28 APRIL 2020 / COVID-19 IN INDIA
[NEWS]
SEAN RAMESWARAM (host): It’s Tuesday, April 28th and there are now officially more than one million Covid-19 cases in the United States. I’m Sean Rameswaram and this is your coronavirus update from Today, Explained.
Testing remains the biggest barrier between where we’re at and where we want to be in this country. On Monday the president said the United States would double testing, but it looks like double of not nearly enough is still just not nearly enough.
The president appears to be doing everything in his power to keep the B in BLT. According to Bloomberg -- the news outlet not the billionaire -- President Trump is expected to invoke the Defense Production Act in order to mandate meat production plants stay open and supply Arby’s with all those crucial meats, I guess.
This comes after factory shutdowns and mounting reports of plant worker deaths due to Covid-19. Apparently the government plans to guarantee additional protective gear for employees, but unions and activists aren’t happy. Some are going as far as calling the plan “a death sentence.” We’ll talk more about the nation’s food supply on tomorrow’s show.
Treasury Secretary Steve Mnuchin says that large companies getting more than $2 million from the small business bailout fund will be audited and could face “criminal liability.” His announcement comes after a public outcry about big old companies like Shake Shack and the Los Angeles Lakers benefiting from the program. To be fair, both Shake Shack and the Lakers have said they’d return the money they got.
If you can’t wait to see the Lakers back in action, you might have to figure out how to wait. Brad Pitt look-alike and the nation’s go to guy on infectious diseases, Dr. Anthony Fauci, told the New York Times that it’s still a little too early to bring back athletes for competition. The NBA and Major League Baseball have been trying to figure out a way to make sports work. The NBA is telling players they can train and receive treatment at team buildings if it isn’t violating a local stay-at-home order beginning May 8th. Is that an unfair advantage? Maybe.
Did you know planes are still flying? JetBlue just announced all passengers will need to wear masks or face coverings while up in the air. It’s the first major U.S. airline to implement such a rule, but it’s well behind the rest of the planet. The rule will be enforced starting May 4th.
May the 4th and may the mask be with you.
[THEME]
SEAN: The curious thing about this historical moment we’re living through is just how easy it is to forget that this is all so historic, right? Like, when you’re worried about your family and your job and being safe when you go to the grocery store, it’s easy to forget that the world’s never seen anything quite like this before. Just think about India for a minute: something like 1.4 billion people are on lockdown. How do you even do that?
I asked Professor Irfan Nooruddin. He’s the director of Georgetown University’s India Initiative.
IRFAN NOORUDDIN (Professor of Indian Politics): Essentially, there are three phases to the lockdown strategy. The first was true in any place that took this seriously was to shut down economic activity to make sure that all unnecessary non-essential contact was kept to an absolute minimum. The second is to begin to think about how to reopen in a gradual and measured manner the economy and society so that people can return to, to work. To return to their normal lives, but with incredible amounts of testing, contact tracing and isolation of anyone diagnosed with the disease. And the final is getting to a mass vaccination program that can be implemented across the length and breadth of the country. In India's case, that's 1.4 billion people that would need the vaccine. And, of course, undoing and rebuilding the damage from the damage done in the previous two phases, because there's no way to get out of those first two phases without a lot of people having to make incredible amounts of sacrifice. But the idea is that if we do that right, you get to Phase 3 sooner than you would if we didn't.
SEAN: Well, let's dig into the three phases a bit more. So phase one obviously has been implemented. I've spoken about it on the show before. India has locked down 1.4 billion people. How did the country even go about doing that?
IRFAN: The very first thing that the country did was begin to use the international airports as a way of restricting the entry of the virus into the country. So it was very much a model in which the threat was seen as imported cases coming from abroad. India has a large diaspora population that works all over the world that may have been exposed and inadvertently bringing it back in. And so the airports became the first line of defense. For a while it seemed like that was going to be enough.
