covids fairy tale

India finds itself in the throes of a humanitarian disaster. Until March 2021, case numbers were low in most parts of the country, leading many to think that the worst was over. Much like in Brazil though, jingoism, overconfidence and false reassurance from the political elite negated hard-won progress.

Mass gatherings have acted as state-sanctioned super-spreader events. More infectious variants and a sluggish uptake of vaccines are also fuelling the current surge. These are the triggers, but there are more deep-rooted issues at the heart of the current crisis.

India is an inherently high-risk country for an epidemic. The country holds 1.4 billion people, living in crowded areas with extensive community networks and limited facilities for sanitation, isolation and healthcare.

Most do not have the luxury of isolating at home for prolonged periods. Over 90% of workers are self-employed with no social safety net. The vast majority rely on daily earnings to put food on the table. Many predicted that because of all of this, the initial wave of COVID in 2020 would have a devastating impact.

The fact that it did not led some to believe that the Indian population was innately less vulnerable to COVID. An old theory, the hygiene hypothesis, was dusted off in an attempt to explain the low number of cases. The idea is that poor hygiene trains people's immune defences, so when people are exposed to the coronavirus, their bodies are well-equiped to deal with it.

But this theory largely relied on population studies that failed to account for various factors involved in disease severity at an individual level. Even with higher quality research, correlation does not imply causation, especially with the threat of new variants on the horizon. And yet this theory settled comfortably into the national psyche of a traditionally patriotic country.

Complacency gave the coronavirus an opportunity to spread. Unlike in the first wave though, proportionally more cases have progressed into deaths this time around because the health system was overwhelmed. Supplies of oxygen, ventilators, health workers and beds are critically low in hotspots like Delhi. But the fact that so many require medical care in the first place, is a symptom of longstanding structural deficiencies in the Indian health system.This book presents what we had in this pandamic . To many problems , poverty , anxiety, alonness ....

Bbut we don't lose our hope and fight for this situation.now I will gonna write about our nations .

INDIA

India recorded 1,84,830 new COVID-19 cases and 3,224 new deaths till 9.40 p.m. on Monday. The country has so far reported a total of 2,69,36,641 cases and 3,06,977 deaths. ... India's average daily test positivity rate (positive cases identified for every 100 tests) continues to decline.the coronavirus pandemic rapidly sweeps across the world, it is inducing a considerable degree of fear, worry and concern in the population at large and among certain groups in particular, such as older adults, care providers and people with underlying health

While COVID-19 is spreading rapidly, most people will experience only mild or moderate symptoms. That said, this coronavirus can cause severe disease in some people.The risks of getting COVID-19 are higher in crowded and inadequately ventilated spaces where infected people spend long periods of time together in close proximity. These environments are where the virus appears to spread by respiratory droplets or aerosols more efficiently, so taking precautions is even more important.Slum Health exposes how and why slums can be unhealthy; reveals that not all slums are equal in terms of the hazards and health issues faced by residents; and suggests how slum dwellers, scientists, and social movements can come together to ...encounter them every day, for they do jobs essential to the American economy. This impassioned book not only dissects the problems, but makes pointed, informed recommendations for change. It is a book that stands to make a difference.Poverty in a Rising India documents the data challenges and systematically reviews the evidence on poverty from monetary and nonmonetary perspectives, as well as a focus on dimensions of inequality.

Covid Tale: A Patient and a Doctor' is a personal account from a clinical perspective of the virus that has changed the world.This is the tale of a senior cardiologist who, after being infected, spent close to a month in hospital battling..

The first known infections from SARS-CoV-2 were discovered in Wuhan, China. The original source of viral transmission to humans remains unclear, as does whether the virus became pathogenic before or after the spillover evenInfection with the new coronavirus (severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2) causes coronavirus disease 2019 ( COVID-19 ). The virus that causes COVID-19 spreads easily among people, and more continues to be discovered over time about how it spreads.The new coronavirus latches its spiky surface proteins to receptors on healthy cells, especially those in your lungs. Specifically, the viral proteins bust into cells through ACE2 receptors. Once inside, the coronavirus hijacks healthy cells and takes command. Eventually, it kills some of the healthy cells..

