The Economist USA 03.21.2020

TheEconomistMarch 21st 2020 33

1

I

t was calledthe Spanish influenza, but

given the number of Indians it killed, the

flu pandemic of 1918-19 should perhaps

have carried a different name. Some 18m

are thought to have died, or 6% of the coun-

try’s population at the time. A century later,

with covid-19 lapping at India’s now far

more crowded shores, fears are rising that

the world’s second-most-populous coun-

try could again bear a disproportionate

share of the global agony.

Until now, India has been lucky with

this coronavirus. Despite the proximity of

China there is only modest human traffic

between the Asian giants, a result of chron-

ically strained relations. Nor do many trav-

ellers visit India from other early centres of

the pandemic, such as Iran and Italy. Partly

as a result, India has registered fewer than

200 cases so far, and only three deaths.

Most of those testing positive acquired the

virus outside the country.

Indian governments, both central and

state, have also been strikingly forceful in

their response. They were quick to restrict

travel from afflicted areas and apply basic

screening at airports. India has also airlift-

ed—and closely monitored the health of—

hundreds of its own citizens from stricken

spots such as Wuhan, Tehran and Milan.

Public information campaigns have satu-

rated every television channel; recorded

messages even interrupt calls on India’s

900m mobile phones. Across most states,

schools and universities have been shut

and public events cancelled. Kerala in the

far south, a state with a record of excellence

in public health, has gone further. Volun-

teers now deliver free school lunches di-

rectly to homes, while kerbside basins have

been installed at even the remotest rural

bus stations to encourage hand-washing.

To enforce adherence to individual isola-

tion orders, health authorities farther

north in Maharashtra are stamping hands

in indelible ink with the word “Home Quar-

antined” and an expiry date.

Health officials insist that they have

managed to limit infections to people who

were exposed to the virus abroad and their

immediate contacts within India. In some

places, they have been assiduous in finding

and isolating those at risk. One case in Ker-

ala, where success in stemming an out-

break of the far deadlier Nipah virus in 2018

has built institutional expertise, involved

tracing nearly 1,000 people who had come

in contact with a single family. But not all

states are as efficient. Border screening va-

ried between entry points and never

amounted to more than taking the tem-

peratures of passengers—a dragnet a co-

vid-carrier could slip through by taking

paracetamol, a doctor grumbles.

Many also note the paucity of testing

data. Due to the cost and relatively small

supply of testing kits, plus the limited ca-

pacity of government labs and a commend-

able desire to control the complex testing

process so that it does not itself become a

vector for the virus, India has so far only

tested some 11,500 people. This compares

with 270,000 in South Korea, a country

with a fraction of the population. And be-

cause the testing protocol has focused so

heavily on travellers, it has become what

one expert calls a self-fulfilling prophecy,

Covid-19 in India

The billion-person question

DELHI

If the coronavirus is taking hold, the consequences will be especially grim

Short of life support

Government health spending per person, 2016

Current$’000atpurchasing-powerparity

Source:WorldBank

Pakistan

India

China

Thailand

South Korea

Singapore

Australia

Germany

United States

86420

$61

$40

Asia

34 Banyan:ThePacificself-isolates

35 RecessionloomsinAustralia

36 ExtremismintheMaldives

36 Making wagyu Japanese again

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