India in the Pandemic: Successful States vs Flailing Central Government

While the COVID-19 pandemic was raging across Europe in March, India’s 1.3 billion people were optimistic—the country had put forth an aggressive response and managed to keep its case count low. India had implemented one of the most stringent lockdowns globally—effectively confining all citizens to their homes and all of its diaspora to their country of residence. For a while, this strategy worked. However, with the first stage of reopening underway by late May, India had seen an explosion of cases, particularly in Mumbai, Delhi, and Chennai. By 14 June, 99 percent of the intensive care unit (ICU) beds in Mumbai were occupied and Delhi was projected to have 550,000 cases by 31 July. This paints a very grim picture for the country, which continues to see an increasing number of fresh cases daily.

As of 18 June, the country has over 360,000 confirmed cases after testing over 6 million samples. Nonetheless, testing per capita is only slightly above 4,500 per million, which lags behind most other countries with large case counts. More troublingly, India’s positive result rate has gone up to 7.4 percent as of 13 June, with some regions like Delhi reporting an all-time high of 36.9 percent positive test results. India today is amid an unprecedented national crisis that is exacerbating the wealth divide between regions while states do what they can for their own residents.

India’s most significant intervention was its sweeping lockdown—with cities like Mumbai now past its eightieth day as of 12 June. The merits of this lockdown are contested, principally on the argument that it has left India’s most vulnerable behind—the large swath of migrant workers who must walk hundreds of kilometres in their bare feet to get home. Several weeks into the lockdown, the central government eventually announced on 1 May that special “Shamik” trains would ferry migrant workers. By late May over 1.4 million had been repatriated. Before this, many migrant workers were not only stranded, but also income-less, homeless, and hungry. This tragedy, however, is where India’s federalist structure was able to fill in the gaps of a lackadaisical central government. States like Maharashtra promptly offered three meals a day—at a cost to the state—to help migrant workers, setting an example for other regions to follow.

In fact, the federalist system has been the saving grace in India, where Prime Minister Modi has delivered unpragmatic messages to the public. In the beginning, when the central government struggled to devise a strategy, states were already encouraging social distancing and capping prices for testing. While a federal cap of 4,500 rupees (USD 60) per test was eventually announced, it has been criticized for being too high, and many state governments and city councils have negotiated prices as low as 2,000 rupees (USD 26). Many states have developed their own testing and quarantine strategies, some of which have been incredibly effective. Kerala, for example, has utilized its experience in preventing the Nipah virus epidemic to contain the pandemic.

Strikingly, the central government’s only other significant response was an unprecedented economic stimulus worth 10 percent of GDP. This, too, has been criticized for a lack of direct cash transfers. Many argue that the response is far too inadequate—that the Indian economy already suffers from policies like demonetization and a hastily implemented general sales tax. This means that the Indian economy was already slowing down with record-high unemployment prior to the pandemic. Many argue that the government should have tapped into foreign reserves which exceed USD 500 billion. Unfortunately, the rationale to use the reserves remains weak—foreign reserves are crucial to stabilizing currency and providing insurance against unanticipated current account deficits or capital flight. A significant amount of foreign debt also means that the government has limited fiscal space to respond. This has led to the grim reality in which the government today has almost no choice but to prioritize its ailing economy over its citizens’ health.

India’s “story” remains incomplete without addressing the rise of communal tensions during the pandemic. Government hospitals in Ahmedabad, Modi’s home city, have segregated Hindu and Muslim patients, allegedly on orders from the government. The government remained silent when television channels began blaming Muslims for a large outbreak originating in a religious meeting, even though many other religions had illegally held such gatherings. In essence, the government of India served as an accomplice to hate-mongering and blaming a marginalized group within Indian society. Because of the country’s subpar response to the pandemic it now faces a fermenting communal crisis.

Nationwide tensions and a lack of clear central policy have left states in India to do the best they can, despite significant differences in capacity. While the central government has mobilized small teams and temporary isolation facilities in train cars in recent days, many states continue to struggle. Delhi has begun converting luxury hotels into temporary hospitals while Maharashtra has lowered the capped test prices to make treatment more accessible. With a federal study suggesting that India will hit its peak of cases only in mid-November, it remains to be seen whether the country can keep its mortality rate low (currently below 4%) as hospitals in urban centres run out of capacity.