What America's dramatic Covid-19 turnaround can teach India

There were many mask wearers as people packed Universal City Walk, in Universal City, CA, Tuesday, June 15, 2021, as the state of California celebrates the end of pandemic-era restrictions, including mask wearing in most situations.
Image: Jay L. Clendenin / Los Angeles Times via Getty Images

On January 12, 2021, the US faced an apocalyptic situation—on an average, over 3,000 people were dying daily due to Covid-19. Four months later, the situation is dramatically different—deaths have come down significantly (approximately 350 per day), and over 44 percent of the population has been fully vaccinated. In May, the CDC updated its guidance that fully vaccinated individuals may carry out most indoor and outdoor activities without wearing masks, a major step towards the goal of returning to the pre-pandemic era. What explains the country’s dramatic turnaround, and what can India learn from it?

Respect the data
The first and most evident approach of the Biden administration in the last five months has been its attitude towards data. The Biden administration, on coming to power, has been more transparent with data and has put experts at the helm of the pandemic response. The administration uses a rubric of data—vaccination, infection, and death rates—to arrive at informed decisions on reopening and to take other public health decisions.  

In India, the total number of deaths in February 2021 was less than 100 per day. As cases began to rise in March, the data clearly showed the possibility of a second wave in an unvaccinated country. Yet, these hard signals were ignored in favor of irrational exuberance as mass gatherings dominated. The public face of the Covid-19 crisis management were politicians, bureaucrats, and celebrities, who were more interested in narratives than facts—while scientists continued to remain in the backseat. Currently, India has over 3,000 daily official Covid-19 deaths, and the reality is severely worse, given the scale of underreporting of Covid-19 deaths in rural India. As decisions about the distribution of oxygen, medicine, or funds are based on data, places like rural India are likelier to get far less support than they need. Not being serious about facts has had deadly consequences.

Hybrid leadership
A public crisis requires hybrid cooperation between different levels of government and the private sector. The Biden administration developed a coordinated federal strategy. On the first day in office, the Biden administration enacted the Defence Production Act, directing the private sector to manufacture critical goods such as glass vials and syringes to accelerate the vaccination drive. Similarly, the Trump administration’s $12.4 billion funding in 2020 of Operation Warp Speed accelerated Covid-19 vaccine development.

Individual states had the autonomy to design their own vaccine strategy, and the federal government coordinated with scientists and the private sector to procure the necessary bulk vaccine supplies, showcasing a good example of hybrid leadership.  

India’s 2020 Covid-19 response was appreciated by many as it took rapid steps to impose restrictions to arrest the pandemic. However, the relative success in the 2020 Covid-19 battle induced a sense of premature celebration in India. Investments were neither made in vaccine development and procurement nor in expanding India’s frail health infrastructure. Little financial or contractual support was given to Indian vaccine manufacturers to ramp up existing manufacturing capacities. As the second wave spread across India, the Indian government inexplicably decided to leave the task of procuring vaccines to the 36 states and territories. The central government has finally revised this decision, and vaccines shall be procured and financed centrally, with free vaccines given to all adults. This is a welcome step in the right direction, towards hybrid leadership.

Fund crisis response and science
On his first day in the White House, Biden and his administration signed an order to fully reimburse states for the cost of personnel and emergency supplies. Such funding provided life-saving funds to states and communities that had already been financially ravaged. The situation in India is unfortunately inverse. The fiscal health of Indian states is frail due to the pandemic, and the second wave will financially burden them even more. The frail fiscal health of the states is evident in the rise of crowdfunding campaigns to help remote areas get essential health infrastructure and supplies. Ideally, like the US’s Operation Warp Speed, India too should have invested substantial funds in 2020 to help its scientists and health sector develop and manufacture vaccines.

Conclusion
The crisis response of the US shows that evidence-based leadership that respects data, scientists and experts, and coordinates and funds science and crisis response can dramatically turn around the fate of a country. India needs a course correction too. Additionally, fearless experts and scientists who inform the public and policymakers need to be empowered and provided with resources and compensation to meet international standards. This is the moment for India to rethink its path, just as the US did a few months ago.
 
Dr. Anjul Khadria (California Institute of Technology) and Dr. Prateek Raj (Indian Institute of Management Bangalore)

Biography: Dr. Anjul Khadria (anjul@caltech.edu) is an Indian biochemical scientist at Caltech who has researched the Indian, British, and American research ecosystems. He studies mechanisms and dynamics of various drugs at Caltech and his research was deemed as essential by Caltech during the pandemic. Dr. Prateek Raj (prateekraj@iimb.ac.in) is an Assistant Professor of Strategy at Indian Institute of Management Bangalore, and a Stigler Center Junior Fellow at the University of Chicago Booth School of Business. His co-authored research on “How to manage large scale public crises?” appeared in the latest issue of Stanford Social Innovation Review.

[This article has been published with permission from IIM Bangalore. www.iimb.ac.in Views expressed are personal.]