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Table of Contents
EDITORIAL
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 1-3

COVID-19 pandemic: Saving lives and livelihoods and human existence


Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India

Date of Submission05-May-2020
Date of Acceptance07-May-2020
Date of Web Publication05-Jun-2020

Correspondence Address:
Raviraj Uttamrao Kamble
Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCFM.IJCFM_45_20

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How to cite this article:
Bhatia V, Kamble RU. COVID-19 pandemic: Saving lives and livelihoods and human existence. Indian J Community Fam Med 2020;6:1-3

How to cite this URL:
Bhatia V, Kamble RU. COVID-19 pandemic: Saving lives and livelihoods and human existence. Indian J Community Fam Med [serial online] 2020 [cited 2020 Jul 7];6:1-3. Available from: http://www.ijcfm.org/text.asp?2020/6/1/1/286029



Never before the world have witnessed a calamity affecting almost every individual in one way or the other. It was either the lives during world war or livelihoods after the great depression that were affected at such a wide scale. The COVID-19 pandemic is a treacherous situation threatening both lives and livelihood in almost every part of the world and is the worst humanitarian crisis since World War II.

In December 2019, Hubei province in China encountered a new coronavirus which soon spread globallyand became a Public Health Emergency of International Concern under the International Health Regulations.[1] On March 11, 2020, the epidemic was declared to be pandemic by the World Health Organization.[2]

Since then, many measures at national and international levels have been put into place to curb the spread of pandemic. However, every responsive measure we take to deal with pandemic has to have fine deliberations to bring the best out of it without putting the vulnerable and marginalized at stake. Experiences from past pandemic have shown that planning and policies are rife with various challenges and thus need to admit the social and ethical dimension as a part of pandemic preparedness.[3],[4] The strategic response to a pandemic cannot be with medical and logistic expertise alone but has to have social, economical, and humanitarian aspects so that the vulnerable and marginalized are not left out.

As on May 05, 2020, the virus has already affected >3.6 million people with 252,425 deathsglobally. The graveness of the situation is no different in India, with 32,138 cases and 1568 deaths till date.[5],[6] These figures show the toll taken by the virus directly and the burden of its deep socioeconomic effects, including food security and nutrition, still remains to be hidden at par. To stop the disease spread, measures such as countrywide lockdown, social distancing, and quarantine have been taken almostworldwide. This has brought halt to economic activities and daily earning of many people, thus looming a dual crisis over the world: health crisis and economic crisis. The economic crisis is hitting with full force throwing millions of people out of work by the day. Unlike the health crisis, it is not class neutral and affects poor people the most.

Increasing violent conflicts, climate change, economic crisis, and natural disasters were already a deep concern for the rise in hunger and malnourished people in 2020 which is now been worsen by COVID-19 pandemics like a hammer blow to millions who can only eat if they earn a wage and the lockdowns and economic recessions are about to push them over the edge. The World Food Program (WFP) predicts the number of people suffering from acute hunger will almost double by the end of this year as compared to number drawn up before COVID pandemic in Global Report of Food Crisis 2020. It also states that 821 million people go to bed hungry every night all over the world.[7] The concern is more in Africa and middle-east countries as the virus threats lives and livelihood with people losing their income and disruption of the supply chain.

UN-WFP Executive Director, David Beasley, remarked that we are facing a global humanitarian catastrophe and are on brink of facing a “Hunger Pandemic” and could also be facing multiple famines of biblical proportions within few months.[8]

As per the International Labor Organization (ILO), 1.6 billion workers representing the most vulnerable in the labor market have suffered massive damage to their capacity to earn a living. The income drop of informal workers amounts to 60% in the 1st month of crisis and with no alternative source of income, these workers and their families will have no means to survive.[9] In the wake of the present pandemic, ILO estimates a rise in global unemployment between 5.3 million and 24.7 million from a base level of 188 million in 2019.[10] The COVID-19 pandemic has led to a fall of 2% below the benchmark in global Gross Domestic Product (GDP), with 2.5% for developing countries and 1.8% for industrial countries.[11] The COVID crisis has affected both international and internal migrants across the world.

