Coronavirus | Opeds and editorials

Protecting the poor from becoming poorer

Globally, governments are faced with hard choices in controlling the spread of COVID-19. Prioritising public health through social distancing and population lockdowns comes at a huge economic cost. While there is still considerable uncertainty about how badly India will be affected by the COVID-19 outbreak, there is no uncertainty that the population lockdown will force significant and widespread deprivations on people at the lower end of the income distribution. Within a short time after the population lockdown was imposed in India, the slowdown in economic activity has resulted in the loss of livelihood among the economically vulnerable. Seen another way, economically vulnerable groups are being forced to sacrifice disproportionately more for the better health of society. COVID-19 and its control measures will affect the health, human capital and income of vulnerable populations in multiple ways over the short and long term. To mitigate these deprivations, it is necessary for government safety net programmes to provide broad-based long-term support focused on specific vulnerable populations.

Short- and long-term effects

The morbidity and mortality rates are disproportionately higher in countries, and among people, at the lower end of the income distribution. The Spanish flu in 1918 left about 50 to 100 million people dead worldwide. Poor countries like India bore the brunt of the pandemic. India lost 18 million lives, or 6% of the population, the highest anywhere. In contrast, the U.S., where the flu might have originated, experienced 6,75,000 deaths. Similar social inequities are seen in the current COVID-19 pandemic — note, for instance, the disproportionately higher mortality rates among minority groups in the U.S. These inequities are not surprising: economically vulnerable people have poor nutrition which lowers immunity; they live in crowded spaces making it easier for a disease to spread; and they have inadequate access to safe water, sanitation, and quality health care. Deaths and illness due to COVID-19 will directly cause economic losses. The death of an earning family member is a huge financial loss anywhere, but particularly so for those living on the margins of the economy. Those unable to work, particularly those in the informal economy, due to COVID-19-related illness will experience substantial income losses. Studies on productivity losses due to other infectious diseases have reported that the poorest households lose as much as half their income.

Epidemics continue to affect survivors long after they are over. Studies on populations exposed to tropical diseases and poor nutrition in-utero or during early childhood have found that the effects of the disease continue into later years of life by affecting cognitive ability, educational achievement, and income as adults. A study on the long-term effects of the Spanish flu, “Is the 1918 Influenza Pandemic Over? Long-Term Effects of In Utero Influenza Exposure in the Post-1940 U.S. Population”, by Douglas Almond, reported that children born to infected mothers were 15% less likely to graduate from high school, the wages of men were 5%-9% lower because of infection, and the disability rate 20% higher compared to birth cohorts not affected by the flu. Importantly, these effects were greater in socially vulnerable populations. There is no reason why COVID-19 will not have such long-term intergenerational effects on economically vulnerable populations. As such, relief programmes need to have a long-time horizon.

Population lockdowns and the associated loss of economic activity has affected employment and livelihoods on a massive scale globally. India has the largest number of people under lockdown anywhere. By all accounts this lockdown has had a significant effect on the movement of people, job losses and incomes. For example, a CMIE survey indicates that 44% of households currently report a loss in income, up from around 10% in early March. A recent telephonic survey carried out by the National Council of Applied Economic Research in Delhi found that 84% of respondents reported loss of income, and nearly 30% experienced shortages of food, fuel and medicines. These outcomes were concentrated among the poorer households and in rural areas.

Historically, economic downturns are associated with loss of livelihoods, decreases in dietary intake, poorer dietary quality and poorer health care consumption. The effect of the lockdown on pregnant women and children is particularly important. Studies have shown that women’s nutrition or access to health services like tetanus immunisation during pregnancy can have long-term effects on the future educational achievement of children. Poor nutrition during pregnancy or in early childhood has been associated with increased infant and child mortality. The closing of schools due to the lockdown has deprived many children of their only nutritious meal through school-feeding programmes. Moreover, children who experienced poor nutrition in-utero or during their early years find that their cognitive levels, educational achievement, and adult incomes are impacted.

Extending safety nets

The Central government and several State governments have announced a range of important measures to address the economic hardship faced by vulnerable households. They promise to provide free or subsidised food to low-wage households, and direct cash transfers to vulnerable groups such as senior citizens, farmers, rural workers, construction workers and widows. The effectiveness of these safety nets will depend on the adequacy of the relief package, how well they reach the neediest groups, and efficiencies in the delivery system. It is important to note that these are one-off measures intended only for a short period of time. However, the economic and health deprivation caused by COVID-19 will have long-term effects.

