As India witnesses a record-breaking surge of Covid-19 cases, the Central and state governments have been scrambling to find appropriate responses to handle this health crisis. At a time when the healthcare system is severely strained, many state governments not surprisingly have employed public health or non-pharmaceutical interventions to control the spread of the disease. These interventions include lockdowns, evening and night curfews, as well as restrictions on capacity or closure of schools, retail businesses, industries, borders and public transportation.
The public health interventions initially adopted by the states ranged from complete lockdown to no restrictions, with many states imposing combinations of partial lockdowns and night curfews. Using information from government orders and websites as well as mainstream media reports, we collated data on the nature of non-pharmaceutical interventions imposed by the states as of April 26, 2021.
We noted the different public health interventions employed in each state and Union territory and categorised them into seven categories depending on severity of the combined interventions. These are reported in the map below.
As of April 26, Maharashtra, Karnataka, Rajasthan and Jharkhand had imposed full lockdowns. Large states like Uttar Pradesh, Bihar, and Madhya Pradesh had implemented their own combinations of lockdowns, restrictions, and night curfews in varying degrees across districts.
As the map shows, there is considerable variation in the way Indian states have used these interventions. Despite this variation, however, the map indicates that a large proportion of the country has been under some form of non-pharmaceutical intervention since the second week of April 2021.
With necessary caveats on the measurement of non-pharmaceutical interventions and the spread of the virus, Paul Novosad and Aarushi Kalra, using district-level variation in interventions between March and October 2020, in yet unpublished research, show that decentralised non-pharmaceutical intervention restrictions were effective in slowing down the rate of Covid-19 deaths.
In the current crisis, public health interventions would be useful in reducing the burden on the health infrastructure by slowing the spread of the virus. However, the widespread use of such measures without appropriate relief packages undermines several grave economic problems.
Economic perils of strict lockdowns
To begin with, such policies severely strain household incomes and livelihoods, and in the absence of state assistance, the economic costs of such measures are borne entirely by households. A research paper by Robert Beyer and others provides evidence that lockdowns drastically reduced economic activity, measured using the intensity of night-lights across Indian districts.
Besides economic costs, lockdown policies can also be associated with additional non-economic costs for vulnerable populations. For instance, research by Saravana Ravindran and Manisha Shah show that cases of domestic violence increased in districts with severe restrictions.
The biggest toll of last year’s hurried lockdown was in the form of deaths caused from wage-loss due to the lockdown. A large number of these deaths was among the most vulnerable populations, such as the migrant workers, the rural poor, the elderly and children. At least 971 people, likely a gross undercount, died because of lockdown induced hunger, loss of livelihood, lack of medical care, and accidents caused by unsafe travel on foot or overcrowded vehicles.
Following outrage about the unjustifiable costs of drastic lockdown measures, the Finance Ministry announced a relief package that was far from sufficient to deal with the humanitarian crisis last year. Not only was the government’s narrative about the size of the relief package misleading, this amount was measly in comparison to aid packages announced by other countries that imposed lockdowns during their first waves. Crucially, these measures did not address the needs of vulnerable population groups like pregnant and lactating women, the elderly, migrant and construction workers.
Numerous surveys last year also showed falling incomes and economic distress and underscored the importance of public services and wider social security measures. In line with the World Bank’s predictions about a massive increase in poverty rates on account of Covid-19, the need for a radical expansion of these social security measures is extremely pronounced.
Then and now, India needed to put to use the existing machinery of the welfare state, by universalising and expanding the reach of extant social security programmes. These programmes include pensions, the Public Distribution System, and Mahatma Gandhi National Rural Employment Guarantee Scheme, which provides rural families 100 days of work a year. Economist Reetika Khera also provided a roadmap to reach vulnerable groups with cash and in-kind assistance, which does not rely on the exclusionary machinery of Aadhaar-based biometric authentication.
Delayed relief so far
In this second wave of the crisis, the relief packages from the states have been slowly trickling in. In the first week of May, Tamil Nadu announced financial support of Rs 4,000 to all rice ration card holders in the state. On May 18, the Delhi government announced a relief package of free and increased quantity of ration; ex gratia compensation for a Covid-19 death in the family; pensions for families that lost a breadwinner; and educational support for children who lost a parent.
Although useful, Delhi government’s announcement came after four weeks of lockdown and numerous SOS calls.
Meanwhile, the Central government continues to turn a blind eye to both the crisis and the relief efforts. Instead of providing immediate relief, the government of India exported 20 million tonnes of grains in the middle of the pandemic.
The map above confirms this harsh reality, as we have demonstrated that most of the country was already facing some form of lockdown restrictions without any relief measures. Unless the Centre and other states act with urgency and provide relief now, the humanitarian crisis is likely to continue worsening in India.
Social security expansion
As the current episode of public health interventions is wiping out jobs and pushing out urban migrant workers once again, governments need to work to ensure food security. This can be done by ensuring a minimum of two cooked meals at feeding centres that could include aanganwadis, government schools, government colleges, and community halls.
Community kitchens, that served the urban poor during the first wave of the coronavirus in Jharkhand, Tamil Nadu and Kerala, provide models to emulate. It is also not too late to implement proposals for an urban employment guarantee scheme to resuscitate an economy decimated by a dual crisis of health as well as incomes.
At any rate, governments need to devise plans to ensure wage compensation to workers in the unorganised sector in rural areas (by way of MGNREGA lists) and urban areas (using the machinery of Unorganized Sector Welfare Boards, for instance). It also needs to be ensured that landlords cannot evict tenants who are unable to pay rent due to loss of income and good health.
The second wave of this pandemic has also seen the emergence of large donation drives and mutual aid efforts, targeting both national and international donors. Much of these donations, however, are focused on remedying oxygen shortages. Organisations engaged in relief work amongst the urban and rural poor however, report that primary demands are for food and ration.
As the wave itself makes its way away from cities and into rural areas, these needs for food and social security are likely to become more pronounced albeit less visible, with dwindling public attention on the health crisis.
It is shocking then that the Central government lacks the will to use existing welfare infrastructure to provide immediate relief to households threatened by the risk of falling sick. These are the same households that may not only be incurring huge out of pocket health expenditures on account of the health emergency and the broken public health system, but may have also lost incomes and jobs due to well-intentioned lockdowns imposed to contain the spread.
Meghna Yadav is a graduate of the Delhi School of Economics. Her Twitter handle is @meghnay3.
Aarushi Kalra is a PhD candidate in Economics at Brown University. Her Twitter handle is @chidiya_
Kanika Sharma is a researcher who works on social inequalities in health in India.
Alamu R is a PhD scholar at Jawaharlal Nehru University.