The great majority of people with coronavirus will have mild or moderate disease and will make a full recovery within 2-4 weeks. But even if you are young and healthy - meaning your risk of severe disease is low - it is not non-existentResearch suggests that COVID-19 doesn't survive for long on clothing, compared to hard surfaces, and exposing the virus to heat may shorten its life. A study published in found that at room temperature, COVID-19 was detectable on fabric for up to two days, compared to seven days for plastic and metal.Experts recommend wearing masks in public and staying at least 6 feet away from others to reduce the risk of a coronavirus infection, but whether you should do both could depend on the.

It was a letter that arrived sometime on March 25 evening that announced the beginning of a nightmare. The letter, which confirmed the Delhi authorities' worst fears, landed at New Delhi's South-East district administration from the district administration of the Andaman and Nicobar Islands. It stated that all the six patients who had tested positive for novel coronavirus in the islands had one thing in common: they had all returned from a gathering at the Markaz (Centre), the headquarters of the Tablighi Jamaat, a conservative Islamic organisation, in New Delhi. The six of them had attended a large convention with more than 4,500 people from the world over.

The nightmare for the authorities was that all the attendees and their contacts had to now be traced and quarantined to prevent further spread of the deadly virus. Until this information came, India's efforts in combating the COVID-19 pandemic were confined to screening travellers who had come from abroad.The 2020 lockdown left tens of millions of migrant workers unemployed.[308][309] With factories and workplaces shut down, many migrant workers were left with no livelihood.[310] They thus decided to walk hundreds of kilometres to go back to their native villages, accompanied by their families in many cases.[311][312] In response, Indian stock markets witnessed a flash crash on 2 March 2020 on the back of the Union Health Ministry's announcement of two new confirmed cases.[346] On 12 March 2020, Indian stock markets suffered their worst crash since June 2017 after WHO's declaration of the outbreak as a pandemic.[347] On 23 March 2020, stock markets in India posted its worst losses in history.[348] SENSEX fell 4000 points (13.15%) and NSE NIFTY fell 1150 points (12.98%).[349] However, on 25 March 2020, one day after a complete 21-day lock-down was announced by the Prime Minister, SENSEX posted its biggest gains in over a decade.[350][351] The domestic stock markets have been in a positive rally from October 2020 to April 2021.[352]

On 25 April 2021 the government confirmed that it had made an emergency order requiring at least 100 social media posts to be removed by Facebook, Instagram, and Twitter, which included posts that it believed were misinformation, inducing panic among the public, or obstructing the response to the pandemic. This included critical tweets by West Bengal Minister of Labour and Law Moloy Ghatak, filmmaker and journalist Vinod Kapri, MP Revanth Reddy, and actor Viineet Kumar.[353][354][355]

On 30 April 2021, in a suo moto case regarding the government's response to the pandemic, a Supreme Court of India bench headed by Justice D Y Chandrachud commented on "free flow of information" and equated its restriction to contempt of court, "There should be free flow of information; we should hear voices of citizens. This is a national crisis. There should not be any presumption that the grievances raised on the internet are always false.[...] there should not be any kind of clampdown."[356]

On 21 May 2021, the Ministry of Electronics and Information Technology ordered social media outlets to remove all content that "names, refers to, or implies [an] 'Indian variant' of coronavirus", under the justification that it is misinformation because the World Health Organization does not officially recognize or use the term in relation to Lineage B.1.617.[357]

Health and other diseases

Main article: Impact of the COVID-19 pandemic on other health issues

The role of the National Centre for Disease Control during the COVID-19 pandemic has been questioned including the subdued sharing of data collected by the IDSP.[289] Disease surveillance in India through IDSP faces perpetual shortage of funds and manpower resulting in a weak nation-wide data collection system.[290] The IDSP does not track deaths taking place outside hospitals,[291] or deaths due to COVID-19 of those not tested,[292] one of the many reasons under-counting is built into the system. The lack of epidemiologists in senior decision making positions of COVID-19 related committees has been evident,[289] including the absence of state-level epidemiologists in a number of states.[293] In April 2020, the health ministry asked states to go on a hiring spree and fill vacancies for epidemiologists.[294] Indian Council of Medical Research has been criticised for did not updating the "treatment protocol for COVID-19" between July 2020 and April 2021.[295] The "National Task Force for COVID-19" did not meet during February and March despite members claiming it was obvious a second wave was in the making.[295] A number of warnings pertaining to a surge in cases in March, shortages in life-saving equipment and a second wave were downsized and went unheeded.[296] A number of problems were found with the forecasting and modeling by the National COVID-19 Supermodel Committee by independent commentators.[297] In early May 2021, the committee said that they hadn't been able to predict the second wave accurately.[298] Manindra Agrawal of the supermodel committee tweeted in March 2021 that there would be no second wave.[299] A lot of problems with India's failing response to the second wave was the general and long term issues of the public health system in India.

