Science, Policy & Pandemics: Covid-19 in India

28 July 2020


Reported by Kate McNeil, CSaP Communications Coordinator

How has the covid-19 pandemic affected India?

In the 15th episode of our series on science, policy, and pandemics, CSaP Executive Director Dr Rob Doubleday was joined by expert guests to take a deep-dive into the economic, food security, and health systems impacts of covid-19 in India.

Listen to the discussion here:

Produced in partnership with Cambridge Infectious Diseases and the Cambridge Immunology Network, CSaP's Science and Policy Podcast's series on science, policy and pandemics aims to answer questions about our understanding of the current pandemic, including the epidemiology, on what basis governments are making current decisions, how much confidence we can have in the knowledge models are producing, and how to manage the uncertainties involved in the present crisis.

Understanding the Economic Impact of Covid-19 in India

"The economic consequences [of covid-19] have been really devastating for India, particularly among the poor" says Professor Sonalde Desai, Director of the National Data Innovation Centre at India's National Council of Applied Economic Research. India's informal sector workers have been economically hit the hardest by the pandemic and lockdown. In March, only roughly 30% of individuals in this sector were able to do any kind of work. While people in other sectors are beginning to go back to work, as of late June, work availability for those in the informal sector remained low. Many are getting sporadic work and are being paid less than they used to. Meanwhile, those operating small businesses have also been hard hit, with increased prices and new challenges in getting supplies or wares to sell.

Looking to the future, Georgetown's Professor Jishnu Das describes the society-level impacts of the pandemic as occurring in three distinct phases. Phase one, the phase we are presently in, is seeing countries strive to manage potential surges, testing, and the short-term consequences of the pandemic as waves rise and fall in different geographies. Once a vaccine is available to a large fraction of the population, he suggests we will move into phase two. During this second phase, the start of a return to normal, Professor Das notes that there will new challenges as services resume. "All other things fell quite dramatically" to the wayside during the onset of the pandemic. Catching up on things such as missed vaccinations, the backlog of missed surgeries, missed opportunities to track and trace the transmission of other diseases such as TB, and lost classroom time for school children will take time, and will have prolonged effects. This, in Professor Das' mind, underlies what he characterises as a third phase of pandemic response. He predicts that there will be further repercussions of the pandemic 10-15 years from now when children who have missed out on classroom time during the pandemic enter the workforce. He predicts that this lost opportunity for investment in human capital could have significant longer-term effects on GDP.

How Has Covid-19 Affected Food Security in India?

As part of our exploration into the consequences of covid-19 in India, the University of Cambridge's Professor Bhaskar Vira and the University of East Anglia's Professor Nitya Rao spoke with Dr Rob Doubleday about how the pandemic has impacted food security. The Government of India stepped in to provide basic food grains and lentils to those in need throughout the pandemic, however, with cash incomes declining and many out of work, there are economic and social access barriers to other foods for many in India, with food purchasing power on the decline. Many slum dwellers are also purchasing drinking water, which is an additional drain on cash. Meanwhile, surveys conducted by NGOs in India have shown a decline in food consumption by almost 50% in rural India.

Professor Vira has suggested that it is important to understand this food scarcity in the context of the structural transformation India has been undergoing. As rural people have become unable to sustain livelihoods based solely upon the land, their households have become dependent upon precarious migrant work in urban areas. The loss of daily wages during the lockdown resulted in an immediate cash crisis and a crisis of consumption not only for workers, but for their rural families who are dependent upon a remittance-based economy. The onset of the pandemic came at the worst time for rural families partially dependent on local agriculture, as the pandemic struck as India was entering the hot, dry season when local production is low and rain-fed regions typically depend on imported foods and wild foods sourced from local markets which were shut down by lockdown.

Health Systems Impacts: The Short- and Long-Term Consequences of Covid-19

Roughly 70% of healthcare in India is in the private sector, and many of the small and medium sized private clinics which provided this care closed during the lockdown. According to LSHTM's Dr Meenakshi Gautham, this has likely impacted the delivery of routine healthcare services. Dr Gautham's LSHTM colleague Dr Finn McQuaid also noted that, in the case of TB management, the disruption of routine health services during the pandemic has the potential to have serious consequence upon India's TB burden, with TB already considered a leading cause of death in the country. TB treatment is long and intensive, and disruptions to treatment such as during the lockdown can result in more negative long-term outcomes. Moreover, a reduction in TB notifications in India during the pandemic means that it is likely that fewer people are receiving a TB diagnosis during this period. Dr Gautham also noted that India's immunization program has been disrupted by the pandemic, and that the capacity of the formal health sector is likely to remain quite limited in rural areas in the coming months. During this period, she notes that many do not have clear pathways to seeking healthcare, whether it is for covid-19 related care or for other health concerns. Consequently, Dr Gautham hopes that the pandemic will result in a longer-term increase in awareness of the need for investments in primary healthcare in India. Furthermore, she predicts that the pandemic may have longer term effects upon the levels of antibiotic resistance in India, as doctors have been routinely prescribing antibiotics as part of covid-19 care.

CSaP's Science and Policy Podcast's special series on Science, Policy and Pandemics is available across all major podcasting platforms, including Spotify, Apple Podcasts, Google Podcasts, Google Play, RadioPublic, Pocket Casts, Podbean, ListenNotes, Acast, Player.FM, Podcast Addict, and Castbox.

Photo of health checks in India by Gwydion M. Williams on Flickr