not seen in our lifetime, are being recorded daily. What happens when the plague spreads at four times its current rate?

The sense of panic can only be imagined, as well as the reaction of our society, with its segmentation, its prejudices and its propensity to quick and unpunished violence. One shudders to think what such a scenario will be like.

There is no point in criticising the Union government because it is not productive at a time like this. It is overwhelmed. What proportion of this is because of state capacity and what is incompetence is not material. Offering little or no defence for what is unfolding on the issues of the migrants tragedy or on testing or on trains is an indication that it is lost.

It needs to make a new start but for that to happen, it must stop being in denial. India needs to see what is around the corner and what awaits us in terms of the disease and  in terms of the economy. An honest assessment of the happenings and an admission of what has happened will be materially useful. 

Some who oppose the Union government for other reasons, such as its majoritarianism, will support it for now. Other battles can wait. This one is defining for us as a people and a nation and the countdown to taking it on and making a fist of it is very short.