novel coronavirus disease 2019 (COVID-19) pandemic first struck the world's wealthiest countries, likely as a result of their global interconnectedness, involving trade and tourism. It spread from China in early 2020 to the west coast of the US and from China to Europe and then the east coast of the US. These wealthy countries shaped the global public health responses aimed at reducing person-to-person viral transmission via respiratory excretions, which involve

Physical distancing

Use of face masks

Hand washing

Stay-at-home / work-at-home (where possible)

Isolation of infected individuals and quarantining their contacts

School closures

Economic lockdowns that involve non-essential business closures

These public health interventions have proven effective in wealthier countries in reducing viral transmission and preventing healthcare systems from being completely overwhelmed by a surge of COVID-19 cases.

However, such solutions would often be difficult to implement in developing countries. In developing countries, people often live in crowded, multigenerational households. They may not have ready access to food refrigeration in the home, requiring daily food shopping. They often lack ready access to running water for hand washing, lack adequate sanitation, have poor or no internet connection for home schooling or work at home, and little or no savings to back up a loss of income (1). Even basic supplies that are taken for granted in developed countries, like soap, are likely subject to shortages. In some wealthy large cities in developing countries, millions of poor people live in shanty towns, where local conditions make following preventive measures designed for developed countries challenging. Examples include favelas in Rio de Janeiro and Sao Paulo in Brazil (2) or the townships of Cape Town and Johannesburg (3).

In addition, many of the healthcare and public health systems in developing countries are compromised by lack of equipment required to care for COVID-19 patients, such as personal protective equipment, bedside oxygen supply, pulse oximeters, ventilators, ICU beds, and insufficient infection control training of healthcare workers. For example, fewer than 2,000 working ventilators are available to serve hundreds of millions of people in public hospitals across 41 African countries (4). There are also chronic shortages of more basic supplies. These challenges are exacerbated by the prevalence of tropical parasitic diseases, malaria, HIV/AIDS, tuberculosis, and cholera in these countries. Data from South Africa's Western Cape province indicate that people living with HIV or tuberculosis have more than 2-fold increased risk of death from COVID-19 (5).

Similar conditions exist in poor and marginalized communities within developed countries. These communities too have significantly less capacity to absorb the shocks from the pandemic; examples of such communities include

Communities in the US with predominantly Latino populations where the prevalence of COVID-19 is 30 to 40%, such as the city of Chelsea in Massachusetts (6)

The Navajo reservations in New Mexico, where the COVID-19 incidence rate surpasses that of New York State (7)

The over 300,000 unskilled migrant workers in Singapore who live in packed dormitories that house up to 20 people per room and account for more than 90% of all the COVID-19 cases in Singapore (8)

Refugees, migrants and the homeless living in encampments on the outskirts or even the centers of cities like Los Angeles, Seattle, New York City, Oakland, Paris, and London

For all people living under these conditions, physical distancing is difficult to impossible.

In Africa, with 1.3 billion people (about 16% of the world's population), the COVID-19 pandemic was reported to have first arrived in Egypt on 14 February 2020, involving a Chinese national. The first confirmed case in sub-Saharan Africa was reported to have been in Nigeria on 27 February 2020, involving an Italian citizen. By 26 May 2020, more than half of all African countries were experiencing community transmission of COVID-19. The last African state to report a case of COVID-19 was Lesotho on 13 May 2020. Since the first COVID-19 case in Africa in mid-February, the pace of the outbreak has rapidly accelerated, taking 98 days to reach the first 100,000 cases and only 18 days to rise to 200,000 cases.

As of 20 June 2020, Africa reported 3.4% of the about 8.5 million total confirmed cases and 7.2% of the about 140,000 newly reported cases that day (9). However, only three African countries make up about 55% of Africa's total confirmed cases: South Africa, Egypt, and Nigeria. These three have relatively well-developed health systems, suggesting there may be widespread under-reporting in many of the other African countries with less developed public health systems. South Africa, Egypt, and Nigeria are usually 1st, 2nd, and 3rd in terms of the 24-hour increase in cases. The case counts in these three countries have been steadily increasing, doubling about every 2 weeks.

