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newsaajtak2021 · 4 years ago

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Gujarat: Over 100 black fungus cases, government announces separate wards for patients

On Saturday, the state government announced that it has placed an order for 5,000 injections of the antifungal drug, Amphotericin-B, at a cost of Rs 3.12 crore, used in the treatment of the fungal infection.

With an alarming increase in mucormycosis cases, a fungal infection as a post-coronavirus complication, the state government in a core-committee meeting under Chief Minister Vijay Rupani on Saturday announced that all government civil hospitals, especially in Ahmedabad, Vadodara, Surat, Rajkot, Bhavnagar, and Jamnagar, where high incidence of the infection has been noted, will set up separate wards for treatment of such patients.

More than 100 cases of mucormycosis, also known as black fungus, have been notified across state government hospitals and Gujarat Medical Education Research Society (GMERS) hospitals, the government said. Currently, Ahmedabad’s Zydus Hospital has around 40 such patients while Vadodara’s SSG hospital is treating 35 patients.

In Ahmedabad’s Civil Hospital at Asarwa, 19 patients are undergoing treatment at the two wards, with 60 beds each, which have been created for treating mucormycosis patients.

Also Read |Mucormycosis cases rising, keep diabetes in check, Ahmedabad doctors warn

Earlier, on April 22, at a press conference organised by the state’s task force of medical experts in Gandhinagar, Dr VN Shah, the director at Zydus Hospital in Ahmedabad, had said within a span of two days the hospital had seen nearly 10 patients of mucormycosis and, overall, the private hospital was seeing an alarmingly high number of mucormycosis cases.

However, as the infection is not categorised as a communicable disease, the state health department does not maintain a public record of the same, unless individually notified by hospitals.

Leader of Opposition and Congress MLA Paresh Dhanani on Saturday also wrote to the chief minister requesting that sufficient stock of the Amphotericin-B injections be replenished at hospitals as shortages are being reported at several places.

Besides the antifungal injection, treatment can include surgical intervention and control over diabetes, with the latter especially aimed at avoiding a relapse of the infection.

As per the state health department, symptoms depend on where the fungus was growing in the body. If the growth is on the sinus and brain region, symptoms can include one-sided facial swelling, headache, nasal or sinus congestion, fever, and black lesions on the nasal bridge or upper inside of the mouth that can quickly become more severe. It may also lead to eye pain and ultimately result in loss of vision if not treated immediately. If in the lung, symptoms may include fever, cough, chest pain and shortness of breath.

Skin mucormycosis can look like blisters or ulcers and the infected area may turn black. Gastrointestinal mucormycosis may be indicated by abdominal pain, vomiting and gastrointestinal bleeding, doctors said.

Experts, based on the patient profile of mucormycosis, have repeatedly warned against excessive use of steroids, especially in those with uncontrolled diabetes. The infection which deteriorates rapidly, often utilises a compromised immune system, thus putting at greater risk those such as cancer patients, organ transplant patients, long-term steroid users, or those inhaling moist oxygen, malnourished or underdeveloped infants, and those who have had stem cell or bone marrow transplant.

Dental consultant at Zydus Hospital, Dr Prachi Desai, meanwhile, said currently there have been cases where patients without a medical history of diabetes or long-term steroid usage were being detected with mucormycosis.

“It is suspected that Remdesivir could be causing an imbalance in sugar levels, which may then lead to this. Recently, I had to operate and partially remove the lower jaw of a 60-year-old patient who was exhibiting all symptoms of mucormycosis but his biopsy and KOH microscopic examination — the only two tests to clinically detect mucormycosis — came negative. We operated going by the symptoms. When this jaw section that was removed was sent for a biopsy, the report came as positive for mucormycosis… We will be reconstructing the lower jaw with fibula (calf bone) and are hopeful that since it is the lower jaw, there won’t be any further spread.”

A hospital source said, liposomal Amphotericin-B, which is to be administered in mucormycosis patients with chronic kidney disease, was currently seeing a shortage in the drug market.

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The medical superintendent of Vadodara’s SSG, Dr Ranjan Aiyer, said, “Until now, the disease has been particularly prevalent in patients with uncontrolled diabetes. Patients are now given steroids during Covid-19 treatment, which is a life-saving drug. But some essential drugs also indirectly affect the body’s immunity. Mucormycosis spreads from the nose and the surrounding area to other places through the eye. So far, we have performed three orbital exenteration (extraction of the eyeball) on patients, whose eyes were severely affected due to the fungal infection.”

