Macro Policy For A Microbe – Because What Worked In A Pre-Coronavirus World Might Not In The World That Follows

The infamous Covid-19 microbe has thrown a wrench into the world’s engine. Sun Tzu had long declared that if you know neither the enemy nor yourself, you will succumb in every battle.

Today, governments are dealing with an invisible enemy, haunted by problems which have plagued our system for long. As of writing this piece, there are over a million active coronavirus cases worldwide, and as many possible solutions as there are countries.

The public health system across the world is groaning under an overwhelming burden of immediate provisioning for testing, tracing and treatment of the virus.

Policy-makers are faced with a Hobson’s choice of implementing lockdowns, imposing drastic social-distancing measures and flattening the transmission curve of the pandemic, while also propping up a rapidly contracting economy due to simultaneous demand and supply shocks.

The 21-day lockdown announced in India may restrict viral transmission, but also freezes the economy. The social contract is under the strain of a failing promise of prosperity and equity, as the contrast deepens between the haves and have-nots, between essentials and non-essentials.

The ‘India’ which has co-opted for digital workflows has been quick on the uptake, but the ‘Bharat’ which survives on daily wages and on the strength of economic migration is being suffocated.

The inherent conundrum of choices lies in this unique trade-off – the inverse correlation between requisite health policy and the economy. The longer the lockdown sustains, the greater the negative impact to the economy.

In the short run, as the government of India has rightly done, there is an absolute imperative to prioritise health over the economy.

Finance Minister Nirmala Sitharaman has highlighted the urgent need to assure and insure sections of the population worst affected by economic suspension.

Next, all policy prescriptions must account for a post-pandemic world, where routine counter-cyclical policies may prove ineffective. Public policy must foresee medium- and long-term challenges and focus on addressing concomitant dilemmas at the macro level – of controlling coronavirus, boosting the public health infrastructure as well as easing economic shocks.

Steps must be taken to improve population awareness, not just about the virus but also through an effective at-home diagnostic tool which can help minimise hysteria and reduce the burden on hospitals.

The National Health Service (NHS) in the United Kingdom has initiated a home-based pilot in London in order to reduce hospital visits and ambulance use. During the pilot phase, in Indian metros, a simple, graded checklist may be widely disseminated through mobile applications, listing out specific mild to severe symptoms rather than generic diagnosis such as fever or cough.

In the next stage, if the three-week lockdown effectively stalls population movement, phased home-based testing can be initiated in identified viral clusters, following the South Korean formula of tracing, testing and treating.

A significant fallout of the complete lockdown has been the issue of migrant labourers, as ‘Bharat’ moves back home in search of social as well as psychological security.

Concerns of how social distancing is translating to emotional distancing were also voiced by Prime Minister Narendra Modi in his recent ‘Mann-ki-Baat’. In rural India, this could translate to a reaffirmation of caste lines, threatening to undo decades of progressive movements.

A joint strategy must be implemented by the central and state governments to ensure people stuck at state borders are comfortably accommodated at nearby construction sites, schools, colleges, marriage halls, religious centres. This will dovetail the dual objectives of stalling their movements and also creating a hub for disseminating essential commodities and information.

Speaking of essential commodities, while the Ministry of Home Affairs has issued a standard operating procedure (SOP) for maintaining supply of essential goods, the same needs to be more detailed and must account for on ground realities, particularly the challenges of information asymmetry.

As complete lockdowns are not sustainable for prolonged durations, public policy must go beyond economic relief measures.

In the medium-term, economic activities need to be restarted in a phased manner.

The service sectors are slowly adapting to work-from-home but the positive employment and production capacities of industry and business, which has been abruptly halted, must be preserved.

Critical sectors that are less-labour intensive need to be opened-up initially to address bottlenecks in supply chains. States need to identify crucial linkages and core sectors, especially focused on agriculture and industry, which may be operational in the first phase.

As an illustration, courier and goods deliveries, e-commerce, some micro small and medium enterprises in handloom, textile, food processing, and even tech-intensive large-scale production units for electronic gadgets etc, may be allowed to operate.

Indigenous production of personal protective equipment (PPE) and testing kits by modifying existing factories may be undertaken, even as imports of the same is encouraged through interest subvention.

A great example is the initiative by private sugar mills in Uttar Pradesh applying for sanitiser manufacturing licences or Maruti Suzuki India beginning manufacturing of masks and ventilators.

By this stage, only those with contact-history and symptoms should be in complete quarantine. Industries which can have good digital integration like the IT industry, financial sector, as well as the service and entertainment industry may be restarted in a later phase, once the pandemic is under control.

In the long term, a radical relook at public investment in social sectors, questioning resource allocation and ownership will be required.

The world has locked down, yet never before has the need to share data, knowledge and lessons been more vital. A core tenet of disaster management is to ‘build back better’.

South Korea learnt its lessons in the 2015 MERS outbreak and Surat in Gujarat transformed its municipal system after being hit by a plague in 1994. A country speaks in the language of its policies and history will be the judge of whether India stammered in its response to this pandemic.

India has proactively promoted social distancing, and guidelines are being amended and issued with immediate precision, displaying that decision-making is very much alive and not in inertia.

In the long run, it is essential to augment our public health systems with a greater focus on preventive care through increased awareness, promotion of wellness, enhanced research, detection and disease control.

Spending on public health needs to be viewed as an investment for the future. India’s ability to fully leverage her demographic dividend is founded on attaining its vision for a healthy India, that is Bharat.

Views expressed are personal.