What explains the unabated upward trend of India's Covid-19 curve?

There hasn’t been enough curiosity about why India’s Covid-19 progression shows what it does. Why are we showing a continual trend up while others around us and of similar size show different trajectories? 

In our neighbourhood, Pakistan peaked on June 14 with 6,800 cases and is currently adding about 600 or fewer daily infections. Bangladesh peaked around the same time with 4,000 cases and is now under 2,000 new daily infections. Sri Lanka peaked on July 10, Nepal had one peak in July and then a decline and then again a rise. 

We’re unique in not showing any break in momentum. Current numbers are just under a lakh cases a day. A month ago, this was about 65,000, two months ago 35,000, three months ago 12,000. It is a march and it is almost unique. 

This could be for reasons linked not to us but to the other nations. For instance, that their numbers are misleading or fake. India is testing four times as many people per thousand as our neighbours are. It may be the case that they have cases not showing. Perhaps. But with similar rates of testing, Pakistan had half the number of cases as India only a few months ago. The lack of testing numbers didn’t affect their disproportionate case file then. But they dropped off after that and we kept going. 

Daily new infections in Bangladesh have been dropping weekly for two months. This is a nation of higher population density than India and a higher proportion of foreign workers returning home with the plague. How have they managed to control the epidemic? 

Elsewhere, the United States’ graph looks like a landscape with two peaks and a flat middle. The issue at hand is not whether they have conquered the spread, they have clearly not. It is why the pattern of spread is different. Iran has a flat graph with between 2,000 and 3,000 daily cases from March to September. China has a scarcely believable one with a February 12 peak of 14,000 cases, which declines to 5,000 the next day, to 2000 the day after that and then totally collapses. It is in single digits today, and China is an outlier which we should ignore here.

Illustration: Binay Sinha

In Europe, Spain, the United Kingdom and, to some extent, Italy show a rise and a dip and a rise again. There appears to be something happening everywhere across the world that is able to pull in the growth at least episodically.

In India, it appears that there is no intervention to the spread. It is in unbroken upward incline. That is the puzzle. We need to figure out two things. First, why this happened and is happening. Second, what happens if this continues into, say, the end of the current year. 

The answer to the first I do not know and don’t think anyone does, but I can speculate. It appears that the state has lost interest in trying to control the epidemic. The fact is that the policy levers available here are not many. The most important is the lockdown, the second most important is restrictions, meaning the closing off of places where contact is high, like cinema halls and gyms and so on. The Centre has followed an eccentric policy here, which is difficult to unpack. Planes  may fly but trains are grounded, cinema halls are shut but examination halls made to open. This came through circulars marked Unlock 1,2,3,4 and also 1.1 and 3.2 and other versions, which in time few people followed. At some point, the Centre also appears to have lost interest in this game and devolved the authority to the states. Is the Disaster Management Act that was invoked in April for the prime minister to take control over the Covid battle still in force? One does not know. This newspaper reported (“Government invokes Sec 35 of Disaster Management Act to fight Covid, states fume”, April 21) that it gave the Centre power “to constitute inter-ministerial central teams (IMCTs) and despatch them to states to make on-spot assessments, issue necessary directions to state authorities, and submit their report to the Centre.” Whether this is still happening is anyone’s guess. 

Another, admittedly more creative, theory I have for the spread pattern is a break in the social contract. There is of course no cure for this virus. Its spread can be stopped only by people behaving responsibly. Meaning keeping their distance and wearing a mask properly. There is no other way in which it can be controlled. On March 25, India house-arrested its population, most of whom have no savings, many of whom need to work daily to eat, and did so amid curfew-like situations, giving the Indian police freedom to be even more brutal than it usually is.

Millions rebelled and walked home (some, to avoid the nastiness, brutality and extortion of the state on the highways, walking on the tracks). These people were then asked to be responsible towards the rest of society and a state that not only abandoned them but deliberately put them in mortal danger. It would be unusual for the state now to expect them to behave in the greater good because the government is saying they should. The Union government busted the social contract in India and did so with millions of people.
 

It is no good saying here that we are like the rest of South Asia culturally. We are. But the rest of South Asia didn’t deliberately get put through torture. Sri Lanka extended a holiday period for a week, asked construction sites to close, allowed workers to return home and then locked down. India is still reeling from that first, dramatic act from the state.

Frontline reported (“Surat: Silence of the looms”, July 31) that over 3 million workers left Surat and its surrounding areas unpaid and hungry and few had returned. Mills there continue to run at only about half capacity. That is another sign that the citizenry doesn’t trust the state to behave predictably. 
 

I don’t have an answer to my second question — what happens if this continues to the end of the year — either. But that’s not relevant. We will know soon enough. The interesting thing about this virus is that its damage to society, public health and the economy will be recorded not by historians but by journalists and in real time.