A Year on, Mind the Gaps in the Pandemic Response

Context: India needs to revisit its disease control strategy to ensure a more robust and humane response in similar crises.

Positive achievements of India in COVID response

• Better on death rates and rates of infection: than higher-income countries
  • India’s case fatality ratio on February 3 stood at 1.4% compared to 2.8% in the United Kingdom or 3.1% in South Africa,
  • India’s deaths per million are 112, compared to 1,362 in the United States, 1,486 in Italy, or 1,831 in Belgium
• Political commitment at the highest level: with steps like screening and quarantine of international travellers.
• Stringent nationwide lockdown: at earliest unlike the U.K. and the U.S, costing many lives due to their late response.
• Vaccination program: With health-care workers, frontline workers, people above 50 and those with underlying health conditions covered under it.

Challenges in the Indian COVID response

• Not done well than similar income countries in South Asia: India’s case fatality rate was higher than Bhutan (0.1%), Nepal (0.7%), the Maldives (0.3%) and Sri Lanka (0.5%).
• Civil Society’s role in Health Management
  • Civil society played an important preventive and promotional role in bringing the infections (like polio and AIDS) under control.
  • Played a meaningful role in providing social support and lobbying with funding organisations such as the Global Fund for AIDS, Tuberculosis and Malaria (GFATM).
• Rising virulent strains of the virus: restricts the borders to normal travellers.
• Lack of evidence-based justification for lockdown: has ultimately led to its failure - when India ended up lifting the lockdown, cases were rising (per million people from 200 on June 9, 2020, to 7,454 on January 1, 2021).
  • Lockdown was marked by excessive dependence on security forces to ensure physical distancing measures and quarantines.
  • Large scale exodus of migrants, leading to deaths due to lack of food, water and social safety net.
  • Lack of effective coordination with states: saw states implementing COVID-19 response policies hesitantly without much initiative or innovation.
• Inefficient use of Information technology: (despite Indian being a Software Superpower)
  • The Integrated Disease Surveillance Programme (IDSP) was not visible throughout the response.
  • Limited coverage and periodicity of serosurveys conducted by the Indian Council of Medical Research (ICMR), resulting in poor information about herd immunity in India.
• Lack of involvement of civil society organisations.
• Widening of inequalities: Rise in existing social inequalities, and the poor face a ‘lost decade’ ahead.

Conclusion: For ensuring a more robust, well-thought-out and humane response to similar crises in future, India must examine all these critical gaps in response to the pandemic.