India in lockdown: "a difficult time"

A large chunk of those who need the most healthcare aid live in the world’s second most populous country - India. And while India has had less than 10,000 confirmed cases so far, they’ve still gone into lockdown - like many African countries in similar positions - to preemptively stop the coronavirus wreaking havoc across the nation. Lalit Kant is an epidemiologist advising the Public Health Foundation of India, and he gave Phil Sansom an idea of the consequences...

Lalit - India is going through a difficult time. We are entering into a period where the government had instituted a strong lockdown. Trains were stopped, the bus stopped, the aeroplanes were stopped. The bordes, were all sealed. 17% of cases come from one single state, also from that state come around 41% of total deaths - Maharashtra. But there are states in India which have a slow growth rate.

Phil - Here in the UK the government's actions have been based, for better or worse, on these modelling studies. Has the Indian government been following something similar?

Lalit - Well there's been advice given to the government of India by different modeling groups and they paint a very stark picture. And at the peak there might be 100 million people infected; 10 million are expected to be, you know, bad. And then they did another scenario that said between 15 May and 30 May we'll get about 1 million cases, 30,000 deaths. All the mathematical models are as good as the input that you have to put into it. But at least we have some indication to go by.

Phil - Those are some staggeringly high potential numbers though.

Lalit - India has its own problems, you know. The population is big; density of population is high. We have a huge slum population - 20% of our population may be below the poverty line. We have a public health system which is not very effective. We have a poor surveillance system. People have lot of blood pressure, cardiovascular disease, diabetes; great challenges that we need to address.

Phil - Are there any plans for how to address those right now?

Lalit - The government is taking the battle to where the enemy is. Hand to hand combat. And India's fight could make or break the global war. We have a good capacity to test but the government of India has always been criticised for testing too a smaller number, so they want to make up by increasing that. And the government has also developed a cluster containment plan where the entire focus would be on those areas where there is community transmission happening. And the government has also put in place an economic package. Stadia are being converted, banquet halls are being converted, the ventilators are being procured. Many of these industries have started to make ventilators and the government of India is also importing large numbers of equipment. I think putting everything together we should be able to manage it.

Phil - And what about this 20% of people living in poverty? How are they handling this need to wash your hands, the need to stay a little bit apart, if you live without much to your name, and so close together?

Lalit - It's a big challenge. Bombay for example, they have a slum area called Dharavi, 10 to 12 people live in small tin hutments, so 10 by 10. If people have to spend money to buy water, 80 people share one toilet, then you know, observing all these things becomes difficult and therefore we need to put all our attention there so we are able to increase the testing and isolate those who are positive.