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reynoldsrap4949 · 4 years ago

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The year of COVID

Just a year ago I was flying to Taiwan, planning to meet my sister in Thailand, wondering

“Were we flying into the face a pandemic?”

On January 26, Taiwan suspended all air travel to and from China, and put in place quarantine measures for passengers who flew from China. I landed the next day, planning a 6 days stay before flying on to Thailand. There were just 6 Corona virus cases in both Taiwan and Thailand.

Taiwan,is an island with 23 million inhabitants, 8 million living in the densely populated metropolis of Taipai. On arrival everyone was masked. Adults, children, in the airport, on the Metro, busses, and indoor public places. I spoke no Chinese, the Taiwanese little English. I had packed masks so followed the Taiwanese lead and MASKED UP. Shops, transit, museums, restaurants were all open. Alcohol sanitizer featured prominently by entryways. People did not gather in my hotel lobby. They ate quietly in restaurants and noodle houses. Parks, gardens, open spaces saw unmasked faces. Chinese New Year was quiet.

I united with my sister in Chiang Mai, Thailand. Sunny skies, a more rural setting, open air restaurants, warm people, smoke from rice field burns. Rare masks were worn except Chinese tourists. More masks on bad air quality days. Thai massages, night markets, temples, elephant sanctuaries, travel in tuk-tuks and benches in crowded trucks. Little talk of Corona here.

A flight south to Surat Thani, off the grid and into Khao Sok National Park. Wild elephants, gibbons, hornbills. An international group gathered for Thai Yoga Massage Training. Had anyone of us been an unwitting asymptomatic carrier, this group could have spread the virus around the world as we returned home.

Two nights again in Taiwan before my flight home March 1. I am still debating my vote for the Primary Election. Airport security was heavier than on arrival six weeks before, passports checked to confirm no travel through China. Masks again everywhere. Some Asian travelers MASKED UP through the 14 hour flight home.

Beyond Customs, San Francisco airport was mostly maskless, as were people out and about.

I planned to voluntarily quarantine in our guest bedroom at home to protect family and community from any potential Corona Virus exposure.

Day 13 of my quarantine, I MASKED UP and went to Harvest for groceries. Nobody else wore a mask. I felt self conscious, wondering if shoppers thought I was sick. I felt the need to explain my mask to a friend.

My self-imposed quarantine ended March 15.

California became the first state to order a lockdown on March 20.

U.S. government masking recommendations were confusing. Ft Bragg streets were empty. Hotels were closed. Soon beach parking was blocked. Slowly locals began MASKING UP. The Corona Virus numbers grew.

By the end of March, the U.S (331 million people) had 59,502 cases (18/100,000) and 804 deaths from Coronavirus. With 23 million people, Taiwan had 235 cases (1/100,000) and 2 deaths. Thailand with 70 million people had 934 cases (1.3 per 100,000) and 4 deaths. Mendocino County with 88,000 people had only 3 cases and no deaths.

Taiwan and Thailand were doing somethings right. If a congested city like Taipei stayed open with relatively low numbers, I bought into their idea of masking up. Taiwan had experience with a SARs epidemic in 2002-4.

As U.S. cases climbed, evidence mounted—- Masks prevented transmission. Ever more people wore masks in public. Unfortunately many thought the epidemic was a hoax, that masks were inconvenient, looked silly. Some communities complied with MASKING more than others.

Essential workers could not avoid crowded essential work and homes, public transportation. Corona spread. Minorities, health care providers, nursing homes, church and other large gatherings were hard hit.

As of early Feb 5, 2021 California (39 million people) has reported 3.38 million cases,(8,667/100,000) and 8558 deaths total. Mendocino County (88,000 people) 3,513 cases or 4337/100,000 and 39 deaths, the North Coast (16,148 people) 366 cases or 2267/100,000.

Thailand 33 cases/100,000.

Taiwan to date —923 cases TOTAL!!!! That is4 cases and less than 1 death per 100,000. Taiwan acted early, tested, contact traced and isolated cases. They have universal health care. Citizens trust their government to put health first. Borders were closed to travelers without testing and quarantine but the economy never closed down. Might we benefit from studying their pandemic plan and management?

#COVID-19 #Coronavirus #Taiwan #Mendocino

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dionisiusdino · 5 years ago

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Pengalaman Semasa Lockdown

Halo teman2, sampe hari ini 16 Maret 2020 dari Italia aku masih memantau kondisi perkembangan persebaran Covid-19 di Indonesia beserta penanganan2nya (berhubung lockdown jadi tiap hari laptopan terus sambil kuliah online hehe). Secara garis besar aku kecewa dengan pola penanganan pemerintah baik dari pusat ke daerah, atau sebaliknya hingga saat ini.

