BATTLING COVID: RESET TACTICS

Containing the spread of the corona virus is like trying to hit a moving target and hence tactics need constant recalibration. EPISODE #55

Dear Reader,

A very Happy Monday to you.

The threat of the covid-19 pandemic has resurfaced in a new avatar: Omicron. The virus which had dodgy origins in Wuhan, China first mutated into the lethal Delta and has now assumed the form of the virulent Omicron—with initial data suggesting that in some instances it is able to elude vaccine defence.

Straight away this only confirms the apprehension that the Severe Acute Respiratory Syndrome corona virus-2 (SARS-CoV-2)—the virus driving the covid-19 pandemic—is very resilient and that the battle against it is far from over. In all likelihood we will have to live with this threat for a few more years.

The good news is that there is a lot of learning since the virus struck the world 18 months ago. And yes we have also had the medical miracle: generation of vaccines in record time. But the bad news is that the mitigation response from most governments is either knee-jerk or one of complete denial. And this when it is clear that this battle will be drawn out. This week I try to unpack this challenge and the consequences.

The cover picture this week is an installation street art I stumbled upon during a random walk to clear my mind. Somehow, the partially vandalised piece of sculpture seemed to strike a poignant pose. Hope it appeals to you too.

There was an error in last week’s newsletter. I wrongly identified the indigenously developed Covaxin as a messenger RNA or mRNA vaccine. Thank you Ajeet and Neetu for flagging the error. I am sorry.

A big shoutout to Kapil, Gautam, Premasundaran, Vandana, Aashish and Rahul for your informed responses, appreciation and amplification for last week’s column. Gratitude also to all those who responded on Twitter and Linkedin. Reader participation and amplification is key to growing this newsletter community. And, many thanks to readers who hit the like button😊.

If you are not already a subscriber, please do sign up and spread the word.

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LIVES vs LIVELIHOOD

This weekend Delhi declared a lockdown. Ostensibly called a weekend curfew—where everyone is home bound from Friday 10 pm to Monday 5 am—it is effectively a lockdown.

The authorities would have us believe that this hard stop to our daily lives will contain the surge in covid-19 infections. To be fair to them there is no evidence to disprove this claim. Just like there is no evidence that this extreme measure will succeed either. Guess they got alarmed not so much when South Africa warned the world about another wave. Nor when it hit the United States and Europe. Instead, they reacted after the detected cases spiked in India. Strange because one would believe forewarned is forearmed.

The graphic below sourced from Google News captures this surge.

I believe the authorities erred on the side of caution. Something that has serious consequences. The resilience of the virus, especially its ability to mutate suggests that there can be no uniform response—especially in such a variegated country like India. It is like trying to hit a moving target.

For this the playbook has to be constantly reinvented. In contrast the policy response to mitigate the spread of the new variant smacks of business-as-usual tactics.

A lockdown, an extreme response, exacts a cost. And hence has to be used sparingly. Especially as it hurts those at the bottom of the pyramid. For instance, this lockdown has meant that daily wagers will be denied two days of wages. And remember that this comes in the backdrop of a round of savage job losses after the entire Indian economy was shut down beginning March 2020.

It is a fact that the informal sector is the biggest employer in the country. And also that a bulk of them work for the contact economy—hospitality, airlines, trade and construction. A report released by State Bank of India research department in November claims that in the aftermath of the shutdown of the economy the size of the informal economy shrank from 52% of gross domestic product or national income in 2017-18 to an estimated 20% in 2020-21.

Anecdotally, in response to my queries, several informal sector workers who had been laid off maintain they survived the last two years by drawing down their savings and on the free food grains being supplied through the public distribution system. In fact, several joined the ranks of the ‘new poor’.

For this cohort the reopening of the economy was the first chance to recover financially. The graphic below shows that retail and recreation sector was just about correcting for the losses they had suffered in the last 18 months.

The Learnings

The weekend lockdown in Delhi and other cities puts the spotlight afresh on the difficult trade-off: Lives vs Livelihood.

It is something that has dogged policy planners since the pandemic struck India in 2020. Progressively, thanks to the jab roll out and learnings about corona virus, the union government has calibrated the trade-off towards livelihood and left it to state governments to manage the local situation as they see appropriate.

