Consequential and Irreversible
It is March 2020. The coronavirus that originated in China is spreading through Italy and parts of Europe. Cases are showing up in other parts of the world. China did a complete lockdown of Hubei province, in which Wuhan is the largest city. You are leading a nation. What do you do?
I was tracking the trajectory of the virus in March. Here is what I wrote to some friends on March 17:
- We should stop counting coronavirus (CV) cases and publicising them. Just treat them normally as they come in hospitals. Given that (a) half of us or more are likely to contract it, and (b) most of these cases are not going to be severe, just treat them as one treats other infectious diseases. It is going to be impossible to quarantine a country like India. Might as well get over with it.
- Stopping the publishing of statistics will calm down the nation. Yes, one will keep hearing of deaths – but we have to accept that (see next point). The wealth and productivity destruction that is happening will do long-term damage.
- Deaths: India death rate is 0.7%. CV leads to 0.5% fatalities. Some overlap since the regular deaths are among the elderly. So, maybe one sees a 50% increase in the deaths. It probably won’t even be noticed unless it’s of a near and dear one.
- Indians cannot do work-from-home. Most don’t have broadband or separate rooms where they can work undisturbed for 8-9 hours daily. And with kids at home – the problem is compounded.
- Get on with life with basic precautions of hand washing which is a good thing anyway, and could actually be the best hygiene measure. Keep distance from people with colds and coughs where possible – which is also a good thing.
- Only 2 practical solutions are possible: immunity and vaccine. First will come before the second.
- CV isn’t going away anytime soon – so might as well get used to it. Else, the economic disruption will set us way back on the path to prosperity.
I echoed some of these points in a series “Unlock India” on my blog in early April. My recommendations:
- All 65+ year olds to be quarantined – families to make the decision for their own safety. Most of the deaths globally have been in older people with pre-existing conditions. In India, just 5% of the population is over 65 years of age.
- Anyone going out should wear a mask. This is for their own safety and for that of others. We are already seeing the rise of the use of masks. We need to get this going faster.
- We need to increase testing, and have people take a simple smell-and-taste test – since the loss of smell and taste seem to be the early warnings
- Those who test positive should stay at home to start with – especially if they are below 65 years of age. In most cases, they will recover on their own. If conditions deteriorate in a week after onset of symptoms, they should approach a doctor / hospital. This will also ensure that limited medical resources are used only for the most critical cases.
- Each individual needs to improve personal hygiene: maintain some distance when possible, and wash hands regularly. We should avoid crowded public spaces for some more time.
- Should outbreaks happen, those areas will need to be quarantined – think of this as a “Local Lockdown.” Instead of unlocking areas selectively and keeping a national lockdown, we need to unlock India nationally and then make decisions on which areas to lock based on the cases that emerge.
- We need to decentralise decision-making about lockdowns to the lowest level possible. Every elected representative (MPs, MLAs, corporators) should be “quarantined” in their constituency instead of living in the safety of capital cities. They have been elected by the people and are close to the ground. They should be the “chief ministers” of their neighbourhoods and make decisions on which clusters to quarantine should outbreaks become severe.
As I look back, I got the big points right. I was wrong on some points – the fatality rate is a fraction of what I had anticipated, I had missed the point about masks in the March note but had added it in the April commentary. What I thought then did not matter – but what India’s leader thought did. My thinking was inconsequential to the nation, but the leader’s decision was consequential and irreversible. And that decision – like multiple other economic decisions – was wrong by a mile.
Tomorrow: Part 2