Jadi aku putuskan untuk mencoba menulis kembali. Juga untuk berbagi pandangan aja soal perkembangan pola persebaran di Italia dan di Indonesia semoga membantu ya.

Sumber data tabel: https://statistichecoronavirus.it/coronavirus-italia/

Resiko terpapar tiap individu disini terus nambah (termasuk aku juga krn masih sama2 manusia) dan hampir tiap pagi dengar sirine ambulans, tetangga marah2, atau kadang saling tepuk tangan sapa2an sama tetangga lain dari balkon. Sejauh ini klo ngliat tabel tersebut sudah ada 27.980 kasus positif terinfeksi dari total 60 juta org, artinya peluang individu terinfeksi di Italia naik jd 0,043%. Dengan kematian hari ini total mencapai 2.158 orang, bertambah 349 orang yg meninggal dari kemaren fatality rate di Italy menjadi yang terbesar di dunia mencapai 7,71%, jauh melampaui China yang kini 3,8% (mari kita doakan bersama2 supaya arwahnya diberi tempat terbaik oleh Allah dan diampuni dosa-dosanya).

Sedangkan di Indonesia, sejauh ini tercatat ada 134 kasus dari total 264 juta penduduk. Berdasarkan hal tsb, jadi sejauh ini peluang untuk terinfeksi Covid-19 di Indonesia adalah 0,00005%. Mungkin ini disebut statistik, tapi 1 nyawa hilang akibat meninggal tetap tidak bisa dibandingkan dari sekedar inputan data angka +1 di grafis :(

Dinamika Fatality Rate di Italy (Sumber: dok. Zakky R Dzulfikar)

Mari kita ingat2, kalo luas 1 negara Italia (301.338 km2) bahkan nggak lebih luas dari Pulau Sumatera, atau butuh 30 kali lipat luasnya untuk bisa menyamai China. Indonesia sungguh negara besar, luas, dan jauh lebih padat dibandingkan Eropa, atau bisa dikatakan gabungan dari luas banyak negara2 Eropa. Ini membuat keprihatinanku jadi sangat besar dengan pola dan cara persebaran virus Covid-19, jika koordinasi pemerintah sangat carut-marut, bahkan tidak ada regulasi jelas hanya selalu himbauan. Kemenaker juga tidak bisa klasifikasi tenaga kerja di Indonesia yang dominan sektor informal untuk input regulasi, tumpang tindih aturan, pembatasan transportasi di Jakarta tanpa adanya tekanan regulasi ke perusahaan tempat kita bekerja dengan bersamaan / didahulukan. Sampai berita bahwa tempat wisata makin membeludak di Puncak ataupun rekreasi Pantai di Banten. Bahkan kawan lama di Tembagapura sudah ada yg kontak minta pendapat krn di Merauke sudah ada 1 kasus terinfeksi.

Aku mau membandingkan pola dulu, tertanggal 27 Februari lalu seluruh institusi pendidikan di Lombardy diliburkan 2 minggu sampai 9 Maret 2020 (POLA INI MIRIP DENGAN HIMBAUAN KEPALA DAERAH DI INDONESIA). Ketika pengumuman sampai, saya masih memantau bahkan berdebat dengan mahasiswa lokal di grup angkatan dan mereka selalu beropini, “This is just fucking flu, enjoy your life please, tetap keluar aja seperti biasa, angka kematian rendah, kalian jangan terlalu terbawa anxiety, dan membuat gaduh grup ini dengan obrolan virus tiap hari". Kubu2an pendapat kawan dari China, Iran, Argentina dengan kawan dari Italia pun terjadi, karena mereka di China juga berdasarkan pengalaman genting kondisi keluarga, jadi menganjurkan utk tetap di rumah dan selalu pake masker serta cuci tangan. Ketika itu teman2 Asian masih dianggap dapat info dari 'Bad Media' menurut beberapa teman lokal, meskipun angka terinfeksi di Italia telah mencapai 655 orang. Rentang tanggal 27 Feb - 9 Maret itu saya terus pantau, ketika keluar utk belanja (krn sy memutuskan berdiam diri dikosan saja kecuali keluar belanja, Xenophobia makin parah juga tidak hanya di Italia, kasus rasial terhadap Asian karena dianggap penyebar virus). Situasinya waktu itu banyak sekali warga lokal yg berkeliaran di jalan, seperti biasa seakan tidak ada wabah, bahkan tanpa masker (anjuran Pemerintah awalnya tak perlu menggunakan masker kecuali yg ada symptom atau tenaga medis).