SCORING IN - THE MICE INSIDE
<CLIP> NEWSCASTER, INDIA TODAY: The Health Ministry has issued an advisory to the Civil Aviation Ministry to conduct health screening of passengers arriving at airports in Kolkata, Delhi, and Mumbai from China.
IRFAN: As more and more evidence appeared that there had been community transmission of the virus, they had to escalate.
<CLIP> PRIME MINISTER NARENDRA MODI: (in Hindi) In the entire country—starting at 12 o’clock tonight—in the entire country, there will be a lockdown.
IRFAN: The prime minister announced a nationwide lockdown, 1.4 billion people told to stay home for three weeks. That has since been extended for at least another couple of weeks, such that India now is under lockdown, at least through the first week of May.
SEAN: And, and my estimation is that is something truly unlike the world has ever seen before. Is that true?
IRFAN: It is.You know, if you think of the two countries that have experienced coronavirus over these last four months that resembled the size or scale of India, those would have to be China and the United States. In China, the very early isolation of the virus in Hubei Province, but other parts of China were not placed under the same sorts of crackdown. In the United States, of course, as we are watching right now, we still have states that haven’t enforced stay at home orders. So what India did was something that neither China or the United States attempted, which was to do a nationwide lockdown. 1.4 billion people across the board.
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SEAN: And what does that mean for the 1.4 billion people? I mean, what have the implications been so far?
IRFAN: Well, on the one hand, I suppose to give the government credit for making a very difficult decision, it has meant that the case counts have not risen as quickly as they would have in the absence of this lockdown. But the real issue has been for the lockdown to have worked as effectively as it could have or should have, other parts needed to be in place. So for one thing, there appears to have not been any plan for what to do with the large numbers of migrant workers who line India's city streets, who live on the outskirts, who live in densely populated slums, many of whom reacted to the announcement of the lockdown by beginning to walk home, to go back to the villages and small towns from which they had come.
<CLIP> RAHUL KANWAL, INDIA TODAY: The plight of the poor urban migrants. Last night, when I was driving home from work, I saw a steady stream of people on the expressway trying to just make their way back home. Now look at some of those pictures—that is exactly what you’re trying to avoid. You’ve got so many people, just so close to each other. They have no more means of transport. Some of them are holding their babies, some of them have old parents with them...
IRFAN: This was the second largest human migration in the history of independent India—the biggest being Partition. So literally we had millions of migrant workers leaving cities to go home, potentially taking the virus back to places that it had not already been.
SEAN: Hmm. And in addition to all the potential community spread there, it’s going to be pretty complicated to undo this mass migration, this historic shut down?
IRFAN: It's gonna be complicated in every country that attempts this. But in India's case, it's complicated by two very important factors that might be of interest to your listeners. One, of course, is that in that Phase One period, the 80-some percent of India's workforce that works in the informal sector, and often relies on daily wages in order to make ends meet, hundreds of millions of people who needed that food and can only purchase food if they can work on a given day. So when you tell them no work for three weeks, that is not just difficult, that is the difference between life and death for hundreds of millions people and we’ll only know the full toll of that when we finally get out of this phase and can actually do a proper accounting. Beyond that, the formal sector of the economy has taken a significant hit. Remember that India was entering 2020 with the economy already struggling. And what we’re now going to have is the possibility of a year in which we have zero growth, maybe even negative growth, depending on how bad it goes. We might have banks failing. We’ll have businesses go out of business. And India simply does not have the fiscal firepower that the United States can marshal, for instance, in putting massive stimulus bailout bills in place. The question, of course, is whether enough of the formal economy can be resuscitated such that eventually the economy begins to boom. A final consideration over here is that there's a lot of pressure on government to open sooner than it might be advisable. And what that, of course, leads to is a concern that there'll be a massive outbreak again in the summer, which will simply send India back to where it is right now.
