India is hitting a record number of new covid-19 cases. That’s not its only problem

A child peeps from a window of a special train at Egmore railway station in Chennai, India, on Tuesday. (Arun Sankar/AFP/Getty Images)
A child peeps from a window of a special train at Egmore railway station in Chennai, India, on Tuesday. (Arun Sankar/AFP/Getty Images)

On Sunday, India logged more than 90,000 new covid-19 cases — a daily count global record — and overtook Brazil as the country with the second-highest number of cases worldwide. India has more than 4.2 million confirmed cases. Only the United States, with 6.3 million cases, has a higher covid-19 count.

The covid-19 crisis has also led to economic pain, and new pressures on Prime Minister Narendra Modi and his government. Here are five things to know about what’s happening.

1. Why has India seen fewer covid-19 fatalities?

More than 72,000 Indians reportedly have died from the virus — far fewer fatalities than in the United States or Brazil. India’s low death rates were initially a cause for optimism. But preliminary theories regarding the immunity effects of tuberculosis vaccines, or the prevalence of a different strain of virus in India, have found little evidence.

India’s predominantly young population could be one reason for the lower fatality rate. But many scientists believe covid-19 fatalities in India are also vastly underreported. Information on suspected deaths from covid-19 is not publicly available. Official numbers exclude those who never received a test. Deaths are often attributed to comorbidities instead.

India’s mortality data was problematic before the pandemic, making it challenging to accurately estimate pandemic-related deaths. Most rural deaths occur at home — only 22 percent of deaths are medically certified with a cause of death.

2. What are the broader health-care consequences of the virus?

The pandemic has massively strained India’s health-care services, a dire situation for patients with acute or chronic illnesses. During the first three months of the pandemic, an estimated 60 percent of cancer surgeries were postponed in India. India also has the largest population of tuberculosis patients, and their treatment has been considerably disrupted. Medical care for acute heart diseases and communicable diseases has fallen significantly.

As is the case in many countries, millions fewer children have been immunized every month. But this is especially concerning for India, which sees one-fifth of the world’s 5.9 million deaths for children under 5 — vaccination campaigns can prevent more than half of these deaths. Fewer women are giving birth in institutional facilities, raising concerns about maternal and infant care.

3. What parts of the country are worst affected?

The Modi government imposed nationwide lockdowns, but was unable to stem the rising number of cases in densely populated urban centers. Health policies fall under each Indian state’s purview, so it’s difficult for the national government to impose centralized reporting policies.

More than 67 percent of reported cases are concentrated in the six states of Maharashtra, Andhra Pradesh, Uttar Pradesh, Delhi, Tamil Nadu and Karnataka. While cases were initially concentrated in large cities, the Indian Medical Association has pointed to community transmission in rural areas since July. Seven states reported their highest daily cases on Monday.

While the government took early preventive measures, the reopening process since June has been accompanied by a rising number of cases. Even regions initially lauded as successes have seen spikes. Despite challenges of managing the virus in densely populated slums — as Adam Auerbach explained here at TMC in April — the World Health Organization praised Dharavi, a Mumbai slum with 1 million people, for containing the virus. But by August, more than half of the residents had contracted covid-19.

States with adequate health-care infrastructure and contact-tracing capacity saw new spikes when India’s nationwide lockdown eased starting June 1. Nearly a half-million workers returned to Kerala from Gulf countries and other parts of India, for instance, resulting in one of India’s fastest growing outbreaks by August.

4. What has been the impact of the pandemic on the Indian economy?

India had the world’s fastest-growing economy until last year. But the Indian economy contracted 23.9 percent during the second quarter of 2020 — the sharpest drop of any major economy this year — triggering the country’s first recession in 40 years. Some 4.1 million to 6.1 million youth jobs are at risk, and an estimated 18.9 million salaried jobs have been lost. Government rural employment programs have also been reduced and make irregular payments.

India is potentially facing its worst economic crisis since independence. According to the World Bank, 90 percent of workers in the informal sector are at risk of falling into poverty, without access to any unemployment insurance.

The IMF’s chief economist and other economists worry the Indian government isn’t spending enough on relief measures. The government has earmarked 1 percent of GDP for covid-19 relief, lower than the average emerging market country’s spending of 2.5 percent of GDP.

5. How has this affected support for the government?

Despite this grim picture, support for the Modi government has not declined. In an August 2020 survey, 78 percent rated the prime minister’s management of the covid-19 crisis as “Outstanding” or “Good.” In addition, 71 percent said the government’s handling of the economy was above average — though 85 percent of respondents had either lost their jobs or experienced declining income.

A number of world leaders enjoyed a short-lived ratings bump after the pandemic outbreak. How has the Modi government continued to maintain its popularity? The government was among the earliest to institute lockdowns, even though these policies adversely affected India’s large migrant worker population.

The government’s high approval may also lie in how Modi delivered Bharatiya Janata Party (BJP) campaign promises related to Hindu nationalism, at the expense of India’s Muslim minority. Last year, the government scrapped Article 370 and Article 35A of the Indian constitution that gave Jammu and Kashmir special status. Last month, Modi inaugurated the Ram mandir. This Hindu temple, to be built on the grounds of a mosque destroyed in the historic city of Ayodhya in 1992, has been on his BJP agenda since the 1990s.

The public may see the government’s coronavirus response in the broader context of its success in fulfilling BJP supporters’ Hindu nationalist aspirations. As India confronts the health and economic consequences of covid-19, the government is likely to continue appealing to identity politics as a strategy of deflection.

Suparna Chaudhry is an assistant professor of international affairs at Lewis & Clark College. Shubha Kamala Prasad is a Max Weber Fellow at European University Institute.

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