Fellowship in the Time of Coronavirus

Despite the Worth Health Organization declaring a “public health emergency of international concern over the coronavirus, I haven’t actually heard much about it in my daily activities in Lucknow. When a coworker coughs, I may hear a joke cracked or “Stay away from me!” shouted in jest. I haven’t observed any serious preparation by my host organization or by municipal public services so far.  

Fulbright scholars in South Korea were recently offered early departure, and study abroad students in Italy, Japan, and Korea have been sent home or had their programs canceled. The AIF Fellows are keeping a close eye on the situation and wondering about our future and how this may affect the final months of our Fellowship. 

As a professional, I’m interested in public health and equitable economic development. That being said, I’m living in India during a fascinating moment.  

Back home in the US, the Federal Reserve has lowered interest rates to address the economic effects of Coronavirus. President Trump is also calling for a one-year payroll tax cut. Such fiscal stimulus policies aim to make it easier for people and businesses to borrow and spend money, and they’re common actions when an economic downturn is anticipated.

However, the real economic danger from Coronavirus is a disruption to international supply chains. The US economy is heavily linked with global markets, and sectors like manufacturing, technology, and agriculture are particularly tied to China. 

The Reserve Bank of India has yet to lower interest rates in response to the virus, with governor Shaktikanta Das citing India’s relative insulation from the “global value chain.” However, China is India’s second-biggest trade partner, and it is unlikely that India will be able to escape this public health emergency without experiencing any economic disruption. 

The Chairman of the Federal Reserve, Jerome Powell, and the governor of the Reserve Bank of India, Shaktikanta Das
The two men in charge of the fiscal policies of the US and India: Jerome Powell, chairman of the Federal Reserve, and Shaktikanta Das, governor of the Reserve Bank of India.

There are also vulnerabilities in the Indian domestic economy, and combined with gaps in the public health infrastructure, they pose serious consequences. 

In the States, elected officials and public health professionals are raising flags over the 27% of workers in the US private sector who do not have paid sick leave. It’s hard to find the equivalent statistic for workers in India, but I did find that 54% of salaried employees in the non-agricultural sector are not eligible for any kind of paid leave, according to a government survey.

Reliable data for all workers in India is scarce because estimates suggest 80-90% of Indians are employed in the informal sector. However, I suspect that the percentage of Indian workers who don’t have access to paid sick leave is actually much higher than 54 percent for two reasons. First, the “gig economy” is set up such that workers are denied access to paid sick leave. (Think of companies like Uber, Ola, Swiggy, and Zomato.) Second, domestic workers like maids, cooks, drivers, handymen, childcare workers, whose services are widely utilized in Indian households, are frequently employed without benefits. 

In the Indian economy, restaurants and the foodservice industry accounted for Rs. 3.7 trillion (50 billion USD) in 2018, 65-70% of which is made up of “unorganized” establishments, like dhabas, street stalls, and stand-alone shops. The food from such establishments is one of the joys of Indian culture – if your stomach can handle it, it’s usually delicious! 

View of street food from above.
A street food stall selling samosas, puris, and jalebi. Sometimes it is served fresh, sometimes it sits out for a while.

However, if the employees of such establishments don’t have paid sick leave, they may feel economic pressure to come to work, even if they are exhibiting COVID-19 symptoms. Couple that with the lack of food safety regulations at informal-sector eateries, and you have a recipe for coronavirus spread.

The same could be said for retail workers, who comprise 8% of India’s labor force. They may not have access to paid sick leave, and their job requires frequent public interaction and contact with frequently touched surfaces. Do they have enough information to do their jobs safely?

Coronavirus is spread via the transmission of respiratory droplets. General prevention measures include frequent hand washing, disinfecting frequently touched surfaces, and typical respiratory hygiene practices like covering one’s coughs and sneezes. Safe food preparation and hygienic eating practices are also important, as saliva could carry the virus.

sign prohibiting spitting
A sign posted at a Lucknow metro station. Those found spitting can be fined at the rate of Rs. 200 (about $2.85).

Without increased caution and preventative measures, transmission amongst the general public could escalate quickly. In my own experience, I’ve observed several cultural norms that are worrisome when paired with a public health emergency. Compared to American culture, it’s much more common to share food with your friends and family, as well as share straws and drinking cups. Food is often eaten with the hands, which are washed only semi-regularly. Public spitting is also a problem, despite the threat of fines. 

Some people wear face masks due to the pollution and vehicle exhaust on the roads, but the WHO reports a lack of evidence that masks are protective against the Coronavirus for people who are not already ill.

The Indian government can raise public awareness and make testing easier and more available. They could take after South Korea, which has set up drive-through testing centers. As of now, passengers on Indian domestic flights are not being screened (international passengers are being screened). Surfaces in large public areas with heavy foot traffic, like metro and railway stations, need to be disinfected frequently. 

World map showing the spread of coronavirus

In an interview with CNBC this week, Dr. Matthew McCarthy, of New York-Presbyterian Hospital predicted that the number of US cases will grow from under 100 currently to thousands of cases in the coming weeks. In Seattle, NPR reported that the Coronavirus has likely been circulating for longer than health officials had previously realized. I wouldn’t be surprised if similar reports start coming out of Indian cities soon. 

For a variety of reasons, the spread of viral disease slows down in warmer weather. From the sweat on my forehead, I can confirm that winter has officially left India. We’ll see if the spring and summer air is enough to protect the country from further spread of the Coronavirus! 

 

This article was written on March 6, 2020.

Photo credits:

  • Jerome Powell: https://www.usnews.com/news/economy/articles/2019-12-11/powell-federal-reserve-leave-interest-rates-unchanged
  • Shaktikanta Das: https://www.rediff.com/business/report/shaktikanta-das-impresses-first-rbi-board-meeting/20181215.htm
  • Map: https://www.newsweek.com/coronavirus-update-new-cases-death-toll-us-china-italy-south-korea-europe-1490434
  • All other pictures were taken by the author.

McKenna is serving as an American India Foundation (AIF) Clinton Fellow with Medha in Lucknow, Uttar Pradesh. For her Fellowship project, she is expanding partnerships with educational institutions to scale up an existing 21st-century career skills training center designed to improve employment outcomes for youth. McKenna graduated with a degree in nutritional sciences. During her undergraduate years, she participated in research on the iron fortificants and protein quality of different fortified blended food products used by the U.S. Agency for International Development to address malnutrition and iron-deficient anemia in developing countries. After several years of nutrition research, she began questioning the underlying causes of malnutrition and poverty in the developing world. She diversified her work to investigate the social and economic factors that impact health outcomes, such as a community advocacy group for affordable housing in Manhattan, Kansas, and eventually to Split, Croatia, in 2017 to learn more about socialized healthcare systems. A childhood exposure to Indian culture left McKenna with a lifelong passion for the country, which led her to spend four months studying abroad in Bangalore at Christ University. She is excited to return to India in a professional capacity as an AIF Clinton Fellow. During her year of service, McKenna is looking forward to evolving professionally, engaging with the cohort, and gaining new perspectives on the development sector.

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