SEAN: I mean, even more so than the United States. I wonder how is India getting money to people, to migrant workers who are now without any sort of financial source? I mean, these are people who don't have bank accounts, in some cases can't read. How do you distribute stimulus, if at all?
IRFAN: Short answer is you can't. I mean, what the government can do and this is thanks to their efforts over the last decade of building a unique identification system, the Aadhaar system, and a really significant effort to digitize finances to make bank accounts more accessible to a lot more people than once were, that the proportion of Indian citizens who have a unique I.D. and that's linked to a bank account is much greater today than it was 10 years ago. So the government will be able to deliver, you know, 5,000 rupees, 3,000 rupees. That's, you know, 50, 70 dollars worth of stimulus money. But for the vast majority of India, including all those migrant workers, those are not options.
SEAN: Phase Two sounds so enormous I imagine it’s hard to even fathom Phase Three -- implementing vaccinations for over a billion people.
IRFAN: Yeah. So phase three is essentially a long run. And though the real challenges are, we have no idea what the dance to get there will be, right? I mean we can’t get to Phase 3 if we haven’t reduced community transitions virtually to single digits or zeros, and unless there’s a vaccination program in sight that will allow for actual return to normalcy.
SCORING IN - FIVE YEARS IN A MINUTE
IRFAN: Phase three is going to require, therefore, that, you know, international supply chains are mobilized to make sure that vaccines get in affordable ways to the vast majority of people, it's a global vaccination campaign of a scale we have never tried. India is actually uniquely positioned as one of the big producers of pharmaceuticals for the world. And so hopefully India's under, you know, the first reports recipients of that when it comes. But beyond that, I think there's some really deep structural issues that Phase 3 is going to have to deal with. This has exposed what happens in a large country in which 80 percent of the workforce is in the informal sector without any protections whatsoever. It exposes what happens when communalism and caste discrimination go rampant because people in a crisis find scapegoats. And so even in the midst of a moment where we should be working together, where solidarity should be highest, rates of anti-Muslim violence, rates of anti-low caste discrimination and violence are actually increasing. And, you know, all of this then, of course, leads to the other Phase 3 question around the world, which is, how do all the surveillance and technological measures implemented to fight Phase One and Phase Two survive into that new phase but now repurposed? What privacy rights have we given up that will undermine the quality of democracy when we finally come out of it? So right now, like most of us, I have a hard time seeing past Phase One. I can begin to imagine the glimmers of Phase Two. But if we really are talking about getting back to normal, Phase Three is critical and it's the one that we have the most time to plan for. So we should be thinking hard about what we want that world to look like when we finally get there.
SEAN: It’s not only bad news in India. There’s a bright spot. It’s called Kerala. That’s after the break on Today, Explained.
[MIDROLL]
SHAGZIL KHAN (Kerala resident): My name is Shagzil Khan. I live in India, in Kerala. That is the state I live in. It's south of India and in Cochin, it's near to the Arabian Sea. So it's a seaside town. I work for India Tourism, I lead foreign tour groups in India. Of course, if you're hearing any noise, that is my young one who is four years. It is his time to watch his cartoon, and he's watching some of the cartoon channels.
In Kerala, in my particular town in Ernakulam, which is in Cochin, if we have to get food, lockdown conditions permit grocery stores to open with strict conditions. They are allowed to open from, say, 9:00 to 5:00. It all depends upon how serious the Covid pandemic has spread in that area. So Kerala government has categorized zones into Green Zone, Orange Zone and Red Zone. And above all of that, they have also categorized hotspots. In those places, people are not allowed to go out unnecessarily. Now, in case if we are feeling any symptoms of Covid, then there are recognized Covid testing centers. And then there are the health workers who would monitor all you are doing or quarantine at all. And your name and your location and your house is registered in the local authority, and they will send a health worker every day to your house to see how you are doing it. If you are not a serious, symptomatic patient, they will call you every day to check how things are going. The information from the government is passed through us in various forms of communication systems. First of all is social media. The police force of Kerala, they have an official Facebook page where they are sending messages. And then there is WhatsApp groups, but that is all for people who have a smartphone. Every day, the chief minister's office is giving you the information at a particular time every evening. Everyone is watching that in Kerala. Then, when we had our first lockdown announcement, Kerala police had announced it on a public announcement system and they will go through every village announcing it. So there are various ways messages are coming through.