More challenging is addressing the long-term health and economic effects of COVID-19. It will require extending current relief measures for a longer duration, to a few years. To prevent human capital deprivation in the future, both long- and short-term relief measures will need to target specific populations like pregnant women and young children. Recent government actions in this direction are helpful but they are focused on the short term. As such, governments need to take a long-term view of mitigating the many economic and human capital effects of COVID-19 and its control measures.

Krishna Rao is Associate Professor, Department of International Health, Johns Hopkins University

Related Topics
This article is closed for comments.
Please Email the Editor

Printable version | Apr 15, 2021 8:31:41 AM | https://www.thehindu.com/opinion/op-ed/protecting-the-poor-from-becoming-poorer/article31439214.ece

In This Package
Examination priorities: On annual exams amid the pandemic
The secrecy around deaths after vaccination
Indian universities need immediate vaccination
Lessons from COVID-19
The second wave: On why new COVID-19 vaccines should be cleared
Weighing in on the saga of a vaccine
Rising poverty: On pandemic-induced disparities
A booster shot for India’s vaccination plan
Allaying concerns: On public trust and vaccination programmes
A moral test: On the vaccine divide
Efficacious too: On Covaxin
Sustaining the drive: On COVID-19 vaccination phase 2
Vaccine inequities: On need to vaccinate all above 45
Addressing vaccine reluctance and policy hesitancy
Redefining the exit plan for COVID-19
Boosting confidence: On need for efficient use of COVID-19 vaccine stocks
Opening up the vaccine market
Origin and spread: On the source of SARS-CoV-2
New questions: On COVID-19 infecting one-fifth of Indian population
A year on, mind the gaps in the pandemic response
Should Board exams be conducted in one go this year?
No to vaccine nationalism, yes to global cooperation
Tempered optimism: On India’s sliding COVID-19 graph
The best shot against COVID-19
More vaccines than takers
Managing the rollout: On addressing vaccine hesitancy
Injecting confidence: On India’s COVID-19 vaccination drive
Vaccine optimism and the scientific uncertainty link
Building trust in vaccines
The debilitating side-effect of a flawed vaccine trial
Gearing up: On vaccines and public trust
A hurried gamble: On vaccines and transparency
The second dose: On COVID-19 vaccine
A constant vigil: On the new coronavirus strain in India
Unmasked, reflections on the pandemic and life
Caution pays: On Centre’s COVID-19 surveillance guidelines
Towards an effective vaccination distribution policy
Essential dry run: On COVID-19 vaccination drive
COVID-19 and limits of political accountability
The purpose of a vaccine
Clear the fog, draw up a clear vaccination policy
Rein in the vaccine nationalism, the profiteering
In vaccine race last lap, the key steps for India
The storage tale of two vaccines
T-cell immunity and COVID-19
COVID-19, climate and carbon neutrality
Signs of easing: On India’s COVID-19 fight
Has India passed the COVID-19 peak?
Sooner, better: On indigenously developed COVID-19 test kits
The battered Puja economy
Outline of a pandemic fight, by and for citizens
Pandemics and the collective consciousness
Vaccines with a global common good guarantee
Saving lives under the long shadow of the pandemic
Until vaccine: On Unlock 5
The challenge of changing health behaviour
Weighing the costs: On COVID-19 vaccine
The slow and frustrating journey of recovering from COVID-19
Health worker safety deserves a second look
Unlocking campuses: On UGC’s revised academic calendar
Recovery from COVID-19 can be a struggle
Uniting to combat COVID-19
Coronavirus fears and preconception advice
An agriculture-led revival as flawed claim
A necessary pause: On the COVID-19 vaccine race
The uncertainties over COVID-19 numbers
The challenges in counting the dead
COVID-19 deaths may be higher than reported
The many challenges in estimating deaths
Alone at the top: On India’s COVID-19 numbers
The participants we need in Phase 3 trials
Differential impact of COVID-19 and the lockdown
More than a vaccine, it is about vaccination
COVID-19 and a country club India must leave
A quest for order amid cyber insecurity
Adopting a public systems approach to COVID-19
Milestone of a million: On India’s COVID-19 numbers
Testing times: On university exams
Predictions, pandemics and public health
It’s time to flatten the pandemic stereotyping
Viral outrage only spikes the data
Sending the right message
