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Table of Contents
OVERVIEW
Year : 2020  |  Volume : 17  |  Issue : 3  |  Page : 136-138

Impact of the COVID-19 pandemic on India


Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, India

Date of Submission21-Aug-2020
Date of Decision31-Aug-2020
Date of Acceptance31-Aug-2020
Date of Web Publication03-Sep-2020

Correspondence Address:
Y S Suresh Babu
Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/am.am_106_20

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  Abstract 


The COVID-19 pandemic has posed a devastating effect on humankind across the world. Its rapid spread is the result of it being a highly contagious viral pathogen. Its spread in India is universal, and nearly 3 million people have been affected, to date. Fortunately, the reported direct death rates have been around 2%, and recovery rates being >70% are promising indicators. The multiple lockdowns by the Government of India have helped in gearing up the health-care sector and significantly improving the availability of personal protection gears and medicine, availability of beds, and training of the health-care workers to deal with this dreaded disease.

Keywords: Coronavirus, COVID-19, India, mortality, pandemic, viral infection


How to cite this article:
Vaishya R, Vaish A, Suresh Babu Y S. Impact of the COVID-19 pandemic on India. Apollo Med 2020;17:136-8

How to cite this URL:
Vaishya R, Vaish A, Suresh Babu Y S. Impact of the COVID-19 pandemic on India. Apollo Med [serial online] 2020 [cited 2020 Oct 31];17:136-8. Available from: https://www.apollomedicine.org/text.asp?2020/17/3/136/294323


  Introduction Top


Pandemics are large-scale outbreaks of infectious diseases transgressing geographical and demographic borders to involve large parts of the world.[1] The pandemic differs from an epidemic in the scale of geographic spread and demographic affection. The majority of the pandemics in the present century have been zoonotic viruses entering the human population through domesticated animals (farmed swine and poultry) and wildlife (bushmeat and habitat encroachments).[2] The influenza viruses have been responsible for most pandemics because of their higher mutations and adaptability to human–human transmission. The present pandemic of Coronavirus (torovirus) is an RNA virus consisting of four subtypes – alpha, beta, gamma, and delta. It is responsible for seven reported and described diseases in humans, which are the 229E, NL63, OC43, HKU1, Middle East respiratory syndrome coronavirus, and severe acute respiratory syndrome-CoV-2 (SARS-CoV-2) (COVID-19), the latter three being essentially zoonotic.[3]

The present pandemic is caused by the SARS-CoV-2 virus. It originated in the Chinese Province of Wuhan in December 2019, and has since spread to affect the entire world and has assumed the proportions of a global pandemic affecting more than 22 million and responsible for around 800,000 deaths, as on August 21, 2020.[4] The first recorded case in India was reported from the Indian state of Kerala in mid-March 2020. Since then, it has spread widely throughout India, which is now the third-largest affected country with 2.8 million affected population with an estimated death of more than 53,000 people.[5] Jain et al. have suggested several reasons for the differentially lower mortality rates in the Indian population, as compared to that of the Western population.[6] The reported rate of recovery in India is, however, healthy at 73%, and the death rates are just below 2%. India is in the human-to-human transmission phase of this pandemic, with potential for wider spread notwithstanding the monsoons, large migratory workforce, high poverty rates, the prevalence of malnutrition, poor public sanitation, and weak health infrastructure.[7] The Government of India enforced several lockdowns during this pandemic. These have helped in delaying the peak of coronavirus infection and in reducing the overall mortality. Moreover, these lockdowns have helped the depleted health-care facilities to upgrade themselves in dealing with a huge number of patients and increased testing of the people in the society.


  Characteristics and Challenges of the Covid-19 Pandemic Top


The COVID-19 pandemic is similar to any other pandemic in its character but is unlike any tragedy the present generation of humankind has witnessed in any sphere of life.