Tapi seiring berjalannya waktu, kenyataan berkata lain, sangat bertolak belakang. Tanggal 7 Maret Pemerintah Italia memutuskan untuk lockdown area Lombardy (regional Italia utara termasuk Milan) beserta 11 provinsi lain termasuk kota saya tinggal (Piacenza), karena kasus semakin parah ekskalasi terinfeksi melonjak DRASTIS ke angka 5.883 orang, dan kematian 17 orang, HANYA DALAM 8 HARI. Sejak itu orang2 dijalan sudah mulai berkurang, tapi tetap saja ketika ketemu orang2 di Supermarket, warga lokal sangat sedikit yang menggunakan masker, padahal di website resmi region Lombardy sudah dianjurkan untuk penggunaan masker atau merevisi peraturan awal (menurut saya pribadi tindakan advice yang ceroboh). Di fase ini pula sekitar 10 ribu warga Lombardy (utara) pulang kampung ke selatan dan berbagai penjuru kota Italia, dengan tanpa bertanggung jawab dan mengindahkan peraturan lockdown.

Puncaknya adalah HANYA DALAM 4 HARI KEMUDIAN, lewat Dekrit keluaran 11 Maret 2020 sekitar pukul 21.40 malam waktu Italia, pemerintah memutuskan Lockdown total seluruh wilayah. Angka ekskalasinya semakin parah yaitu 12.462 orang dengan kematian mencapai 827 orang. Pemerintah melalui dekritnya menyimpulkan untuk mengubah HABIT penduduk Italia yang suka nongkrong, ngopi, cipika-cipiki, dan meremehkan dengan cara ini. Saya hanya ingin mengingatkan dan menegur untuk teman2 merefleksi dari peristiwa kesombongan di Italia, untuk tidak aji mumpung, dan STAY DI RUMAH untuk saling menjaga satu sama lain. Saya tau ini sulit sekali dengan tuntutan pekerjaan, dll, tapi tolong diusahakan semaksimalnya sembari tetap mencari nafkah. Karena mungkin kita bisa kuat dan sehat, tapi belum tentu untuk ayah-ibu kita, anak-anak kecil, kakek-nenek ataupun saudara2 terdekat kita.

Klo ada yg bilang, "Lho kan di Italia faskes kesehatannya bagus. Lha di Indonesia?" Dulur-dulurku saya beri info, memang benar bahwa sistem jaminan kesehatan di Italia adalah salah satu yang terbaik di Eropa dan bahkan dunia. Namun, dengan jumlah penambahan kasus yang terus berlipat sebanyak ribuan kasus setiap harinya, kini semua RS yang ada sudah sangat kewalahan. Ventilator tidak memadai, ruangan pasien khusus suspect penuh, bed juga penuh, pasien untuk kemoterapi bahkan harus tertunda penanganannya. Pemerintah sampai meminta funding hingga sekarang karena dana medis juga makin terbatas, dan bahkan meminta bantuan tenaga medis dari China untuk sama2 menangani kasus di Italia sebagai bentuk solidaritas. Ini belum jika memikirkan bagaimana nasib pasien lain yang bukan terinfeksi virus tapi butuh penanganan darurat. Beberapa teman juga melakukan appointment harus ditunda untuk diterima RS setelah 5 hari. Bahkan yg terbaru, dokter dan perawat sudah sangat depresi karena harus memilih pasien mana yang harus diselamatkan dan tidak, karena fasilitas dan tenaga sudah tidak memadai. Juga ditambah informasi kalau pasien yang sekiranya sudah terlalu tua (di atas 80 tahun) dan/atau yang sudah terlalu kronis sakitnya, tidak akan diterima lagi di RS akibat ketiadaan tempat utk menampung pasien.

Semua kembali lagi ke HABIT DAN KEBIASAAN kita dan lingkungan sekitar kita untuk bisa menghentikan persebaran virus Covid-19 ini. Kalo kita denial, acuh, bahkan sombong dan menyerah dengan keadaan, kebiasaan baru tidak akan tercipta, menggagalkan persebaran virus hanya jadi keniscayaan. Sejauh ini saya bersama 4 teman lain dari Indonesia masih tinggal di momen lockdown dalam kota ini, kami terpaut jarak 1 1/2 jam dengan kereta dari saudara2 Indonesia kami di Milan. Kami mengikuti prosedur pemerintah, WHO dan CDC, serta arahan KBRI.