Taking South Africa as an example of difficulties to be overcome in developing countries, it is noted that about 80% of South Africa's more than 58 million people, are of Black African ancestry and most black adults still live in apartheid-era townships (10). The townships are crowded. People live in small makeshift houses, built out of boards and corrugated metal sheets, less than one meter (3 feet) apart from each other, often with communal toilets and communal water taps, each used by 30 or 40 people a day (11). These factors make it very difficult for residents of the townships to comply with social distancing requirements. Furthermore, many township dwellers have essential jobs outside of the townships, particularly in the city's hospitals and food supply, and often need to travel long distances every day on public transportation to get to work (12, 13).

The initial COVID-19 cases in South Africa involved people who were wealthy enough to have recently traveled abroad. The first known COVID-19 patient in South Africa was a man who tested positive upon his return from Italy on 5 March 2020. By 11 March, 6 new cases were reported, with 1 case from the same travel group from Italy and 5 others who had traveled to other European countries. On 15 March, the first local transmissions were reported. The number of cases rose to 150 on March 19 and then skyrocketed to 554 in merely five days. Within a month of the 1st case, there were 1500 cases; the number then doubled about every 10 to 14 days, reaching a total count of about over 92,000 on 21 June 2020.

From the official surveillance reports, it is difficult to tell how hard the townships have been hit by COVID-19. The national South African institute for Communicable Diseases website breaks down case counts only by age, sex, and province (14). As of 22 June 2020, the Western Cape province (the location of Cape Town, the country's 2nd most populated city) is the epicenter of the South African COVID-19 outbreak, with about 53% of the national cumulative cases, followed by Gauteng (the location of Johannesburg, the country's most populated city, and Pretoria, its administrative capital) at 21%.

The Western Cape provincial government website breaks down case counts by districts and by the eight health subdistricts within the city of Cape Town, namely Eastern, Western, Northern, Southern, Khayelitsha, Klipfontein, Tygerberg, and Mitchells Plain (15); the province's hot spot is the city of Cape Town, with now 78% of the province's cases. One third of Cape Town's population of 3.7 million lives in townships (16) ), which news reports say are the COVID-19 hot spots within the city (Khayelitsha, Klipfontein, Du Noon in Western, Hout Bay in Southern, and Mitchells Plain), as are the "working class" areas of Tygerberg (17, 18).

South African officials acted quickly to contain COVID-19's spread. At the end of March, the country entered into one of the strictest lockdown regimens in the world. People, many from the townships, were allowed to leave their homes during this period only to work in "essential services," access health care, collect social grants, attend small funerals (no more than 50 people), and shop for essential goods. Easing restrictions started 1 May 2020, at a time when South Africa was reporting fewer than 500 new cases daily; but, by the beginning of June, about 1000 to 2000+ new cases were being reported daily. Nevertheless, because of a deteriorating economy, the government opted to further ease the lockdown despite the rapidly rising case counts.

Almost 1 billion people, or 32 percent of the world's urban population, live in "informal settlements" under crowded and unhygienic conditions (eg, the South African townships), the majority of them in the developing world (19). Interventions to prevent the spread of COVID-19, like physical distancing, that have worked well in resource-rich settings are impractical in these circumstances either in South Africa (1), /), in other resource-limited countries, or even in certain parts of some wealthy cities in developed countries. Rapidly correcting the crowded conditions in these areas will be difficult, but Singapore is immediately reducing the population density of the current accommodations for their migrant workforce and rethinking their future housing (20). The South African government is said to be planning to "de-densify" the overcrowded "informal settlements" (21). When possible, changing the living conditions in "informal settlements" such as the townships, favelas, and homeless encampments needs to be carried out in partnership with community organizations in those areas so that any measures taken are more likely to be effective.

In addition, stay-at-home policies during the COVID-19 pandemic have imperiled the lives of many people dependent on each day's income to feed their family. Because the negative economic effects of the lockdowns have major effects on socioeconomically disadvantaged communities, important components of pandemic response planning include food rations and monetary support (11)THIRUVANANTHAPURAM: The single biggest challenge in 2021 would be ensuring that people in all the countries, both rich and poor, get access to the Covid-19 vaccine, World Health Organisation's Assistant Director General Dr Peter Singer said on Wednesday.

Singer pointed out that WHO Director General Dr Tedros Adhanom Ghebreyesus had observed that the "world is on the brink of a moral catastrophe" as the vaccine distribution had so far been skewed in favour of high income countries. He commended the role of Kerala and India in checking the spread of Covid-19 in the face of several difficulties and said "what we saw was a test of global solidarity" in 2020.

