I recently came across a succinct background description of COVID-19. I quote: “The world is suffering from a small species of diameter 65-125 nm and length of about 26-32kbs. A virus which was initially named as SARS-CoV-2 belongs to beta coronavirus group. Later on it is named as novel corona virus (2019-nCov) or COVID-19. The World Health Organization declared it as a Pandemic on 11 March 2020.” But the clarity ends here, and then confusion, lack of coordination, much empty vessel sounding statements, division in readiness for vaccination and above all political mud-slinging take over. The OECD Employment Outlook 2020: WORKER SECURITY AND THE COVID‑19 CRISIS reports: “What took more than a decade to achieve has unravelled within a matter of months. In early 2020 the employment rate in the OECD reached a record-high of 68.9%, 2.6 percentage points above the previous record just before the global financial and economic crisis of 2008. Then the pandemic struck. Within months, COVID-19 spread around the globe triggering the worst public health emergency in a century. It has sparked an economic crisis not seen since the Great Depression of the 1930s. More than 10 million people have been infected with the virus, more than half a million people have died and trillions of dollars have been pumped into the world economy to protect lives and livelihoods. In the face of this challenge, a four Rs strategy, which progresses from response and rehabilitation to reciprocity and resilience, is needed to re-build a better, more robust, and inclusive labour market.”
While, fortunately, it has not happened in our country, a recent piece on the pandemic causes democratic shivers down the spine: “…covid-19 also poses a particular challenge for legislatures. It argues that among the secondary impacts of covid-19 that have not received sufficient scholarly attention, is the risk that legislatures would become casualties of the pandemic. This risk is not merely theoretical. In fact, a recent estimate suggests that two billion people live now in countries whose legislature was shut or limited due to the pandemic. This, in turn, raises concerns not only for the well being of legislatures, but also for the health of democracy itself.” Appreciating the uniqueness of COVID19 as a private, social and governance crisis may be of relevance here, of which I mention only a few:
(i) Usually, howsoever severe the ailment may be, there are chances for a departing soul to share the last words, or at least the last looks, with the loving souls staying behind in this planet. In the case of COVID19, this is simply non-existent for even if the opportunity exists, it cannot and cannot be allowed to be exercised by anyone.
(ii) Any ailment has always, excepting plaque long back, been one to be taken care of in continuous interaction between the patient and others, besides the doctors. In the case of COVID19, communication and interaction are beyond the realm of considerations.
(iii) The society has to be an institution permanently open to interaction and working together, but under COVID19 it cannot function under the prevailing norms.
(iv) The various branches and wings of a government are known to function and perform in isolation without bothering what the others might be doing. But with COVID19, all the wings have to be continuously coordinating with one another and within a single framework for a single goal.
(v) Usually the “study of power and process in health policy…. available deals with the content of health policy – the ‘what’ of policy. This literature may use medicine, epidemiology, organizational theory or economics to provide evidence for, or evaluation of, health policy. Legions of doctors, epidemiologists, health economists and organizational theorists develop technically sound solutions to problems of public health importance. Yet, surprisingly little guidance is available to public health practitioners who wish to understand how issues make their way onto policy agendas (and how to frame these issues so that they are better received), how policy makers treat evidence (and how to form better relationships with decision makers), and why some policy initiatives are implemented while others languish. These political dimensions of the health policy process are rarely taught in schools of medicine or public health.” The problems get accentuated under COVID19.
(vi) The understanding of the dynamics of COVID19 is still an evolving one. While, e.g., in the case of the HIV, the exposure and the likelihood are all revealed, but these are not so in this case. So the point of start for care, for treatment and relative behaviour could be at a dangerously risky phase sooner, and in a way very different from the healthcare practitioners and the government machinery have been used to.
(vii) The capacity of the government and the income level of the patients and their families are critical in taking care of any patient of any ailment, but the issue of COVID19 goes much beyond these as there are many socio-behavioural questions involved.
(viii) The prevailing capacity to face any health crisis is undoubtedly under tremendous pressure in times of emergency anywhere, but this is particularly so in the developing and less-developed parts in a much deeper and wider dimension.
(ix) India has been talking and emphasising the strength and significance of the demographic dividend, but COVID19 immediately converts this strength into a potential risk because of the socio-behavioural dimension of the disease. (x) While healthcare focus has usually been patient-centred, the COVID19 demands attentions and interventions on a scale much wider and deeper.
This is the reason why the Coverage Target of the Vaccine has been under constant review and revision; the vaccination of pregnant women was announced only on 3 July 2021. This is understandable given the imperfections of the evolving understanding of the pandemic. But we must hasten to add that the understanding is indeed evolving in an unprecedentedly positive way as proven by the fast emergence of vaccines.
The Human Capital Index 2020 Report states that “COVID-19 struck at a time when the world was healthier and more educated than ever. Yet data presented in this report reveal that substantial human capital shortfalls and equity gaps existed before the crisis. Worldwide, a child born just before the advent of COVID-19 could expect to achieve on average just 56 percent of her potential productivity as a future worker. Gaps in human capital remain especially deep in low-income economies and those affected by violence, armed conflict, and institutional fragility. Expanded sex-disaggregated data show that girls currently enjoy a slight edge over boys in human capital accumulation in most economies, reflecting in part a female biological advantage early in life. Women continue to be at a substantial disadvantage, however, in many dimensions of human capital that are not captured by the HCI’s components, including participation in economic life.”
The human actions are subject to politics if these affect the interests of the individuals beyond the person undertaking the action and impact upon community outcomes. Given the realities of the character and impact of COVID19, we need to adopt certain principles by moving beyond politics. The necessity of these has become emergent and important as there are cases of resistance to vaccination and political counterarguments to the governance interventions. We know that misinformation moves pretty fast and easily create a group of base followers. There is a need for collective sharing of an approach where the interventions to meet the challenges of COVID19 are concerned and in a way unrelated with winning the next round of elections.
Here I keep remembering something called the Theory of Second Best quite often mentioned by my Economist friends; I do not know much about it but I hope my little understanding proves right. Since the understanding of COVID19 is yet incomplete, we cannot think of as possessing the ultimate weapon to defeat this. Thus we do not yet have the First Best to win our war against the disease. But we at least have something with which we can fight with and for which we all need to be on the same page.
This something can be administered by the government of the day. Given the potential of the disease to affect all adversely irrespective of whether one is in the government or outside, the behavioural principle tells us that no government would do something to let people die.
This tells us, in other words, that the interventions announced by the government of the day should be followed collectively in order to win over COVID19. This is the only best alternative as the First Best is yet unavailable. I hope this is what my friend Economists call the Theory of Second Best. Time is for this Second Best for no better option is available on the horizon.