Seperti menjaga jarak 1 meter, membawa surat jika keluar rumah, tidak bepergian keluar kota, keluar rumah untuk belanja (ada aturan 15 orang maksimal dalam 1 ruangan supermarket), tidak menimbun makanan & keperluan secara berlebihan (keluar hanya 6-7 hari sekali), tidak panic buying, tidak kongkow2 dan berkumpul, keluar rumah untuk alasan medis atau alasan darurat seperti pulang kampung saja. Kita juga mengikuti arahan hasil Kulwap (Kuliah Whatsapp) di grup Mahasiswa di Italia bersama pembicara dari kawan WNI yg studi PhD Microbiology di Radboud University beberapa pekan lalu. Dari situ kita semakin mendapat informasi tentang Virus ini, menjalankan saran untuk makan sehat, menambah imunitas, jahe (karena anti-inflamasi tinggi), reresik, serta cuci tangan selalu dan mengoptimalkan penggunaan masker dimanapun kita berada. Kami semua dalam keadaan sehat, terus kuliah, bekerja dan akan berupaya terus sehat dengan saling menjaga satu sama lain :)

Aku sertakan link dibawah dari website media Italia tentang aturan ketika lockdown untuk sekedar informasi & pertimbangan, bukan untuk dijiplak mentah2, jika mungkin ingin bertanya silahkan saya sangat senang jika bisa berbagi.

https://www.corriere.it/cronache/20_marzo_13/passeggiate-sport-all-aperto-certificati-seconde-case-ecco-regole-governo-7af1adf4-64eb-11ea-ac89-181bb7c2e00e.shtml

Semoga membantu sebagai pengingat dan penegur, serta terima kasih telah meluangkan waktu membaca, jangan lupa berdoa selalu. Salam solidaritas seduluran !

(foto ketika pertama kali tiba di Piacenza, 7 September 2018)

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globalpeacefoundationindia · 4 years ago

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Health Care for Women during COVID 19: A Divide Within the Divide

By Catherine C. Nair

“When you don’t have 'cushions' around you, you feel the pain much when you fall” - Ernest Agyemang Yeboah

I perceive the “cushions” in the above quote as economic security that paves way to other forms of securities when faced with challenges for any person regardless of the gender. In India, health care is one of those facilities, “the more you pay, the better you get” feels like the disguised tagline for most private hospitals that charge an exuberant amount of money, which in some cases tricks you , leaving you even more miserable.

When it comes to a good quality of health care facility, I feel the discrimination is more on the basis economic status and less on gender. Of course there are instances of women being exploited in quarantine centers, but one common aspect in most of the cases is that these were government run institutions. This brings us to the point that the government will provide you facility, but don’t expect quality and security. India has one of the weakest health systems in the world, with abysmal health indicators. India spends only 1.28% of GDP on public health. This is lower than the proportion of national income spent by the poorest countries on earth: as per the World Bank, countries classified as Lower Income spend 1.57% of their GDP on public health. The results of this are not surprising. People in Bangladesh, Nepal and even Liberia – a country with a per capita GDP one-seventh that of India – are healthier than Indians (Daniyal, 2020). During the COVID 19 pandemic we see conditions even getting worse as lack of facility and soaring cases are leading to full occupation of the facilities and denying people for other serious treatments, one of the groups here is pregnant women.

The COVID situation has created hassle to access healthcare for all economic classes but we see stark differences in the kind of issues faced, when we solely look into health care facility provided to women. We see a “A divide within the Divide” in which “a divide” refers to the economic divide prevalent in the already existing gender divide. Women from higher income groups were reported to be anxious due to cancellation of weekly check-ups, increased risk of COVID-19 infection during hospital visits, and delay in life-saving procedures like caesarean sections due to shortage of staff and lack of infrastructure like operation theatres. However, the emergency telemedicine services provided by several hospitals, over and above the class advantages of easy access to direct doctor’s consultation, and availing a vehicle pass had somewhat eased the situation for these women. In contrast, the concerns of pregnant women from poorer socio-economic backgrounds are completely different. With most of the ambulance services diverted for COVID-19 related activities and suspension of transportation facilities, women in labour are finding it increasingly difficult to access maternal health services. A 28-year-old woman gave birth in the Emergency Response Vehicle on the way to Safdarjung hospital in Delhi. Similarly, in Surat, another woman delivered her baby in a 108 ambulance on the way to the hospital. Non-availability of adequate ambulances for covering maternity services led to the delay in reaching the health facility in both these cases (Bisht, 2020)

So, it all comes down to the amount of wealth one can shell out to get assured safety and security for everyone. All credits to the inefficient public health system of our country; but for women their socio-economic realities in the context of this pandemic exposes them to even more exploitation and danger.

