India needs about Rs 26,000 billion to combat Covid-19: ICMR report

The New Indian Express
13 June 2020
By: Sumi Sukanya Dutta

A whopping 6.2% of the country’s GDP is required to fight the Covid-19 pandemic in India with intensified public measures, a report by the Indian Council of Medical Research (ICMR) has said. Considering that Union health ministry’s budget is 1.3 per cent of the GDP and the Centre has pledged Rs 150 billion towards the public health crisis so far. This means that the cost of Covid-19 care could be nearly five times the annual allocation for health budget and 75 times the money dedicated currently towards the disease management.

In absolute number that means, cost of Covid-19 management in the country could be Rs 25,534 billion or US $339 billion. The report “A Model-Based Analysis for COVID-19 Pandemic in India: Implications for Health Systems and Policy for Low- and Middle-Income Countries” has also noted that “in the event of a lockdown for 8 weeks, the peak of the epidemic shifts by 34-76 days, and the number of cases at the end of 8-week lockdown reduces by 69% to 97% with varying effectiveness of lockdown.

“However, the cumulative long-term cases remain the same,” says the report prepared by the public health specialists and health economists attached with the ICMR, PGI, Chandigarh, London School of Hygiene and Tropical Medicine and a member of the National Task Force on Covid-19.
The 25-page report submitted to the government also underlines that intensification of public health surveillance measures with 60% effectiveness is estimated to reduce the cases at peak and cumulative number of infections by 70% and 26.6% respectively.

Strengthening the health system response in terms of enhanced testing, isolation of cases, treatment and contact tracing, as is being done currently, would have to be the mainstay to reduce the impact of the pandemic in terms of reduction in infected population and COID-19 deaths in India until a vaccine becomes available, experts have said.

One of the highlights of the report is that without the lockdown and public health measures such as testing, contact tracing the peak would have come in mid- July but has now been shifted in November and the total number of infections at the peak would be much lesser than the unmitigated scenario. “The first two weeks of the lockdown were most effective in containing the spread of the disease and as per our analysis. The peak could be expected in October-November,” Dr. Narendra Arora, chair of the operations research group of the national Covid-19 task force said.

“While some modelers and scientists in the US and UK were predicting doom for India in May-June, we have done much better and the main cornerstone of our Covid-19 strategy has been the effective cluster management,” Dr. Arora said, adding, the country is much better prepared to deal with infections now than it was in March. According to the report, the health system cost of managing Covid-19 in the scenarios of no-mitigation or 8-week lockdown is estimated to be Rs 11,313 billion. “This is nearly 4.5% of the GDP. These estimated costs increased by 2.25 times with an intervention of 8-week lockdown and public health measures with 60% effectiveness,” says the report. “The incremental cost of intensified public health measures per infection and death prevented is estimated to be 43,867 and 3.84 million respectively.”

The estimated requirement of isolation beds, ICU beds, and ventilators at the peak of the epidemic in the unmitigated scenario is 1805, 394, and 69 per 1 million population, respectively—the experts estimated.

In the event of public health measures being strengthened with 60% effectiveness after lockdown, the requirement of ICU beds as well as ventilators each will be reduced by 83% . The report noted that the majority of the mild cases would require isolation in a non-hospital setting-- the current dedicated resources in terms of isolation beds, ICU beds, and ventilators are adequate to meet the necessity till the 3rd week of September.

“Beyond this point, there is a period of unmet need for approximately 3.3 months for isolation and ICU beds and 2.9 months. Similarly, in the scenario of intensified public health measures with 60% effectiveness after lockdown, the demand can be met till 1st week of November and afterwards it is inadequate for 5.4, 4.6 and 3.9 months to meet the demand for isolation beds, ICU beds, and ventilators, respectively,” the experts say in the report.




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