World Bank projects a sharpest decline in global remittances in recent history by about 20% due to fall in wages and employment of migrant workers. Remittances help families to afford health care, food, and basic needs and this fall would push them to vulnerability.[12] The lockdown and social distancing measures in India have prompted a chaotic and painful process of mass return with the exodus of migrants moving to their rural areas of origin in a span of few days. Migrants are at increased risk of livelihood crises, and the prevailing lockdown has left 42% of migrants with no ration and 33% are stuck in the cities with no food, water, and money.[13] Thus the pandemic may further impoverish them due to loss of livelihood and may affect their food and nutritional intake, access to healthcare and education of children. As migrants are not included in urban society, they are denied social security schemes, healthcare, and other entitlements. Further, the lack of identity and residential proofs makes it difficult for them to access schemes meant for the poor making them more vulnerable.

The pandemic also had affected the care of other seriously ill non-COVID patients due to the maintenance of the high level of suspicion by hospitals by demanding a COVID-19 test report to safeguard the health of other admitted non-COVID patients and healthcare staff. Past experiences have shown that a large number (30%) of quarantined individuals during severe acute respiratory syndrome outbreak suffered from posttraumatic stress disorder and depression.[14] The present pandemic having more stringent stay on social distancing and quarantine thus poses a greater risk of mental illness amidst the measures.

Unfortunately, the pandemic coincides with the Rabi harvesting season in India and is the time when the farmers' harvest reaches the market. However, the strong measures taken by the government to arrest the spread of the virus have made the harvesting and procurement operations difficult for farmers pushing them to more hardship in earning livelihood.

In a country like India, where the majority of the population falls under unorganized sector, the street vendors, contract workers, migrant workers, agriculture workers and almost everyone from informal sector is hit by this crisis making them give away their saving and pushing more towards the below poverty line. The prevailing measures of lockdown may slow the spread of the disease, but the poor cannot afford to stay idle at home. The individual from developed countries with good social security might sustain staying idly at home for some period, however, the staying power of the Indian poor is virtually nil. Although the nation has shown solidarity by supporting measures in this time of crisis and government has done commendable efforts with ensuring test kits, protective gear, ventilators, setting up COVID hospitals, isolation wards, etc., along with increasing the testing capacity at large.

Timely interventions for overall population are also critical; lots of efforts are being made by the government by tapping existing social security schemes such as pensions, Public Distribution System, MNREGA, and Mid-Day Meals to reach the poor and vulnerable. Expanding the present food security schemes in remote areas and to the vulnerable, doubling the ration to reduce the number of distribution, providing ration at home instead of school meals and fortification of government-supplied food to ensure adequate nutritional intake. A cash transfer to the poor has been initiated, and the 33 crore bank accounts under Jan Dhan Yojana being leveraged for this purpose. Small scale service industries have also felt the pinch in the course due to expenses that cannot be put off like salaries, lease installments, loan repayments, etc., and thus a loan guarantee could be offered to these industries to sustain the crisis. Along with these measures, good fiscal and liquidity policies are required to protect the purchasing power of vulnerable.

Apart from its immediate effects, the outbreak is likely to have a long-lasting social and economic impact not merely on national but on the global platform due to due to the direct or indirect effects of illness and transmission control policies of the government. The vulnerable and marginalized section already face challenges in accessing healthcare, education, and infrastructure and these disparities will be exacerbated by the pandemic. As we see that the morbidity due to the impact of the pandemic on aspects other than COVID-19 disease itself cannot be underestimated, it is required that equal weightage be given to containment of virus and protection of lives and livelihoods of many.