Needed: Clear testing data
The social contract needs to be rewritten
The pandemic is about eyes shut
Joblessness and opportunity in Tamil Nadu
Green-lighting ecological decimation amidst a pandemic
COVID-19 has no religion
A case for extension: On rural jobs scheme
Surely, even if slowly: On a COVID-19 vaccine
Bend it like Italy: On flattening the COVID-19 curve
Promise and delivery: On India’s first COVID-19 vaccine
States hold the key: On Unlock 2.0
PCR testing is a double-edged sword
Science vs nonsense: On Patanjali’s COVID-19 claim
Shut and open: On tennis during the pandemic
The perils of follow the leader syndrome
The many questions about Favipiravir
In new lockdown, a second chance for Tamil Nadu
United front in Delhi: On Kejriwal government-Centre camaraderie
A prescription of equitable and effective care
Multilateralism post COVID-19
Making public transport safe during COVID-19
A better rate: On COVID-19 recovery
Look back in relief: On the migrant labour crisis
Needed, a transfusion for public health care
Wrong priorities: On keeping religious places open during a pandemic
Crossing the line: On Delhi’s decision to limit health services
Profit, not profiteering: On regulation of COVID-19 testing charges
In Persian Gulf littoral, cooperative security is key
Paging the private sector in the COVID fight
Curves and recoveries: On India’s coronavirus numbers
India’s Parliament is missing in action
Axing the economy’s trunk
Scripting a new narrative for COVID control
Open with caution: On Unlock 1
It’s time for a universal basic income programme in India
The waning of subaltern solidarity for Hindutva
Export blocks: On India’s trade amid the pandemic
A moment to trust the teacher
The echo of migrant footfalls and the silence on policy
Enjoying the fruits of their labour
Helping supply chains recover
The heavy burden of social suffering
An effective lockdown
The lockdown has highlighted stark inequalities
Will sport be the same in empty stadia?
Cinema after COVID-19
The eternal longing for the distant home
Working safely: On workplaces during the pandemic
A hole in the whole: On health sector woes
China, better prepared for the post-COVID world
How public health boosts an economy
Keep it retrospective
Backing the ‘angels in white coats’
Standstill: On opening of stadia for training
Flawed stimulus is justice denied
We need social physicians
A callous response
Peaking: On India’s coronavirus tally
Farm gate in focus: On amending Essential Commodities Act
A question of quarantine: On migrant workers and other travellers
TASMAC tribulations: On Tamil Nadu liquor sale
The pandemic and the challenge of behaviour change
One for the poor: On Centre’s corona package
Lockdown syndrome: On virus-induced economic crisis
Are India’s labour laws too restrictive?
Stop the return to laissez-faire
States cannot be left to the Centre’s mercy
Local motif: On Modi’s call for self-reliance
Liquidity lifeline: On Nirmala’s MSME package
A plan to revive a broken economy
Provide income support, restore jobs
Perilous state: On State finances
COVID-19 and the path ahead
Reaffirm cooperative federalism
Riding roughshod over State governments
Tragedy on the tracks: On the killing of 16 migrant workers
Coming to terms: On India refusing to admit community transmission
The trends shaping the post-COVID-19 world
The epidemic and ensuring safety in courts
Responding to COVID-19 at the grassroots
The face of exploitation
Contempt for labour: On dilution of labour laws
Slower growth and a tighter fiscal
Back home: On return of Indian expatriates
Blame game: On Donald Trump’s anti-China rhetoric over COVID-19
Resuscitating multilateralism with India’s help
A war-like state and a bond to the rescue
Fear and loathing in the land of the free
Everyone wants a good stimulus
Rent control amidst pandemic
Slow release: On lockdown 3.0
No comfort in numbers: On Bengal’s coronavirus cases
Pandemics without borders, South Asia’s evolution
India’s disease surveillance system needs a reboot
No relief for the nowhere people
BRICS against COVID-19
Recovering early: On India’s COVID-19 patients
It’s about food, nutrition and livelihood security
Taiwan’s coronavirus protocol shows how it is done
Needed: a pandemic patent pool
Getty Images/iStockphoto
Plasma therapy is no silver bullet
Take care of yourself too, fellow journalists
Strategic shift: On home isolation of mild coronavirus cases
Coping with today, planning for tomorrow
No end in sight: On India’s coronavirus strategy
Vividly imagining the life of migrant workers
A task for South Asia
