India’s Response to the COVID-19 Outbreak

The government of India’s quick response to the outbreak of COVID-19 at the outset of 2020 began with aggressive tracing and quarantining, and culminated in an unprecedented nationwide lockdown that took effect on March 24th. The current count of 33,300 confirmed cases of COVID-19 and just over 1,000 dead across India are drastically lower than originally feared. Polls show Modi’s normally high personal approval ratings have not flagged, giving him room to walk the tightrope between controlling the virus and reviving the economy. Officials took the first steps toward re-opening the economy on May 1, while also announcing that half the country will remain under lockdown until May 28.

Early Government Response and Containment Strategy

On January 9, China informed the World Health Organization that a new coronavirus had been found in Wuhan. That same day, the Indian health secretary, the ministry’s senior-most bureaucrat, warned her state-level counterparts of a possible emergency, and the Indian government began preparing its response. The following day, the government convened the joint monitoring mission, which handles nationwide medical emergencies, and the following week, the government created committees of ministers, bureaucrats, and medical experts, which were focused on managing India’s COVID-19 response. Prime Minister Narendra Modi pushed for decisions to be preemptive, focusing on containment of the virus, and indicated he would not shy away from hard-nosed economic calls.

For a population of 1.3 billion people, mass testing and mass quarantining were viewed as impractical. As one senior official said, “there wouldn’t be enough testing kits in the world.” What emerged instead was an initial response strategy that stressed border controls, vigorous contact tracing, and quarantining, with testing used only sparingly. Travel from China was restricted on January 17. However, the government was slower in banning travel from Europe and the Persian Gulf region. The Persian Gulf region alone proved to be the source of over 50% of India’s original COVID-19 carriers.

As infections in India rose, the government accepted it would have to lock down the country. The trigger was the detection of cases in Mumbai’s slums, indicating transmission from middle-class clusters to working class areas where social distancing and contract tracing would be difficult. On March 24, Prime Minister Modi announced a nationwide lockdown, ordering the entire population to stay in their homes, all businesses to close, and all public transit to halt, for a period of three weeks. Prior to March 24, six state governments had already issued lockdown orders.

Easing Restrictions and Increasing Testing

The government announced on May 1 that it would lift the lockdown in districts that have recorded no COVID-19 cases in the past 21 days, which is just over half the country. The remaining areas will remain in various levels of lockdown depending on whether COVID-19 cases are present or were reported nearby. With each two-week cycle, locked down areas would graduate to more liberal levels of containment. If new cases appear, however, the reverse will take place.

Officials expect an uptick of cases in late May-early June as the lockdown is lifted because of asymptomatic carriers and a greater possibility of transmission. They hope to contain these new outbreaks rapidly. One major development is that large-scale testing is now possible: India can now carry out 50,000 tests a day and has carried out over 830,000 already. The goal is to push down the curve so that the doubling rate of cases, reduced from 3.5 to 10 days during the lockdown’s first month, will rise to well above 15 days by early May and keep rising until June. By then, the government plans to have in place a much more comprehensive medical infrastructure to handle what it believes will be renewed waves of infections.

Questions remain about the number of actual positive cases in the country. States that have carried out sufficient testing to detect asymptomatic cases consistently show five times more positive cases than states that have not. That would mean India’s present 33,000 confirmed COVID-19 cases (as of April 30) might be closer to above 100,000. The present figures are probably within an order of magnitude closer to the real situation as there has been, so far, no spike in the number of deaths at crematoria or burial grounds and no surge in patients at intensive care units in hospitals. But a number of scientists have argued India’s testing levels need to be much higher before any claims can be made that the COVID-19 spread is under control.

Criticism of the Government’s Response

Criticism of the government’s response to the COVID-19 crisis has focused on a few points. One, the government was slow to purchase personal protective equipment (PPE) for medical personnel. The Ministry of Health and Family Welfare struggled with government procurement regulations and wasted much of March before beginning purchases. India continues to be short of PPE and key medical equipment.

Two, when the nationwide lockdown was announced, there was a huge exodus of migrant workers attempting to return to their homes. Modi’s failure to reassure such workers led to state chief ministers announcing contradictory policies, some encouraging workers to return to the job and others urging them to leave. Many workers were intercepted and 2.7 million now live in quarantine camps across the country. Several million more have returned home or are stranded. The medical fallout of the confusion around migrant worker movement seems limited, however. Bihar, a major labor-exporting state, screened 300,000 returned workers and found no major COVID-19 footprint. With businesses warning of labor shortages as the lockdown draws to a close, an attempt is being made to match two million migrants with job openings. The first train and bus services to send workers to their home states began this week.

Three, there is a continuing debate about the severity of the government’s response. India’s lockdown, according to Oxford University’s Stringency Index, has been at the maximum 100 since March 24th, among the highest of any country.

Looking Ahead

The severity and length of India’s lockdown will depend on whether there are sizeable eruptions as the economy is allowed to restart through May. The expectation is that a rolling lockdown, possibly going on for months, will be imposed and lifted on different parts of the country based on infection rates. Reviving the economy will be a central factor as the government considers its next steps. Unemployment has risen to over 25%, and most forecasts predict a drop in growth of 4 to 6 percentage points. The most pressing concerns are the need to bring in the winter harvest, restart a stalled credit cycle and avoid potentially huge bankruptcies among small and medium-sized companies. So far, New Delhi has avoided any big bang fiscal moves. An initial relief package for the poor and a few other measures have amounted to only 0.8% of GDP. The polls show Modi’s normally high personal approval ratings have not flagged and that gives him leeway in deciding how to walk between controlling the virus and reviving the economy.

Over the coming weeks, Rhodium will be tracking India’s response to the pandemic and efforts to revive the economy, as well as the implications for India’s clean energy and climate goals. We will be rolling out notes that go into more depth on: COVID-19’s implications for India’s relations with the US, China and multilateral organizations; the Indian government’s economic recovery strategy; impacts on India’s power sector and renewable energy policies; and any political impacts on Modi and his policy commitments on climate and the Paris Agreement.

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