He said there were clear signs of the pandemic receding as the number of recoveries had far exceeded the number of people still affected.

Also, the vaccination process was gaining momentum.

Overcoming the pandemic was crucial to achieving the other UN goals such as reduction of poverty, hunger, illiteracy, gender inequality and air pollution, besides ensuring availability of clean water and sanitation, he said.Countries cannot recover until all their people can live their lives with confidence.

To save livelihoods as well as lives, we need to reach people with vaccines as soon as these are available. Doing this on an unprecedented global scale poses a huge challenge, especially for developing countries.

Both Pfizer-BioNTech and Moderna have announced that vaccines could be available soon; other trial results are imminent. So, the question is moving from if we'll have vaccines to when and how we can get them to people everywhere.

We want to make sure that low- and middle-income countries have fair, equitable access to vaccines , with priority for people who need it most urgently. In many places, we'll also need to strengthen health systems and build logistical capacity for vaccination to succeed.

This is where the World Bank Group plays a key role. In October, the World Bank approved up to $12 billion to help developing countries purchase and distribute vaccines, tests, and treatments. IFC, our private sector development arm, is making $4 billion available for manufacturers of vaccines and related supplies in low- and middle-income countries. Our staff have expertise ranging from public health to procurement to transport and logistics, and we have a strong presence on the ground in developing countries worldwide. India's middle class may have shrunk by a third due to 2020's pandemic-driven recession, while the number of poor people — earning less than ₹150 per day — more than doubled, according to an analysis by the Pew Research Center. In a comparison, Chinese incomes remained relatively unshaken, with just a 2% drop in the middle class population, it found.

The report, released on Thursday, uses World Bank projections of economic growth to estimate the impact of COVID-19 on Indian incomes. The lockdown triggered by the pandemic resulted in shut businesses, lost jobs and falling incomes, plunging the Indian economy into a deep recession. China managed to avoid a contraction, although growth slowed, the report said.India's 100 billionaires have seen their fortunes increase by 12,97,822 crores since March last year which is enough to give every one of the 138 million poorest Indians a cheque for Rs 94,045 each," the report said.

How pandemic ravaged India's poor

On the other hand, over 1.70 lakh people lost jobs every hour during the month o April 2020, according to the report. The Centre For Monitoring Economic Research, a Mumbai-based think tank, has often pointed out that the employment outlook is not improving even as the country's economy recovers.

During the initial months of the pandemic, most of the job losses were from the informal sector, which is still struggling. The Oxfam report suggested that 75 per cent or over 9 crore of 12.2 josh lost due to the pandemic were from the informal sector, where income levels are already low.Over 300 informal workers died due to the lockdown, with reasons ranging from starvation, suicides, exhaustion, road and rail accidents, police brutality and denial of timely medical care. The National Human Rights Commission recorded over 2,582 cases of human rights violation as early as in the month of April 2020," the report added.

Healthcare, education inequalities

Not just jobs and income, but inequalities have also increased in other areas such as healthcare and education during the pandemic.

Access to education for India's poorest population has reduced with online education replacing physical classes. The report noted that just three per cent of the poorest 20 per cent of Indian households had access to a computer, while just nine per cent had access to an internet connection.

The Oxfam report also noted that 6 per cent of the poorest 20 per cent households had access to non-shared sources of improved sanitation, compared to 93 per cent of the top 20 per cent households in the country.

"The spread of disease was swift among poor communities, often living in crammed areas with poor sanitation and using shared common facilities such as toilets and water points," it said.

Experts have already said that the Covid-19 pandemic has caused permanent damage to the country's poorer population and only higher spending by the government can help them recover. The coronavirus (COVID-19) is a crisis like no other the world has faced in recent decades in terms of its potential economic and social impacts. We estimate that the pandemic could push about 49 million people into extreme poverty in 2020.

A large share of the new poor will be concentrated in countries that are already struggling with high poverty rates, but middle-income countries will also be significantly affected. Almost half of the projected new poor (23 million) will be in Sub-Saharan Africa, with an additional 16 million in South Asia. The number of extreme poor in the poorest countries that are served by the World Bank's International Development Association is projected to increase by 17 million. At the same time, 22 million of the projected new poor will be in middle-income countries. The poor live primarily in rural areas. While this could minimize their exposure to the disease, it also means they have limited access to health services. Moreover, since rural households tend to depend more on domestic remittances from urban migrants, economic shutdowns in urban areas will hurt them too. The poor in urban areas, on the other hand, live in congested settlements with low-quality services, which would significantly increase their risk of being infected by the contagion. Disruptions in food markets could be more severe in urban areas.