We are all connected now, we are all affected. So let us all take at least this few months, let us sacrifice all our pleasures of socialising and going out so that we can enjoy it more better in the later days.
SEAN: Professor, it sounds like things are going a lot better in Kerala than other parts of India.
IRFAN: Completely. In India right now, we have glaring examples of both exemplars for what the rest of the world could be doing and should be doing. The state of Kerala has arguably not just flattened the curve, but shattered it.
SCORING IN - VECTOR MODE
IRFAN: It was one of the earliest states in India to have cases. They swung into action, case counts have stayed extremely low. Fatalities are even lower than what might be expected and then are being witnessed in other parts of the world and yet in other states in north India, we are seeing a very different response because the governments didn't do what they should have been doing.
SEAN: How amongst all of this did Kerala manage to successfully flatten its curve, to successfully implement a lockdown?
IRFAN: Kerala is unique of the Indian states in that it has, since independence, and even prior, has had strong worker movements that led to the creation of what we think of as a social democracy within the Indian constitutional framework. It's government is a communist government, one that is, I think, more in the spirit of a social democratic system. What this means is that the investments in public health systems in Kerala has been higher than the national average by a couple of points for the last 70 years. That is an institutional legacy, a set of investments that they can now benefit from. But if I was going to point to a single thing, it is that in Kerala they used a whole of government approach from the get go. The moment the first case was reported in Kerala, the chief minister convened a state response team that coordinated 18 different functional teams. They held daily press conferences. They communicated with the public on a daily basis. They leverage the fact that India's bureaucratic system, the famous Indian Administrative Service, but also its state equivalents, have outposts and representatives in every village across the country. But, of course, in Kerala as well, clear communications and investment in the public system in that bureaucracy, the faith and the bureaucracy, the technocratic capacity of the bureaucracy was harnessed by the chief minister so that you had a whole of government approach. They were talking with one voice.
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SEAN: So is everyone else in India looking at Kerala and saying … let’s go there? <laughs>
IRFAN: That's the frustration that the Kerala example, right? It’s like, on the one hand, we all might want to live in Norway <laughs> and wonder why our countries can't be more like, you know, that or like Kerala. But it's not the kind of fix that can be done overnight. That shouldn't make us hopeless, I think if there's a single lesson to be learned from the Kerela example, is that state governments make choices about where they invest their resources, how much of their budget is allocated to things like education, health, social services. And, admittedly, governments, especially in a poor country like India, have to make hard choices between different things they could spend their money on. Kerala, right now, is evidence of what good can come when you choose to spend it on healthcare.
SEAN: And as this virus becomes an increasing concern in South America, in Africa, which to this point have still been largely spared. What do you think the so-called “Global South” can learn from India?
IRFAN: The main thing I think is going to both be that when the government speaks with one voice, as the central government did in enforcing the lockdown, citizens will, even if reluctantly, even if painfully, will adhere to it. But it requires an unequivocal endorsement of the advice of public health authorities that social distancing is not optional, it is necessary.
SCORING IN - YOUR GLASS EYE SEES THE FUTURE
IRFAN: The challenge for the global South is not that different than the challenge in the global North in terms of enforcing lockdowns and bearing the economic brunt. And if you can't have a plan in place to do those simultaneously, you undermine the efficacy of the hard, difficult decision to make a lockdown in place. Not only are people more likely to break it, not only are people more likely to grow impatient and unwilling to cooperate long, but people will actually die because they simply don’t have access to the food and medicines required for them to survive.
SCORING OUT - YOUR GLASS EYE SEES THE FUTURE