Implicit in this pivot is the belief that you need to be cautious but not panic about covid-19; basically learn to live with covid-19 as it gradually becomes endemic. It is baffling therefore to see the state governments adopt extreme measures so abruptly. Yes infections are up, but mercifully neither hospitalisation nor fatalities have grown correspondingly. Indeed science is telling us something.

The thing is that in the last two years the world and India have learnt a lot about covid-19. Yes it has been a process of trial and error, but there is no doubt that we are much better equipped today to deal with the pandemic. In contrast, when the lockdown was first declared two years ago, no one had a clue about the nature of the pandemic. Worse there was no vaccine, though scientists had begun talking about it. In this backdrop a lockdown, undoubtedly harsh given the experiences of stranded migrants, could be justified as a means of mitigation. The situation today is vastly different.

The biggest takeaway in the last 18 months in the battle against covid-19 has been the success of the vaccine. Yes it does not offer absolute immunity—given that several jabbed people are falling prey to the rampaging Omicron. Yet it does reduce the risk of hospitalisation and death—the stand-out memories of the Delta wave last year. At the same time the cycle of infections-vaccine-infections is gradually creating what experts call “hybrid” immunity. Consequently over time the rate of reinfections will go down.

To be sure I am not suggesting that we should take Omicron lightly. Of course not. Just because it is not leading to hospitalisation and deaths does not mean it is not causing some physiological damage. My limited point is that the mitigation response has to be aligned to the present form of the virus and that it should weigh the livelihood consequences.

In an interview to CNBC-TV18, Soumya Swaminathan, the chief scientist of the World Health Organisation, said as much. And if I may add in very blunt terms at that, even as she said India should be prepared for Omicron but not panic.

“Things like night curfew, there is no science behind it. One has to take evidence-based measures. There is a whole list of public health measures.”

And then added;

“Entertainment venues are places where these viruses spread the most. It's natural to bring in some restrictions there.”

Swaminathan’s point about entertainment spots being potential hubs for spreading covid-19 is in contrast to the existing guidelines which allow malls to be open while shutting down parks—denying people recreation to ease some of the stress that accumulates during abnormal home confinement.

The authorities need to take note of the alarming experiences in Europe and the United States where we are witnessing a violent public backlash against such restrictions. So far in India the citizens have complied—though they have mostly failed the mask test. But there is no guarantee that matters may not come to a boil here too. Especially since in a month from now we will see our politicians—including those imposing lockdowns—rally crowds for votes as another election cycle kicks in. As the cliche goes ‘Sauce for the goose is not sauce for the gander’. This hypocrisy is bound to rankle.

In the final analysis it is clear that any fightback against covid-19 will have to focus on effecting behavioural change of individuals. Small wins—like wearing masks properly—will be critical in winning the war.

Here again there is no quick fix. However the prospects improve dramatically if the public is part of the solution—by being made responsible for collective safety. And for this the playbook has to be dynamic. Stasis is not an option. Like the corona virus we need to smarten up too.

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Recommended Listening

Last week I experienced a devastating personal loss. To help process it I tapped the literary work of Joan Didion. Coincidentally I stumbled upon Didion after a friend shared an obit (following her recent death) published by The Guardian.

Didion lost her husband (and equally accomplished novelist) John Gregory Dunne in 2004. He died abruptly at the dinner table as Didion readied the salad. A year later she published a memoir titled ‘The Year of Magical Thinking’.

It was an account of her husband’s death and the processing of her grief. Sharing a few quotes below:

“Life changes fast. Life changes in the instant. You sit down to dinner and life as you know it ends”

“A single person is missing for you, and the whole world is empty.”

“We are imperfect mortal beings, aware of that mortality even as we push it away, failed by our very complication, so wired that when we mourn our losses we also mourn, for better or for worse, ourselves. As we were. As we are no longer. As we will one day not be at all”

Coincidentally, National Public Radio aired a fresh episode of ‘Fresh Air’ on Didion over this weekend. In this episode they shared clips from two previous interviews with herr. The interview conducted by Terry Gross—the best interviewer I have ever heard—explores the author’s thoughts on the memoir.

I was particularly struck by Didion’s remarks in the second interview (which begins from the time stamp 11.20 minutes). The 30 minute interview is a must listen.

Till we meet again next week. Stay safe.