Where they work. The poor work largely in the agriculture and service sectors and are usually self-employed or informally employed, mainly in micro and family enterprises. Those employed in the informal service sector in urban areas are likely to bear the most severe initial impacts. In addition, many of the vulnerable non-poor, who are increasingly employed in the gig economy, particularly in middle-income countries, will also be at risk of slipping into poverty. Those engaged in agriculture may be able to cope, at least initially, with potential disruptions to food supplies or price spikes, but are likely to be affected by a decline in demand in urban areas over time.

High dependence on public services, particularly health and education. In the immediate term, limited access to high-quality and affordable health services can have devastating impacts in the event of an illness in the family, while school closures can lead to a decline in food intake among children of poor families who rely on school feeding programs. In the long term, the impacts of lost months of schooling, early childhood interventions, health check-ups, and nutrition can be particularly high for children in poor families, adversely affecting their human capital development and earning potential.

Limited savings and lack of access to insurance. This, in the absence of adequate safety nets, can force the poor to rely on coping strategies with potential long-lasting negative effects, such as the sale of productive assets or diminished investments in human capital.Emerging data from affected countries suggests that the poverty and distributional impacts of COVID-19 are materializing fast, with dire consequences. One of the first available rapid phone surveys that assessed the impacts on livelihoods took place in China's rural areas. It found that about half of the villages surveyed experienced income losses averaging 2000-5000 RMB ($282-$704) per family over the previous month. Villagers are reducing their spending on food as a result, with significant consequences for nutrition and long-term human capital development.

Similarly, phone surveys in Bangladesh in March show that 93 percent of individuals interviewed experienced income losses averaging 75 percent over the previous month, and around 72 percent lost their jobs or saw their economic opportunities reduced. As a consequence, the number of respondents living under the national poverty line has increased from 35% to 89%.

Policies needed to mitigate poverty and distributional impacts will have to respond to each country's context and circumstances. Having said that, the numbers above suggest that across affected countries:

An effective response in support of poor and vulnerable households will require significant additional fiscal resources. A back-of-the-envelope calculation can illustrate this. Providing all the existing and new extreme poor with a cash transfer of $1/day (about half the value of the international extreme poverty line) for a month would amount to $20 billion —or $665 million per day over 30 days. Given that impacts are likely to be felt by many non-poor households as well and that many households are likely to need support for much longer than a month, the sum needed for effective protection could be far higher.

Any support package will need to quickly reach both the existing and new poor. While existing safety net programs can be mobilized to get cash into the pockets of some of the existing poor relatively quickly, this is not the case for the new poor. In fact, the new poor are likely to look different from the existing poor, particularly in their location (mostly urban) and employment (mostly informal services, construction, and manufacturing).

Decision-makers need timely and policy-relevant information on impacts and the effectiveness of policy responses. This can be done using existing, publicly available data to monitor the unfolding economic and social impacts of the crisis, including prices, service delivery, and economic activity, as well as social sentiment and behaviors. In addition, governments can use mobile technology to safely gather information from a representative sample of households or individuals. Phone surveys can collect information on health and employment status, food security, coping strategies, access to basic services and safety nets and other outcomes closely related to the risk of falling (further) into poverty.New Delhi: One of the greatest challenge which humanity faces today is of eradicating various forms of poverty in many countries. There has been a significant reduction in global poverty from 1.9 billion people who lived below poverty line in 1990 to 836 million in 2015[1]. These numbers show that progress has been made by bringing down the numbers but that does not indicate complete eradication of poverty. A large section of the population is still struggling to get access to basic human needs. Even if the rates are declining, it is still estimated that 6% of the world's population will be suffering from this issue. Asian countries have shown rapid development in recent years and are still efficiently working towards tackling poverty but the progress they have achieved is uneven which could be seen in terms of gender and in terms of accessibility. Women have been subjected to less exposure, there's a discrimination in access to education, property, job opportunities and are more likely to suffer due to poverty compared to men. are highly preferred when it comes to job opportunities.

