Social Distancing Is a Privilege

On March 24, Indian Prime Minister Narendra Modi announced a complete nationwide lockdown for 21 days—one of the strongest national measures to prevent the spread of the coronavirus. The decision marked a sharp turn. Just a week ago, the world’s second-most populous country was being seen as a mysterious anomaly that had remained relatively unscathed from the deadly pandemic. But then the math caught up. As the lockdown began, the number of confirmed cases in the country was beginning to grow exponentially, rising to 933 by March 28.

While New Delhi has taken decisive action, there are fears it has come too late and that too many of the country’s poor and homeless will be left exposed. The World Health Organization (WHO) declared the spread of COVID-19, the disease caused by the virus, a pandemic as long ago as March 11. Back then, India refused to label it a health emergency, and large parts of the country continued about business as usual. Even now, the entire country has tested fewer than 30,000 people, representing one of the lowest testing rates in the world.

Ramanan Laxminarayan, a leading public health expert and the director of the U.S.-based Center for Disease Dynamics, Economics, and Policy, projects that despite the lockdown, the peak of the pandemic will likely hit India by late April or early May and that around a million people will need hospital beds and critical care at that point. This is where disaster could strike. India has just 0.5 hospital beds per 1,000 people (Italy has more than six times as many) and spends just 3.7 percent of its GDP on health (the United States spends 17 percent of its GDP on health care). Meanwhile New Delhi has allotted large sums of money to build the world’s tallest statues in an obnoxious display of nationalism.

Last year, Yogi Adityanath, the chief minister of Uttar Pradesh, India’s most populous state, put aside $91 million for the construction of a statue of the Hindu deity Ram even as hundreds of people in his state had died of encephalitis in the last few years, with key emergency facilities lacking necessary oxygen cylinders. Adityanath’s stated aim was to build a statue taller than the 597-foot one of the freedom fighter Sardar Vallabhbhai Patel, inaugurated by Modi in 2018, which cost $400 million.

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It is not just a long-standing misallocation of funds that is the problem. Even when Modi announced his lockdown on March 24—with no mention of how people would get their daily supplies—his words sparked panic. People rushed to the streets in large numbers before Modi could finish his speech. Pharmacies were swarmed with nervous faces; social distancing was quickly forgotten. At supermarkets, anxious families stocked up on essential commodities. Milk and eggs disappeared from the shelves. But while the privileged—a tiny minority in India—were stocking their refrigerators with weeks of supplies, the country’s daily wage workers and laborers were flocking to their hometowns, often barefoot, some with their infants tied to their backs and young children crying in tow as police beat them mercilessly for flouting curfew rules.

“If I do not go out for a week, my children and my wife will die.”

In Mumbai, the country’s financial capital, some 300 migrant workers crammed themselves in food container trucks so they could reach home away from the scrutiny of baton-wielding police. The heart-wrenching images of young men, with sweaty, bare bodies making their way out of the claustrophobic containers, made headlines on the country’s TV channels.

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In neighboring Dharavi, Asia’s largest slum with a population of 1 million in an area of less than a square mile, workers laughed when I asked them if they had been practicing social distancing. As I stood outside a hovel, trying to keep some distance from people the day after Modi’s lockdown order was announced, even talking about social distancing felt obscene near a room of eight people crammed together with barely any space to breathe.

Ghanshyam Lal, a migrant laborer who works in a Mumbai tannery, has been feeding a family of eight on his daily wage of $3 a day. He told me he didn’t care about the virus as much as he did about putting food on the table. And he worried about his wife, Asha, who was on dialysis at a government hospital and may now be booted out to make way for wealthier patients who had tested positive for the coronavirus. “How easy it is for the prime minister to say do not step out of your houses,” he said. “If I do not go out for a week, my children and my wife will die.”

Lal’s fears are not exaggerated. In a city with a population of 20 million, the government hospitals have only 400 ventilators and a thousand beds for intensive care.

At Mumbai’s Kasturba Gandhi Hospital, which is taking the bulk of patients who have tested positive for the coronavirus, doctors told me that their neighbors have distanced themselves from the doctors’ families. “We are saving lives. We are breaking down in the bathrooms while we are being treated like untouchables outside of the hospital premises,” said one young doctor who wished to stay anonymous.

On Sunday, March 22, wealthy Indians came out on their balconies clapping and banging utensils to mark a national day of curfew. “Modi, Modi,” they chanted. But it was a misplaced celebration of nationalism. It also highlighted a fundamental divide in the country. On the one hand, there is the country’s upper-middle class, the elite that has stocked hand sanitizer, mango puree, and ground coffee and is posting patriotic selfies on social media. But a much larger underclass, the country’s poor and struggling, is battling poverty, has no access to soap, water, or toilets, and is living in packed clusters in slums. These same people are extremely vulnerable to the virus; for them, social distancing is a curious privilege. Read More Can India Avert a Health Apocalypse? The world’s largest democracy is particularly vulnerable to infectious diseases—but history shows it can be surprisingly resilient. Argument | Sumit Ganguly Why India’s Muslims Are in Grave Danger An expert on communal riots says the country may well be witnessing the start of a larger pogrom. Q&A | Ravi Agrawal

The unpreparedness of India’s health care and social system to deal with the pandemic is aggravated by an indifferent law enforcement that deploys brutal force against its people. On March 25, as the lockdown began, a 32-year-old man was beaten to death by police in West Bengal when he stepped out to buy milk for his family. And when police are not brutalizing the poor, they are being indifferent to the migrant laborers who are walking miles from one state to the other, trying to reach their families on empty stomachs and with no public transport. Their cries are falling on deaf ears. Rahul Musahar, an 11-year-old boy who used to work with his father collecting scrap every day, was shifted to a government hospital in Bhojpur district in Bihar this week. Musahar had not eaten food in three days. His mother, who is pregnant with her second child, tried desperately to feed herself and her son. Because of the lockdown, Musahar’s father, who would earn just enough money to survive a day, could not arrange for a meal. Musahar died on return from the hospital, not killed by the virus but by hunger—which could potentially kill many in India if the government does not take immediate measures.

While the world was stocking up on masks and gloves, India was busy dousing communal fire stoked by its own government.

Could India have been better prepared? Last month, while much of the world—including next-door neighbor China—was raising the alarm about the fast-spreading coronavirus, India was making global headlines for a bloody carnage in the country’s capital in which 54 people were killed and hundreds injured. And all of it was spawned by hate speech by top-ranking ministers in Modi’s cabinet. The city’s police watched on. While the world was stocking up on masks and gloves, India was busy dousing communal fire stoked by its own government.

Thousands of families displaced in New Delhi’s violence—with their kin in hospitals and their livelihoods destroyed—were living in temporary relief camps in the capital. Then, as the country suddenly woke up to the threat of COVID-19, the camps were abruptly razed to the ground. The victims were left with no help.

A country that is already grappling with its worst unemployment rate in decades and a rising and divisive nationalism now must deal with a pandemic that will strike a major blow to its economy—especially for its so-called informal workers who have no health care, benefits, or safety nets to fall back on. WHO has said India has a major role to play in containing the pandemic—after all, it is home to one-sixth of the world’s population. And while New Delhi’s decision to lock down has been belated, it has the potential to minimize damage: With all forms of public transport canceled, included domestic and international airlines, travel and co-mingling will be sharply reduced. But a bold stroke like this needs to be accompanied with a healing hand for the economically and socially disadvantaged. The next few weeks will be crucial for all of India but especially for its poor.