Bibliography

Bisht, D. R. (2020, May 8). www.thewire.in. Retrieved from COVID-19 Lockdown: Guidelines Are Not Enough to Ensure Pregnant Women Receive Care: https://thewire.in/women/covid-19-lockdown-pregnant-women-childbirth

Daniyal, S. (2020, July 21). www.scroll.in. Retrieved from Coronavirus: Why are Indians Running Away from Isolation Wards?: https://scroll.in/pulse/956280/is-indians-lack-of-trust-in-public-healthcare-hurting-efforts-to-battle-coronavirus

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drsunilposhakwale · 5 years ago

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Covid-19 and the challenges to the Indian economy

Bhaskar Mukherjee and Prof Sunil Poshakwale

The Indian economy is expected to get a hammer blow from the effect of Covid-19. While an economic contraction is inevitable, it is very challenging to estimate the level, given the uncertainty of how long the pandemic persists. Reliable data is hard to come by and the challenge is magnified in these unprecedented times due to the effects of the lockdown. Even where data is available, its application to compute Gross Value Added GDP using simulation models may be rendered statistically irrelevant because of the staggering range of the variation. While one hopes that the government has the resources to compute the numbers in a dynamic context, there has not been any substantive press releases with such details. Most of the reporting has thus been reliant on Investment Banking Reports with the inherent strengths and weaknesses of the simulation models they have used for sectoral GDP calculation. As these are mostly proprietary, they are not available for public scrutiny and without their analysis one can hardly comment on the accuracy of such forecasts. However, conclusions when published are used in India’s noisy and highly polarized politics to further political positions. They are reported in mainstream television media with headline grabbing bombast accompanied with selective usage of footage from real life stories that can be found to buttress as many points as there are humans. All this justifiably causes a great deal the angst amongst the populace about “what if” their predictions are real? During such times of crisis, data-driven analysis should be the only way to assess the extent of the disaster as it is unfolding. It is precisely because of these reasons the authors have adopted a simple Do It Yourself (DIY) methodology to work out estimates of what might happen in each constituent sector of the economy. The emphasis is to ensure that the assumptions are clearly stated and documented so that subsequent revisions can be effected, once more data is available.

The Lockdown in the Indian Economy was declared on March 25, 2020 when the financial year 2019-2020 was nearly over. As the Financial Year (FY) for the Indian Economy starts from April 1, its impact is mainly going to affect the FY 2020-2021. Most of the 2nd quarter of Calendar Year (CY) 2020 (or 1Q of FY 2020-2021) is going to be lost with a cliff-edge drop impact on the GDP. For purposes of simplicity, the authors have considered zero revenue for impacted sectors. Thereafter while several sectors will take many quarters to recover others should be able to pick up the threads unless the pandemic runs amuck causing disastrous levels of death. Given in the following is a construct of the Gross Value Added (GVA) measure of the Indian Economy by considering a sectoral drop percentage in various constituent sectors.

● For the Trade, Repair, Hotels, Tourism and Restaurants sectors, a change factor of 0.5 or 50% has been considered with the GVA drop being 50%.

● Electricity, gas, water and utilities have been considered at 100% representative or minimal impact.

● With transport starting to operate, change in transport is considered at a factor of 0.75, with GVA drop being 25%.

● While agriculture is not expected to be impacted severely there is a lot of loss of value due to the lockdown, considered at a GVA drop of 20%.

While these are armchair affixed factors, within the macroeconomist’s discipline these should and would be based on statistically determined sectoral simulations. The big-ticket conclusions from the given armchair exercise on the effect of a full 3 month lockdown from April to June on an annualized FY 2020-2021 basis, are the following:

The table below lays out the details of calculation behind the aforesaid numbers:

Source: Base Line GDP 2019-2020 constructed based on GDP growth % applied to data gathered from : http://statisticstimes.com/economy/sectorwise-gdp-contribution-of-india.php. INR = 0.01402 US$

It is revealing to compare these estimates to the professional estimates prepared by global financial giants such as Goldman Sachs1, Nomura2 and HSBC3.