The people under rural sector have been provided access to financial services under the "Pradhan Mantri Jan Dhan Yojna" which focusses on providing insurance, banking, pensions and credit to the ones in need. Improvisation of social security provisions enables "direct benefit transfer.[2]" The universalization of health care system under "Pradhan Mantri Jan Arogya Yojna" was strengthened and further aims to provide health facilities ensuring "inclusivity" and "equity". National Social Assistance Programme is aimed to focus on the disadvantaged and vulnerable sections of society which includes widows, senior citizens, differently-abled people, and it also facilitates access to life insurance, pension of workers and also personal accident insurance. The "economically" disadvantaged have also been assured housing along with financial assistance.

Many other welfare initiatives have been launched by the government such as the Saubhagya scheme, which aims to provide electricity to households. Also, the government is working on various projects in order to protect property and people from natural disasters under National Disaster Management Act, 2005 and the National Policy on Disaster Management, 2009 which lays emphasis on mitigation, prevention and a prepared approach towards relief strategies[3].

In India, unemployment is a major reason behind poverty. The Mahatma Gandhi National Rural Employment Guarantee Act is one of the schemes initiated towards improving living standards in rural areas and other "productive assets"[4] such as in agriculture productivity, access to better markets and creation of rural infrastruture. Women from STs, SCs and other tribal communities have greatly benefited from this scheme.

But the current situation of COVID-19 has created a crisis-like situation for many. During the declaration of complete lockdown, there was an underestimation of the "mass exodus" of the migrant population as well the Niti Aayog report which states that the size of the Indian informal workforce is at 85%[5]. The lockdown resulted in loss of income for a major chunk of the work-force, who were forced to move to their home states due to difficulty in surviving in major towns beacuse of economic hardships. The urban areas which were a source of "social security" for the rural poor are now being seen as places where its impossible to make a living in current circumstances. Millions of daily wage workers in the informal sector have been massively struck by the above concerns. This is also the reason behind the adverse effects on the physical, mental well-being and security of the poor Indian population. COVID-19 outbreak has showcased how the poor are often poorly represented during the policy-making decisions. For India ito achieve its SDG goals and ensuring noone is left behind, poverty eradication and inclusive development should sit at the apex of its national efforts.

Courage, strength and collaboration between the regular citizenry like the medical professionals, scientists and researchers has proved to be difficult in combating the pandemic we are facing. It is important that our governments take quick and robust decisions and implement the required and effective policies. This preferentially requires "overcoming the resistance of entrenched institutions and mindsets[6]" which is an extensive challenge in itself.The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems and the world of work. The economic and social disruption caused by the pandemic is devastating: tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people, currently estimated at nearly 690 million, could increase by up to 132 million by the end of the year.

Millions of enterprises face an existential threat. Nearly half of the world's 3.3 billion global workforce are at risk of losing their livelihoods. Informal economy workers are particularly vulnerable because the majority lack social protection and access to quality health care and have lost access to productive assets. Without the means to earn an income during lockdowns, many are unable to feed themselves and their families. For most, no income means no food, or, at best, less food and less nutritious food.

The pandemic has been affecting the entire food system and has laid bare its fragility. Border closures, trade restrictions and confinement measures have been preventing farmers from accessing markets, including for buying inputs and selling their produce, and agricultural workers from harvesting crops, thus disrupting domestic and international food supply chains and reducing access to healthy, safe and diverse diets. The pandemic has decimated jobs and placed millions of livelihoods at risk. As breadwinners lose jobs, fall ill and die, the food security and nutrition of millions of women and men are under threat, with those in low-income countries, particularly the most marginalized populations, which include small-scale farmers and indigenous peoples, being hardest hit.

Millions of agricultural workers – waged and self-employed – while feeding the world, regularly face high levels of working poverty, malnutrition and poor health, and suffer from a lack of safety and labour protection as well as other types of abuse. With low and irregular incomes and a lack of social support, many of them are spurred to continue working, often in unsafe conditions, thus exposing themselves and their families to additional risks. Further, when experiencing income losses, they may resort to negative coping strategies, such as distress sale of assets, predatory loans or child labour. Migrant agricultural workers are particularly vulnerable, because they face risks in their transport, working and living conditions and struggle to access support measures put in place by governments. Guaranteeing the safety and health of all agri-food workers – from primary producers to those involved in food processing, transport and retail, including street food vendors – as well as better incomes and protection, will be critical to saving lives and protecting public health, people's livelihoods and food security.

