COVID-19: Beyond Biological Dynamics

Imrana Qadeer,Sourindra Mohan Ghosh

doi:10.1177/0049085720936076

Abstract

In the absence of specific drugs and vaccines, precautions at the personal level (hygiene, maintaining physical distancing and so on), people’s participation in population-level interventions (such as sharing scientific information, case-tracking and strategic area-specific lockdowns) and health service system preparedness are the three key available measures against the COVID-19 pandemic. However, the necessary ingredients for these three measures are missing— induced by poverty and structural inequality; a lack of people’s trust and a crippled public sector in health with a low resource base; shrinking, fragmented and weakened infrastructure that has lost on inter-institutional referral links and monitoring and surveillance systems. Not only has an ill-planned lockdown crippled an already struggling economy and depleted health systems and overshadowed containment efforts but the time has not been utilised to strengthen primary healthcare (PHC) services and secondary and tertiary public sector healthcare infrastructure. A phased relaxation of the lockdown with a comprehensive fiscal stimulus to jump-start the economy, coupled with the strengthening of health systems that put the needs of the poor at the forefront, is suggested.

Highlights

Introduction‘Flatten the curve’ is the current war cry but how, why and for whom are questions left to bewildered citizens to interpret or follow unquestioningly
In the absence of specific drugs and vaccines, precautions at the personal level, people’s participation in population-level interventions and health service system preparedness are the three key available measures against the COVID-19 pandemic
To unpack and understand the contextual coating of the COVID-19 infection in India we examine the conditions in which it arrived and spread across the states (Table 1)

Summary

Introduction

‘Flatten the curve’ is the current war cry but how, why and for whom are questions left to bewildered citizens to interpret or follow unquestioningly. Given the past experience with epidemics of plague in Surat and dengue in Delhi when private providers either left the city itself or charged exorbitantly for simple testing, it is not surprising that the private sector that was so vocal about ensuring the viability of private healthcare, especially releasing the money stuck with the Central Government Health Scheme (CGHS) and more funds for critical care, initially quietly waited in the wings; not even volunteering to take the responsibility of conducting tests at a reasonable price unless the state supplied them kits free of cost Those who did speak from the private sector wanted the transformation of public institutions into COVID care units and proposed they could take the serious patients into their ICUs (Varghese, 2020). A section of the retrenched labour sought to find employment in the agricultural sector resulting in a rise in farm employment (5.8 million), most of which might be essentially disguised unemployment (Vyas, 2020)

A Looming Agricultural Crisis

Findings

Conclusion