The characteristics and challenges from an Indian perspective are as follows:

  1. Rapid spread: It should be considered inevitable, and no part of the country or population can claim to be immune from the pandemic. Owing to the high proportion of the immunologically virgin nonimmune population, the present trends in travel, trade, and migration patterns will only send the statistics on an upward spiral[8]
  2. Overburdened health-care infrastructure: As the pandemic spreads, more people get sick and seek medical care; it, therefore, places huge stress on an already-stretched and fragile health-care infrastructure. There is also an acute shortage of staff, facilities, hospital beds, and equipment in the public sector to cope with the pandemic. The private health sector is largely inadequate as they are concentrated in urban geographies, and the cost of care is beyond the reach of the majority populace[9]
  3. Rising death rates: The direct death rate from COVID-19 infections is just below 2%. Although statistically it seems moderate, in actual numbers, they are quite significant.[10] Furthermore, they are compounded by the growing elderly population with associated comorbidities, with India being the diabetic capital of the world, and an increase in lifestyle diseases such as coronary artery diseases and obesity. Indirect deaths are due to diseases other than COVID-19 but attributable to the consequences of the pandemic primarily as people refrain from seeking medical help for other diseases for fear of venturing out and secondly due to diversification of resources to fight the pandemic, creating a relative scarcity of health infrastructure to treat chronic illnesses[11]
  4. Inadequate medical supplies: Although the problem of medical supplies was acute, during the initial stages of the pandemic, it has been addressed to a larger extent through the better supply chain by improved procurement and stockpiling of necessary and essential medicines and personal protection kits by scaling up of indigenous production.[12] The shortfall in the availability of manpower and high-end equipment like ventilators is to be addressed, especially in the rural and quasi-urban centers. The development of suitable vaccines is still not on the horizon and may take a long time before anything substantial breakthrough, owing to logistical and technical constraints[13]
  5. Socioeconomic impact: Frequent lockdowns, containment measures, absence of economic activity, job losses, sickness absenteeism, travel restrictions, and closure of educational institutions and business establishments have had a serious impact on the socioeconomic fabric of the society.[14] Reduced individual and household incomes and cut in industrial productivity have affected government revenues, growth rates of the economy, and national gross domestic product rates.[15]



  Long-Term Implications of the Covid-19 Pandemic Top


  1. Social: This pandemic hopefully will bring about a change in social practices such as better respiratory and hand hygiene, use of face masks in public places, sustainable land use, afforestation, better animal husbandry and poultry farming techniques, and maintaining and protecting the sanctity of wildlife habitats[16]
  2. Surveillance and reporting of zoonotic diseases have to be strengthened by the institutionalization of surveillance programs[16]
  3. Health expenditure planning: budgetary and contingency allocation has to be made to manage future challenges that could be posed by zoonotic epidemics[17]
  4. Research into vaccine development: Priority expenditure and fast-tracking of vaccine development and minimum stockpiling should be considered[17]
  5. Travel culture: Nonessential travel may be reduced significantly in the near future[18]
  6. Economic impact: National and household incomes will be significantly reduced, and therefore expenditure should be prioritized. The existing government health schemes and disease eradication programs may suffer from the want of adequate budgetary allocation. Complacency may creep in the management of flagship programs such as the Tuberculosis Eradication Program, Universal Childhood Immunization, AIDS Control Program, and Integrated Child Development Programs. We should be vigilant not to lower our guard in our fight against other communicable diseases.[19]



  Responses to the Pandemic Top


  1. With the pandemic in the phase of human-to-human transmission community, the spread is a reality, and efforts to mitigate the pandemic should be both at the international and domestic fronts. This can be in the form of international travel restrictions, concerted efforts to develop a vaccine, and risk transfer from low-income to high-income economies in the form of subsidies, workforce training, and funding of health outreach and infection containment programs.[16] Subsidization and prioritization of resources toward the economically weak nations and hotspot areas with inadequate institutional supports is the need of the hour[20]
  2. Risk communication to the masses through the instruments of public broadcasters and social media helps in widening the outreach of government schemes and countering misinformation.[21] Dissemination of information on personal hygiene, use of face masks, avoidance of high-risk behavior, and care of the infected and high-risk groups is paramount in our efforts to contain the pandemic[22]
  3. Widening the coverage of Ayushman Bharat Health Insurance Scheme, Public-Private partnerships, universal surveillance, and reporting of new infections, mass production of testing kits, increasing the testing capacities, containing spark or hotspot zones, and enforcing social distancing measures such as patient isolation and quarantining are essential strategies in the management of the pandemic.[23] The present infrastructure should be scaled up to meet the surging demand for health-care resources.