Goldman Sachs:

Goldman Sachs predicts the Indian economy will shrink by 45% on an annualized basis this quarter, and suffer its most severe recession since 1979 this fiscal year, as the coronavirus pandemic wreaks havoc on many of its industries. Their latest quarterly growth forecast, detailed in a May 17 note, is significantly worse than its previous estimate of a 20% decline. On the positive side, its economists expect the Indian economy to rebound 20% in the third quarter, compared to the current quarter. They then anticipate 14% growth in the fourth quarter and 6.5% growth in the first quarter of 2021.

Goldman Sachs’ estimate applied to the authors’ baseline results in the following:

GDP Drop: 31% Value: US$ 730 Billion

Nomura:

India’s real gross domestic product growth is likely to contract 5.2 percent in the financial year ending March 2021, which loweres its economic outlook amidst an extended lockdown. That is against a contraction of 0.4 percent projected earlier. “We now expect year-on-year growth to remain negative for three consecutive quarters — with growth faltering to 1.5 percent in Q1 (January-March) before plunging to -14.5 percent in Q2 (April-June), and then weakly recovering to -6.0 percent in Q3 (July-September) and -1.5 percent in Q4 (October-December),” the research house said in a statement.

Nomura’s estimate applied to the authors’ baseline results in the following:

GDP Drop: 5.2% Value: US$ 121Billion

HSBC:

HSBC’s forecast on GDP decline is not available as yet.

The authors sincerely hope that neither theirs nor Goldman Sachs’ estimates come to fruition. While a deep recession spares no one, it is unspeakably hard on the poor and working classes with little savings and reliant on day to day work for earnings. Below Poverty Line (BPL) population in India was approximately 22% of the population in 2012. It is expected that loss of millions of jobs as a result of the economic contraction is going to increase this number substantively. These are some of the most vulnerable sections of the society mainly from the eastern states of Bihar, UP, Orissa and Bengal (including illegal immigrants from Bangladesh). With employment opportunities mainly concentrated in the Western and Southern states of India, a large number of BPL families travel to these states to take up employment as unskilled and semi-skilled labour in sectors such as construction, quarrying, textiles, jewellery making, hospitality and tourism, to name a few. With hardly any leverage in an oversupplied labour market they continue to remain the most vulnerable and exploited. Since the start of the lockdown, pitiable images of these migrant workers in Delhi, Mumbai, Ahmedabad, Surat have drawn the attention of the world. Due to the cliff-edge drop in economic activity in the earlier named sectors, they have mostly remained unpaid since the start of the lockdown in India from end-March by unscrupulous private sector employers and contractors. On average their earnings are estimated at around Rs 10,000 per worker, a month.

Only recently since early May the government has organized migrant special trains to transport this restive population back to their hometowns and/or to their extended families. As they now return, by end of May their unpaid wages would total 3 months or a full quarter due to no fault of theirs. At a very conservative estimate, they could number up to a fifth of India’s labour force of over 500 Million at 100 Million. These workers potentially support family members numbering between 200 to 400 Million or more. A resurgence in the Indian Economy can only happen if India’s migrant labour are nursed, rehabilitated and motivated to join the rebuilding effort. In line with Pandit Deendayal Upadhyay’s principle of Integral Humanism the authors lay a case to propose the provision of a special one time grant, to rehabilitate these affected millions. A modest grant of ₹10,000 per month for 3 months for 100 million workers is going to cost ₹ 3 lakh crores or US$ 42 billion.

While naysayers will be quick to criticize this as a wasteful “dole” one should also consider it from a humanist prism as a stabilization cost for the society. An unstable society is on a slippery slope of breakdown of law and order. The academic underpinnings of the proposal are anchored in John Maynard Keynes’s Macroeconomic Policy. Keynesian intervention has been successfully used in the past to overcome the 1930’s depression. Fundamentally the macroeconomic equation at any present moment is considered as balance between Aggregate Demand (comprising consumption and investment) and Aggregate Supply (comprising wages, rents, interest and profits). Keynesian macroeconomic policy stipulates that in unprecedented deep recessions boosting the Demand Side of the macroeconomic equation is the only way to kick start the economy.

Given below are adjacently placed tables of Fiscal Stimuli and GDP by Country extracted from the website Statista4. Based on the same, the authors have compiled a table of gross value of fiscal stimulus in US$. Out of all G20 countries, Japan has passed the largest fiscal stimulus package that amounts to about 21.1 percent of its gross domestic product (GDP). This package amounts to about 117.1 trillion Yen (1 Trillion US$), and consists of delivering universal cash handouts of ¥100,000 (approximately US$ 930) to every individual in Japan, comprising 126 million people. The USA has also a high fiscal intervention percentage as they did during the 2008 subprime housing-related Economic Crisis.