Privacy concerns during a pandemic
Unlocking justice in the lockdown
Safe return: On migrant worker distress
The outline of another pandemic combat strategy
Pandemic and panic: On Tamil Nadu’s five-city lockdown
You are reading
Protecting the poor from becoming poorer
Did SARS-CoV-2 begin from a lab?
Protection for protectors: On safety of healthcare workers
Rapid failures: On antibody testing kits
The COVID-19 paradox in South Asia
Fishing in troubled waters during a pandemic
How will India emerge out of the lockdown?
Making doctors wash hands
Locked out of cities, homes and livelihoods
Script of unity: On coronavirus and social prejudices
Exploiting a pandemic: On Trump’s immigration policy
The village is still relevant
A time for planetary solidarity
There may be no going back
No transparency in West Bengal
Focus on the curve: On India’s COVID-19 numbers
Economy in lockdown: On India’s worst case scenario
A shot of hope with a game changing vaccine
Caught in the heightened arc of communal polemics
Singing the corona tune
Helping a lending hand: On RBI’s second lockdown stimulus
A season of change: On IMD forecast system
A virus, social democracy, and dividends for Kerala
Across the gulf: On stranded Indian workers
Virtual reality: On telemedicine
A blueprint to revive the economy
A case to use JEE-Main instead of JEE-Advanced this year
Will the aviation industry recover from the pandemic?
Data-driven reporting during COVID-19
Stress test: On revised lockdown guidelines
Disastrous decision: On Trump halting funds to WHO
Cease the distractions, seize the moment
Getting the containment strategy in India right
In India’s response, a communications failure
Harmonising with nature
End the harassment of farmers now
A narrowing window: On extension of lockdown
Corona bond: On Eurozone COVID-19 rescue package
Halting the march of rumours
Polls during a pandemic
The pandemic and the contours of a health response
Economic liberalisation and its faults
Invasive, alien, most fearsome
Trade in tatters: On the global slump
Wanted, a collective national endeavour
Disingenuous and no antidote
COVID-19 and the crumbling world order
Women’s safety during lockdown
Lives and livelihoods: On economy after lockdown
Stage fright: On denying community transmission
Team India and winning the pandemic battle
In time of need: On hydroxychloroquine export
Will COVID-19 affect the course of globalisation?
Finding a scapegoat in WHO
Curating news for children during pandemic
A time for extraordinary action
For better use: On MPLADS funds
Needed, greater decentralisation of power
A key arsenal in rural India’s pandemic fight
Preparing for exit: On lifting the lockdown
Sanctions and pandemic: On America’s Iran policy
‘A script of action, responsibility and compassion’: Chief Minister Ashok Gehlot writes on Rajasthan’s fight against COVID-19
Taking a long view of the pandemic fight
Ten questions posed by the virus
A different economic approach
Why healthcare workers above 60 should be ‘benched’
Enemy at the gates: On Kerala-Karnataka border row
Reducing farm distress during a pandemic
Why everyone should wear masks
The criticality of community engagement
A niggardliness that is economically unwarranted
The spectre of a post-COVID-19 world
Light and sound: On Narendra Modi’s 9-minute light ceremony
A million and counting: On global coronavirus spread
Safe forests, safe people: On diseases of animal origin
Quarantine and the law
Making the private sector care for public health
Looking east to contain COVID-19
Limits to rugged individualism
Uncritical endorsement: On exodus of migrant workers and the Supreme Court
Beyond the blame game: On the Tablighi Jamaat episode
A long road: On India’s 21-day coronavirus lockdown
The missing notes: On politics and the fight against COVID-19
China’s zero: On China’s lead in containing coronavirus
Unprecedented step: On Wuhan lockdown
The return of the expert
Lessons from Hubei
A pandemic in an unequal India
Faith can’t override public health
Devising a people-centric response to COVID-19
Karnataka CM writes on how the State is fighting the pandemic
Tamil Nadu CM writes on how the State is stopping the pandemic in its tracks
The hunt for a cure begins with telling the truth
COVID-19 and a city’s anatomy
Long live the nation-state
The COVID cycle
Coronavirus | The worst of times, the best of times
It’s also a fight against punitive measures
The age of the neoliberal virus
The deep void in global leadership
Thinking national, acting local
Every man is a part of the main
Beyond social distancing to fight COVID-19
Next Story