Jammu and Kashmir police officers force people to duck into a circle marked to maintain social distance this March

India, impossible confinement

Experts fear that it is impossible to control the spread of the virus in a population of 1.3 billion people and that the health system will collapse

Delhi woke up on Wednesday wrapped in a strange silence. The inhabitants of the chaotic city woke up surprised at the ghostly start of a three-week lockdown imposed on 1.3 billion people, who must obey and act responsibly to stop the spread of the coronavirus throughout the country. 

No trace of collapsed traffic; from the crowds crowded in the alleys of food markets; not a single rickshaw insight; closed tearooms; the missing food stalls and the bicycles, with their wicker baskets, piled in piles around the corners. No one was even seen praying. Empty Hindu temples, mosques and Sikh temples. 

The highways looked deserted, and the only people on the streets were police and paramilitaries setting up checkpoints. In front of some places like large grocery stores or hospitals, chalk circles on the floor made it clear that social distance when lining up is something to take seriously. 

Many people woke up to that image of emptiness and high uncertainty. They are not sure that they can survive confinement. In India, more than 300 million people live below the poverty line, eating just enough, with incomes that last for the day and no ability to save.  

Ram Yadav, 55, drives a rickshaw in North Delhi and shares a room with four other colleagues. They pay just over 12 euros a month. You feel overwhelmed and anxious. He doesn’t know how he’ll survive three weeks without an income, maybe more. “I have to pay the room, the rent for the rickshaw and I have a family to send money to. I don’t know how I’m going to do it. We are already boiling only rice with salt to eat.” Yadav also points out that in these overcrowded conditions, it is impossible to maintain any social distance. 

High population density and weak healthcare system

The consensus among experts is broad. Confinement is the most reasonable decision for a country like India, where the health system is inferior. The state only has 40,000 respirators, one doctor for every 11,600 inhabitants, one hospital bed for every 1,826 and one isolation bed for every 84,000 people. For now, the situation in India is not the same as in Europe or the United States. At the moment, about 600 cases have been registered, and there are ten dead people. But far fewer tests are being conducted than in other countries, only about 17,000 have been held.

Bhramar Mukherjee, professor of epidemiology at the University of Michigan and director of a group investigating the global spread of the coronavirus, says “India cannot take risks at this time. Even in the best scenarios shown by the projections, the health system, already very precarious, will collapse. Many people will die. ” The expert states that “we must increase the number of tests and look for realistic surveillance strategies. We have to prepare ourselves for a process that is going to belong.” 

In a densely populated country, where personal space is a luxury, Prime Minister Narendra Modi’s decision – a social distance and for people to “forget what it means to go out” – seems like an impossible request to fulfil. Sharing space is a fundamental part of the culture of India, a country where up to three generations of the same family usually live together, and millions of people gather daily to pray in their respective temples. At least 64 million people live in slums without hygiene measures or services. 

Doctors lack the means

There are already indications that India is beginning to falter under the weight of the number of coronavirus infections. A Calcutta doctor, who works in a hospital with infected people and prefers to remain anonymous, assures  The Guardian that the four doctors in his hospital have no choice but to work without the necessary protective equipment recommended by the World Health Organization. Health because the people in charge of the institution have not asked for them. 

“Like many other colleagues and paramedics, I am concerned that I am already infected and asymptomatic. That is stressful because I have continued to work with patients,” he regrets, adding that “after working directly with patients who we suspect may have coronavirus, I am confident that we will not be able to prevent the infection from spreading until the authorities do a lot more testing. “

“Many people who are susceptible to carrying the virus are not screened after coming to the hospital with symptoms. Many others do not even come to the hospital,” he says.

The picture is just as chaotic in the state of Bihar, which at the moment registers about 50 cases of coronavirus. At least one person, a man who returned from Qatar, has died. Dr Ajay Kumar Bharti, the chief physician at Sadar Hospital, where the patient died, says they are not equipped to deal with the virus safely. “There are no surgical masks. We have asked a tailor to make 5,000 of us cloth and make them quickly.” 

Before confinement was imposed across the country, some states had already begun sealing their borders. The railways, which move more than 20 million people a day, stopped circulating. Tens of thousands of workers returned to their places of origin from states like Kerala and Maharashtra, centres of the coronavirus outbreak. The fear that the virus has already spread throughout the country is real. 

Dr Rajiv Rajan, a public health expert, denounces that “the number of beds available in hospitals is not enough. The alarms will go off when the sick begin to arrive at hospitals.”

For the inhabitants of Jammu and Kashmir, the measure announced by Modi refers to a family fear. Since the government suspended the special status of the territory in October and divided it into two areas, confinement is already part of its daily reality. The repression suffered in the last six months has weakened many essential services, including health.

Kashmir’s health system does not currently have the necessary personnel or equipment to deal with the spread of a virus. The rate of patients per doctor is the worst in the country; there are very few nurses and only 100 ventilators for a population of 12 million people. 

“What we are doing is taking preventive measures to control and isolate the virus. God save us if we receive many patients or very sick patients. The service will be saturated in a matter of hours,” explains one of the doctors from a hospital in Srinagar. “We have a few fans. Between 50 and 100. And they are busy. If it happens, it will be a nightmare.” 

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