COVID-19 Notes
By Dr. Satish K Gupta*
Updates
3,06,064 new cases recorded in the last 24 hours till 9 am today in India
Daily positivity rate (20.75%)
Weekly Positivity Rate (17.03%)
When should we declare the end of the pandemic?
Nearly two years into a pandemic, people appear fatigued and bored by the confinements. Already drained off the money poor have little energy to face the continued lockdowns.
Life versus Livelihood
Pandemic has not only claimed more than five and a half million lives but also adversely affected billions of livelihoods.
It is not the time to think about billions?
In the early stage of the pandemic, it is the preventive strategy like containment should lead, in the middle, early diagnosis and management remain the key (as was done during the second wave) but in the late stages rehabilitation should take over.
Why are we still meddling with principles?
Factors driving the pandemic mode:
● Virus
The Virus is calling shots. We can’t tame the Virus any more. However, the Virus has already given us the green card by becoming mild. It is no more killing people. People don’t even need hospitalization. More than 80% of Covid beds are vacant in Hospitals.
● Data Sites
A large number of internet sites mushroomed during the pandemic showing scary Covid Matrix. Sites that feed on Covid data will never let the Pandemic end. They create an atmosphere of fear and awe keeping the phobia alive. A Syndrome of Tubular Vision has overtaken the world. One just sees number of cases, tests, and Covid deaths.
● Politicians and Bureaucracy
The managers entrusted with the health of the nation work with an abundance of caution. They have at stake, their carrier and future.
People have already become enough aware of the disease and preventive measures, hence weekend curfews, alternate day opening of shops, and other coercive measures today serve no additional purpose but the loss of livelihood and inconvenience.
●How to get out of Cocoon?
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- The fear of the unknown will continue to loom large even in times to come. Virus can mutate any time.
- Bureaucracy needs to be wiser, political leadership stronger and public ready to support to bring the desired change.
- We need to come out of the cocoon and see the light of the day.
- Unless sites start showing the fiscal loss, loss of wages, and sufferings of people; there will never generate momentum to declare the end of the pandemic.
- Impact of Pandemic on financial parameters*:
A recent survey by the India Today group showed that 64% of people in India faced a decrease in their earnings during pandemic.
● GDP
In the wake of the nationwide lockdown in March 2020, the GDP growth crashed to 23.9%. In 2020-21, the overall GDP shrank 7.3% — this was the worst performance of the Indian economy since independence.
● Inflation
Even before the spread of the Covid-19 pandemic, the Consumer Price Index had crossed the RBI mandated upper limit of 6%. During the pandemic, as the demand plummeted, prices of commodities came down. However, as the economy recovered from the pandemic, prices of commodities surged and CPI breached the 7% mark in October and November 2020. (See figure)
● Fiscal deficit
Owing to the interruption in economic activities, following the spread of the Covid-19 pandemic, there was a considerable shortfall in the Centre’s revenue collection. At the same time, additional expenditure to mitigate the impact of the pandemic on vulnerable sections of society created immense pressure on the fiscal resources.
The government estimated fiscal deficit for 2021-22 was 6.8% of GDP*. The government budget deficit was 9.40% of the country’s GDP in 2020-21.
● Unemployment
Covid-19 has caused record unemployment in India. The pandemic-induced lockdown spiked the unemployment rate in the country to 23.5% in April-May 2020. (See figure)
Impact of Pandemic on Non Fiscal health parameters
Pandemic affected Not Just livelihood parameters but also other non-Covid health issues got a set back:
● Management of communicable and non-communicable diseases is suffering. Surgeries have been postponed. Various national programmes have taken a back seat.
● Family planning services have suffered
● Non Covid Vaccinations have pushed behind threatening to revive suppressed threats
Possible Objectives of continuing in Pandemic Mode?
1. Further lowering of mortality: The mortality rate has stabilized at around 0.13% during this wave. We have been accepting the mortality rate of 0.1% for influenza for several years. Is it not time to simulate Covid with influenza?
2. Avoiding sudden pressure on Health infrastructure: With more than 80%of beds being still vacant in hospitals, easing coercive measures should not override the buffer in coming days.
3. Vaccinations: India had performed exceptionally well in this sphere, more than 90% of adults have already received covid vaccination. Vaccine hesitancy has been replaced by vaccine enthusiasm, doses are available in plenty, continued pandemic phobia does not seem to significantly contribute more to the scheme. Vaccination drive can be continued even after the disease is accepted as endemic.
What else can we achieve by remaining in Pandemic Mode?
Can we achieve Zero case scenario?
Unlikely, Virus has established a reservoir, the disease is likely to remain endemic like so many other infections.
Can we decrease the mortality further?
Bringing mortality to less than 0.1% seems difficult because co-morbidities will have their toll. Further decrease in mortality rate is possible only by an effective antiviral.
Can we prevent mutations in the Virus?
We can not tame the virus. The virus is dictating terms. We can only boost our immunity. Vaccinating the world is the priority. COVAX is working at high speed, if not full throttle. More than 1 billion doses have already reached poor countries.
Sudden spurt in the number of cases?
Yes! this is the only objective being served by continuing the Pandemic Mode but it seems to be coming at a heavy fiscal cost. But one should wait for Case Positivity Rate to come down to less than 5% to be in safe zone.
Finding the right moment is the key to press the release button. The virus has already given the lead by becoming mild-mannered. It is time to start thinking about this before public fatigue and anger take over and become difficult to manage.
After all, pandemic management should be judged not just by the number of cases treated or the number of deaths averted, but also by the number of mouths fed with two meals, the number of hands given the jobs to have a sustainable life, and a confident future.
Also read: Understanding COVID-19: What could be the next variant like?
*Dr. Satish K Gupta is an MD in Medicines, a Visiting Senior Consultant Physician and Internist at Max Super Speciality Hospital, and a Clinical Assistant Professor at GS Medical College, Chaudhary Charan Singh University, Meerut. He is the author of Journey of COVID in India: A Doctor’s Perspective.