 
  References Top

1.
WHO Statement. Statement on the Second Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Outbreak of Novel Coronavirus (2019-nCoV). World Health Organization; 31 January 2020. Available from: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).[Last accessed on 2020 May 03].  Back to cited text no. 1
    
2.
World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19-11 March 2020. World Health Organization; 11 March, 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. [Last accessed on 2020 May 03].  Back to cited text no. 2
    
3.
Tracy SC, Upshur R, Daar A. Avian influenza and pandemics. N Engl J Med 2005;352:1928.  Back to cited text no. 3
    
4.
World Health Organization. Eleventh Futures Forum on the Ethical Governance of Pandemic Influenza Preparedness. Copenhagen, Denmark: World Health Organization; 2008. Available from: http://www.euro.who.int/__data/assets/pdf_file/0008/90557/E91310.pdf. [Last accessed on 2020 May 03].  Back to cited text no. 4
    
5.
Worldometer. COVID-19 Coronavirus Pandemic. Available from: https://www.worldometers.info/coronavirus/. [Last accessed on 2020 May 05].  Back to cited text no. 5
    
6.
Government of India, Ministry of Health and Family Welfare. COVID-19 India. Available from: https://www.mohfw.gov.in. [Last accessed on 2020 May 05].  Back to cited text no. 6
    
7.
Paul Anthem. Risk of Hunger Pandemic as COVID-19 set to Almost Double Acute Hunger by End of 2020. World Food Programme Insights; 16 April, 2020. Available from: https://insight.wfp.org/covid-19-will-almost-double-people-in-acute-hunger-by-end-of-2020-59df0c4a8072. [Last accessed on 2020 May 04].  Back to cited text no. 7
    
8.
Statement to UN Security Council: WFP Chief Warns of Hunger Pandemic as COVID-19 Spreads; 21 April, 2020. Available from: https://www.wfp.org/news/wfp-chief-warns-hunger-pandemic-covid-19-spreads-statement-un-security-council. [Last accessed on 2020 May 04].  Back to cited text no. 8
    
9.
International Labour Organization. COVID-19 Stimulating the Economy and Employment. Press Release; 29 April, 2020. Available from: https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_743036/lang--en/index.htm. [Last accessed on 2020 May 03].  Back to cited text no. 9
    
10.
United Nations: About 25 Million Jobs could be lost Worldwide Due to Coronavirus. The Economic Times (World News); 19 March, 2020. Available from: https://economictimes.indiatimes.com/news/international/world-news/about-25-million-jobs-could-be-lost-worldwide-due-to-coronavirus-united-nations/articleshow/74705919.cms?from=mdr. [Last accessed on 2020 May 03].  Back to cited text no. 10
    
11.
Maliszewska M, Mattoo A, Der Mensbrugghe V. Dominique. The Potential Impact of COVID-19 on GDP and Trade: A Preliminary Assessment (English). Policy Research Working Paper; no. WPS 9211; COVID-19 (Coronavirus). Washington, D.C: World Bank Group; 2020. Available from: http://documents.worldbank.org/curated/en/295991586526445673/The-Potential-Impact-of-COVID-19-on-GDP-and-Trade-A-Preliminary-Assessment. [Last accessed on 2020 May 04].  Back to cited text no. 11
    
12.
World Bank Predicts Sharpest Decline of Remittances in Recent History. Business World. Press Release; 23 April, 2020. Available from: http://www.businessworld.in/article/World-Bank-Predicts-Sharpest-Decline-Of-Remittances-In-Recent-History/23-04-2020-190040/. [Last accessed on 2020 May 04].  Back to cited text no. 12
    
13.
Pandemic Will Deepen Job and Livelihood Crisis of Migrants: Study. The Hindu (Karnataka); 26 April, 2020. Available from: https://www.thehindu.com/news/national/karnataka/pandemic-will-deepen-job-and-livelihood-crisis-of-migrants-study/article31439073.ece. [Last accessed on2020 May 04].  Back to cited text no. 13
    
14.
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