The Indian government has recently announced a comprehensive stimulus package of ₹20 lakh crore (or 20 trillion) worth approximately $280 Billion Dollars at an old exchange rate of 71.3, estimated to be 10% of GDP. These are a combination of fiscal, monetary and macro-financial measures5.

The key elements of the fiscal package (3.5%) captured in the earlier table are the following:

· In-kind (food; cooking gas) and cash transfers to lower-income households

· Insurance coverage for workers in the healthcare sector

· Financial sector measures for Micro Small Medium Enterprises (MSME) and Non Banking Finance Companies (NBFC)

· Concessional credit to farmers, as well as a credit facility for street vendors and an expansion of food provision for migrant workers.

The monetary and macro-financial measures are structural in nature mainly comprising of regulatory, liquidity and policy amendments pertaining to RBI. One of the excellent policy decisions of the government is in amending legislation to give freedom to farmers to sell their produce anywhere. The new model Agricultural Produce Market Committee (APMC) Act7 proposes to do away with the concept of notified market area and allow the aforesaid measure. “Over time” such a policy decision is going to lead to increased agricultural revenue and even allow India to emerge as a force to reckon with in international markets as farm based value additive agro-units emerge to take advantage of this supply flexibility. There is a tremendous value and demand for Indian agro-produce such as seasonal fruits and vegetables, amongst the Indian diaspora, but mechanisms for their reliable and assured supply is required. Structural changes however strategic in nature, affect the supply side macroeconomic equation and usually take time to create an impact.

There is a legitimate question in the minds of people as to how the government is going to fund the stimulus even if it is just a medium term (4 year) loan, without controlling runaway inflation. The following is the Debt Status of the top 100 debtors in India (based on their 2019 balance sheet) accessed from Money Control6. Analysis of this suggests that public deposits more than adequately cover outstanding debt:

Banking and Finance Sector Debt actually comprises Public deposits held by these financial institutions. Presuming that the Reserve Bank has done its job professionally regarding oversight on the quantum of advances lent by banks, public deposits more than adequately cover outstanding debt. It also explains how the government can work on a stimulus using public funds. The government also has various other policy tools such as easing controls on the level of deficit financing and external borrowings to name a couple, which it has been reticent so far in using. The fear has always been about the decline in value of the Rupee and its adverse impact in funding oil imports, but at a time when every country in the world has thrown such caution to the wind and oil prices are at an historic low, there is a compelling case for more direct fiscal stimulus in the form of direct benefit transfer to India’s migrant labour and daily wagers to kick start the Demand side of the macroeconomic equation. Economic policy to alleviate the immediate effects of Covid 19 needs to be tactical to stabilize society. Strategy has a long term horizon in terms of yield of aspired results. A fine balance of both approaches should serve India well in the times to come.

The present government has displayed commendable commitment to the highest levels of humanism by initiating the lockdown and thus effectively containing a runaway spread of the pandemic. As preparations are made to restart the economy after the effects of the lockdown, stimulating the demand side of the economy is the need of the hour. Augmenting the already announced fiscal measures by providing succour to India’s itinerant labour with an additional one time distress grant, will enable them to have a fresh start once the economy opens up again. Industry and Businesses also need to share responsibility towards minimising labour migration by offering them food supplies and a minimum allowance to meet their monthly expense. While the mechanism of identification of the recipients of such a benefit is a technical challenge in its own right and merits an in-depth assessment, this is perhaps one policy that will have wide political consensus in the otherwise fractured polity of India.

References:

https://www.businessinsider.com/goldman-sachs-india-economy-recession-gdp-decline-45-percent-q2-2020-5?r=US&IR=T

HSBC Global Research’s -India-Covid Impact in charts, authored by Ms.Pranjul Bhandari et al. dated April 30, 2020

https://www.statista.com/statistics/1107572/covid-19-value-g20-stimulus-packages-share-gdp/#statisticContainer.

https://www.imf.org/en/Topics/imf-and-covid19/Policy-Responses-to-COVID-19#I

https://www.moneycontrol.com/promo/mc_interstitial_dfp.php?size=1280x540

https://economictimes.indiatimes.com/markets/stocks/news/new-act-may-give-freedom-to-farmers-to-sell-anywhere/articleshow/58025600.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

About the Authors:

Bhaskar Mukherjee is a Chemical Engineer with over 34 years’ experience in the Oil, Gas and Chemicals Business, based in UK.

Dr Sunil Poshakwale is Professor of International Finance, School of Management, Cranfield University, England.

#indian economy

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