The government has announced it is lifting the lockdown in many sectors, and India’s working population, the youngest in the world, will not only be able to put the economy back on track, but will also be our warriors in the fight against Covid-19.
After sectoral easing, India now has to plan how to ease the lockdown for sectors such as retail and informal workers. A critical component of getting the economy back on its feet is to plan to get consumers to step out of their houses. Again, India’s young population will be its greatest asset.
In a recent interview, noted epidemiologist Dr Jayaprakash Muliyil made a case for a strategy for acquiring herd immunity. A lockdown is a way to buy time, but when the lockdown is opened, the virus could emerge again.
Dr Muliyil argues that we should protect the elderly, while sending the young out. If the elderly can be protected for a period of, say, six months, till the virus runs through the young population, they will also be safer, as the virus will not be able to jump from person to person due to lack of susceptible carriers.
Since we cannot stay in lockdown forever, or even for the months it may take for a vaccine to develop, thinking about developing immunity is critical.
We do not know the share of the population, or the threshold, required for acquiring herd immunity from Covid-19. But beyond a point, when most of the young — about 85 percent of the population — have acquired immunity to the virus, there will be no carriers.
Protecting the elderly will reduce need for critical care
The big question is: Is it possible for India to try to adopt this strategy when countries like the UK tried herd immunity, but then quickly went into lockdown? Yes, because of the difference in the age profile of the population.
While in the UK, Italy and China, the share of the population above 65 is between 20 to 25 per cent, and in the US, about 15 per cent, in India, the share is about 8.5 per cent. Most of the critically ill, as well as most deaths, are in this age category.
The government seems to be thinking along the same lines. In his speech on 14 April, the PM asked people to do seven things. The first of those was to protect the elderly.
In an advisory for senior citizens, the government has projected that there are 16 crore people above 60 years of age in India. The advisory includes dos and don’ts, such as washing hands, avoiding markets and not hugging their loved ones. These can be implemented by rich and poor alike.
India’s main strategy has been to reduce the burden on critical care, India’s most scarce resource. In addition to quarantining and testing patients, protecting the elderly will be an important element of India’s Covid-19 strategy. Once this is done, the need for critical care is expected to be lower.
India’s migrant workers have been quarantined for more than 21 days in densely populated dwellings. They could easily have had exposure to the virus as there was no social distancing among them. There have so far been no reported Covid-19 cases requiring critical care from these mostly young persons with few co-morbidities. In a strategy of easing the lockdown that takes demographics into account, they can be allowed to go back to work.
‘Young’ districts can open up faster
A phased strategy of regional removal of lockdown can be prepared based on this framework. Based on Census 2011, we can see the age profile of India’s districts. Today, there are 529 districts in India where 85 per cent of the population is below the age of 60.
Many of these are among the 353 districts identified as the ‘Green Zone’ by the government, where there are no Covid-19 cases. The very large share of the young population of these districts would qualify as those needing least critical care.
Among these districts, the elderly should continue to be protected. In India, the normal retirement age is 60. When offices and workplaces open after the lockdown, they will be populated mainly by the young. Those above 60 can be asked to stay at home. Even those below 60 can be given a choice, especially if they have any co-morbidities. This would help bring the economy back on track. While some among the young will get the virus, the need for critical care is likely to be limited, and we can ensure their recovery.
There are 58 districts in India where the share of the population above 60 is less than 10 per cent. They can be opened up right away. There are a total of 275 districts with less than 12.5 per cent elderly people. That can be the next step. The 529 districts with less than 15 per cent senior citizens can come next.
Most of the districts with the largest share of the elderly are in Kerala, and some in Tamil Nadu. Kerala has one of the best health systems in the country and has so far had a low death rate and high recovery rate.
Another key advantage India has over, say, the UK, whose critical care system got overburdened, is that owing to the early lockdown, people are more aware about the virus and will be more likely to observe precautions. At the end of the day, maintaining personal distance, washing hands, wearing masks for the elderly is something that only families and individuals can implement.
The overriding question today is how people can start earning their living while the hospitals in India can cope and lives can be saved. The longer-term question is to defeat the coronavirus by acquiring immunity against it. In the absence of a vaccine, the young are India’s corona soldiers. Their immunity will prevent the spread of the virus.
The author is an economist and a professor at the National Institute of Public Finance and Policy. Views are personal.
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