Coronavirus in India: How Many Deaths Before We Cancel ‘Alarmist’?

How many deaths do we need before the debate on ‘maximum good for maximum number of people’ even starts?

Updated14 Mar 2020, 06:03 AM IST
Opinion
5 min read

India has its first coronavirus fatality. How many more deaths will it take before we stop calling the prevention methods and messaging “alarmist”? In an attempt to allay fears about the coronavirus outbreak in India, an AIIMS doctor writes thus about the Asian Flu pandemic of 1957: “The pandemic saw a total of just 1,098 deaths in the country.”

Just 1,098. Just.

The author—like many other commentators, policy-makers, and even idle- babblers—has tried to alert readers to the fact that many more people die every year of malnutrition or other ailments like tuberculosis. Bloodbaths at Wall Street and Dalal Street are also seen as equally deadly if not more, than the pandemic. Of course, this is no apocalypse even though at least three out of 100 people contracting this highly contagious infection are sure to die. And the remaining 97 will add significant burden to India’s already broken healthcare systems.

Three in 100 is the rate of mortality but in the elderly the number is very high—21 percent according to some studies—and most adults do have some form of hypertension, diabetes, lung issues et al. Let’s not forget that India is the hypertension capital of the world.

Let’s Talk About Deaths: Coronavirus or Otherwise

It is always interesting to note how a nation undergoes a process of self-constitution during moments of crisis. The narrative is usually built on the subordination of truth and selective forgetting of past. This also means building a hierarchy of tragedies, and thus, of people involved in them.

Let us assume that we had stellar data collection and retention mechanisms back in the 1950s. Let us also assume that our data can be trusted and reports are never fudged or misread or made up. Let us talk about deaths.

India’s capital is still reeling under the effects of communal violence that claimed at least 53 lives. Would we dare prefix ‘just’ before this number? After all, looking at the population of India, it is but a drop in the ocean. And communal/majoritarian violence in other parts of the world have snuffed a really steep number of lives. Will comparing the killing fields of Pol Pot in Cambodia or the concentration camps of Nazi Germany with the victims of North East Delhi violence lessen the pain suffered by those who lost their family members? Will the State be allowed to wash its hands off saying that communal acrimony is not apocalyptic since more people die of cancer or tuberculosis or even in road accidents every year than the number of victims of communal violence?

But talking about precautions to contain coronavirus is paranoia.

Coronavirus and the ‘Trolley Problem’

How many deaths do we need before the debate on ‘maximum good for maximum number of people’ even starts? No, the famous ‘trolley problem’ in ethics is nowhere near resolution but we need to, as a society, at least think of how many lives are we willing to lose before extreme measures can be taken. And it is perfectly legitimate for societies and establishments to make that choice.

Shutdowns and lockdowns come with a price tag. We cannot refute that our immediate actions do not have long-term or long-distance effects. The ethical theory of ‘consequentialism’, tells us to measure the consequences of our intended actions. For that it is important to have a finish line in mind.

How long, indeed, is ‘long-term’ and what is its scope? Whose ‘greater good’ do we have in mind while considering a particular course of action?

Jeremy Bentham had recommended that greater good needs to be calculated as accumulating over time as the product of intensity and duration. Yet, we cannot predict anything for sure.

The ‘deontological’ approach, in contrast, would necessitate doing what is right, right now. It would take into account that there is no hierarchy of rights or even lives. This ethical framework suggests that “the morality of an action should be based on whether that action itself is right or wrong under a series of rules”.

It is okay if we follow the consequential approach and not think of saving the elderly and the ailing for the ‘greater good’. But lets be at least realistic about it.

Coronavirus ‘Panic’ in India is Not Unfounded

“A fire on your stove you could put out with a fire extinguisher, but if your kitchen is ablaze, that fire extinguisher probably won’t work,” said Dr. Carter Mecher, a senior medical adviser for public health at the Department of Veterans Affairs and a former director of medical preparedness policy at the White House during the Obama and Bush administrations. “Communities that pull the fire extinguisher early are much more effective.”

The above extract from a New York Times report on the worst case estimates for coronavirus deaths in the US is of note. Dr Mecher further states, “By the time you have a death in the community, you have a lot of cases already. It’s giving you insight into where the epidemic was, not where it is, when you have something fast moving.”

So no, our fears with respect to the spread of the contagion are not unfounded. We are already too late in our response. Given Indian population’s health indices and the state of our healthcare, we can rest assured that our worst-case estimates could be higher than that of the US. Let us not ignore our peculiar circumstances. Air pollution has significantly impacted our immune system. India’s socio-genetic advantage— whatever that is—may not keep us safe even if we attempt to boost it with blessings, home remedies, or totems.

Indian Government’s Reaction is Not Knee-Jerk This Time

Iran, after desperately trying to hide the cases till something hit the fan, has now asked the IMF for an emergency fund of USD 5 Billion to deal with the pandemic. Germany’s Chancellor has publicly stated that at least 70% of the country’s population will be infected. French President Emmanuel Macron said, “What we are living is a true world crisis.” Rishi Sunak, the new Chancellor of the Exchequer of Britain has said the pandemic would have “a significant impact” on the country’s economy. Despite Britain’s exemplary National Health Service that has shown itself to be proficient in identifying and isolating infected persons, the cases are expected to multiply.

Indian government’s insistence on precautions cannot be ridiculed or sneered at, at least this once.

Are we prepared to be sucked in by the gyre of economic distress should a significant part of our population fall prey to coronavirus? Of course, just 3% of us will die, mostly the old and the ailing. But is the economy ready to bear the healthcare costs and productivity loss on account of the rest 97%?

If the answer is yes, this may not be an apocalypse. And we can make merry as usual.

Liked this story? We'll send you more. Subscribe to The Quint's newsletter and get selected stories delivered to your inbox every day. Click to get started.

The Quint is available on Telegram & WhatsApp too, click to join.

Published: 13 Mar 2020, 01:51 PM IST
Stay Updated

Subscribe To Our Daily Newsletter And Get News Delivered Straight To Your Inbox.

Join over 120,000 subscribers!