There are several problems that are unique to developing economies like India. These include poverty, low level of sanitation, high population densities in urban areas, a burgeoning population, malnutrition, and the presence of high level of comorbidities among the elderly. The responsibilities and problems in our fight against this pandemic are thus made more difficult. The multiple lockdowns by the Government of India have helped in gearing up the health-care sector and significantly improving the availability of personal protection gears and medicine, availability of beds, and training of the health-care workers to deal with this dreaded disease. We have the demographic advantages of a young and enterprising population, a stable and determined political dispensation, and a native pool of talented scientific community, which is equipped to see us through these difficult times and overcome this pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: Risks, Impacts, and Mitigation. In: Disease Control Priorities: Improving Health and Reducing Poverty. Ch. 17, 3rd ed. Washington (DC): The International Bank for Reconstruction and Development/The World Bank; 2017.  Back to cited text no. 1
    
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Oxford Martin Programme On The Illegal Wildlife Trade, Science ICFC. Position Statement: Managing Wildlife Trade in the Context of Covid- 19 and Future Zoonotic Pandemics; 2020.  Back to cited text no. 2
    
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Matthews PC, Beloukas A, Malik A, Carlson JM, Jooste P, Ogwu A, et al. Prevalence and Characteristics of Hepatitis B Virus (HBV) Coinfection among HIV- Positive Women in South Africa and Botswana. PLoS One 2015;10:e0134037.  Back to cited text no. 3
    
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Perez JC. Wuhan Covid- 19 synthetic origins and evolution. Int J Res- Granthaalayah 2020;8(2):285- 324.  Back to cited text no. 4
    
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Coronavirus in India: Coronavirus India Latest News, Coronavirus death toll in India, total coronavirus cases in India. Available from: https://economictimes.indiatimes.com/news/coronavirus- in- india. [Last accessed on 2020 Aug 20].  Back to cited text no. 5
    
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Jain VK, Iyengar K, Vaish A, Vaishya R. Differential mortality in COVID- 19 patients from India and western countries. Diabetes Metab Syndr 2020;14:1037- 41.  Back to cited text no. 6
    
7.
COVID- 19 pandemic death rates by country; 2020. Available from: https://en.wikipedia.org/wiki/COVID- 19_pandemic_death_rates_by_country. [Last accessed on 2020 Aug 20].  Back to cited text no. 7
    
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Ranjan R. COVID- 19 Spread in India: Dynamics, Modeling, and Future Projections; 2020.  Back to cited text no. 8
    
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Sahoo H, Mandal C, Mishra S, Banerjee S. Burden of COVID- 19 Pandemic in India: Perspectives from Health Infrastructure; 2020.  Back to cited text no. 9
    
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Labib PL, Aroori S. Expanding the definition of covid- 19 deaths will show the true effect of the pandemic. BMJ 2020;369:m2153.  Back to cited text no. 11
    
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Flynn SE. The COVID-19 Pandemic: Implications for Critical Infrastructure. Journal of Critical Infrastructure Policy 2020;1:36-41.  Back to cited text no. 12
    
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Caddy S. Developing a vaccine for covid- 19. BMJ 2020;369:m1790.  Back to cited text no. 13
    
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Dhatrak SP. The socio-economic impact of Covid- 19 or corona pandemic in India. Shanlax Int J Arts Sci Humanities 2020;8:84- 8.  Back to cited text no. 14
    
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Elevation of Indian economy in the luminosity of Gandhiji's self reliant dogma after COVID- 19 Pandemic. Adalya J 2020;9:21-5.  Back to cited text no. 15
    
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Koul PA, Dhar R. COVID- 19 pandemic in India: A clarion call for better preparedness. Lung India 2020;37:187- 9.  Back to cited text no. 16
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Frank L, Concannon T, Patel K. Health Care Resource Allocation Decision making During a Pandemic; 2020.  Back to cited text no. 17
    
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Allam Z. Oil, Health Equipment, and Trade: Revisiting Political Economy and International Relations During the COVID- 19 Pandemic. Elsevier P, Australia: Surveying the Covid- 19 Pandemic and its Implications; 2020. p. 119- 27.  Back to cited text no. 18
    
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Banerjee B. National Health Policy 2002. Jaypee Brothers Medical P, New Delhi: DK Taneja's Health Policies and Programmes in India; 2017.  Back to cited text no. 19
    
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Perappadan BS. Coronavirus | How is India containing COVID-19? The Hindu. Ernakkulam; 2020. P. 8. www.thehindu.com.  Back to cited text no. 20
    
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Frank L, Concannon T, Patel K. Health Care Resource Allocation Decision making During a Pandemic; 2020.  Back to cited text no. 21
    
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Vaezi A, Javanmard SH, Infodemic and risk communication in the era of CoV-19. Adv Biomed Re 2020;9:10.  Back to cited text no. 22
    
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