In the COVID-19 crisis food security, public health, and employment and labour issues, in particular workers' health and safety, converge. Adhering to workplace safety and health practices and ensuring access to decent work and the protection of labour rights in all industries will be crucial in addressing the human dimension of the crisis. Immediate and purposeful action to save lives and livelihoods should include extending social protection towards universal health coverage and income support for those most affected. These include workers in the informal economy and in poorly protected and low-paid jobs, including youth, older workers, and migrants. Particular attention must be paid to the situation of women, who are over-represented in low-paid jobs and care roles. Different forms of support are key, including cash transfers, child allowances and healthy school meals, shelter and food relief initiatives, support for employment retention and recovery, and financial relief for businesses, including micro, small and medium-sized enterprises. In designing and implementing such measures it is essential that governments work closely with employers and workers.

Countries dealing with existing humanitarian crises or emergencies are particularly exposed to the effects of COVID-19. Responding swiftly to the pandemic, while ensuring that humanitarian and recovery assistance reaches those most in need, is critical.

Now is the time for global solidarity and support, especially with the most vulnerable in our societies, particularly in the emerging and developing world. Only together can we overcome the intertwined health and social and economic impacts of the pandemic and prevent its escalation into a protracted humanitarian and food security catastrophe, with the potential loss of already achieved development gains.

We must recognize this opportunity to build back better, as noted in the Policy Brief issued by the United Nations Secretary-General. We are committed to pooling our expertise and experience to support countries in their crisis response measures and efforts to achieve the Sustainable Development Goals. We need to develop long-term sustainable strategies to address the challenges facing the health and agri-food sectors. Priority should be given to addressing underlying food security and malnutrition challenges, tackling rural poverty, in particular through more and better jobs in the rural economy, extending social protection to all, facilitating safe migration pathways and promoting the formalization of the informal economy.

We must rethink the future of our environment and tackle climate change and environmental degradation with ambition and urgency. Only then can we protect the health, livelihoods, food security and nutrition of all people, and ensure that our 'new normal' is a better one

India faces multiple major challenges on the COVID-19 front. It is densely populated: 464 people/km2 compared with Italy's 206, Spain's 91, Iran's 52 and the USA's 36. It has a huge population: 1380 million (USA 330 million, Iran 83 million, Italy 60 million, Spain 46 million). Social distancing without total shutdowns is unthinkable, especially in the big cities with crowded streets, trains, buses and offices. Cough hygiene is largely absent. Hand hygiene is equally suspect. The latest data from the government National sample survey organisation say that only 36% of Indians wash their hands with soap before a meal.1 Even more distressingly, 160 million Indians do not have access to clean water to wash their hands.2 The research suggests that diabetes and hypertension worsen COVID-19 outcomes: the prevalence among Indian adults of diabetes and hypertension is 10% and 25%, respectively. India has high rates of TB and pneumonia. People have resisted being screened and flouted quarantines with impunity.3 The awareness about disease dynamics is very poor, even among the wealthier and more educated parts of the population: after the national voluntary 'people's curfew' called by the prime minister on 22 March, which was by and large a success, people came out on the streets and celebrated with no attention to social distancing, achieving the exact opposite of what the curfew was supposed to achieve. Imposing a lockdown is next to impossible in India's vast rural hinterland, home to 900 million people (65% of the population). Seventy per cent of the rural population is dependent on agriculture and April and May is the harvesting season for their Rabi crops.

Before the 21-day lockdown imposed from 25 March, mathematical modelling put the number of expected cases in India between 300 million and 500 million by July end, with a peak somewhere in April and/or May of 100 million cases, with 10 million (10%) requiring hospitalisation, 5 million recovering, 5 million needing critical care and 1 to 2.5 million deaths. After the lockdown, these numbers are estimated to come down by about 80%, with 1 million needing critical care, including ventilator support.4 India has just 20 000 ventilators. That is a 98% shortfall. The government response has been to make 40 000 more by June. Even into late March, India had an abnormally low testing rate of 18 per million population (South Korea 6931, Italy 5268, UK 1469, USA 1280).5 While there are several reasons for this, it is clear that this strategy is unsustainable and that testing rates will have to be raised dramatically. Media reports indicate that the acute shortage of personal protective equipment (PPE) is of the government's own making. While industry bodies had reached out to the government with the need to create stockpiles of PPE in early February, the government did not ban exports of PPE until mid-March. Bureaucratic delays compounded matters further.6

The COVID-19–induced 21-day lockdown has put more strain on an economy that was already experiencing declining growth and increased joblessness. More than 75% of India's substantial 100 million migrant workers have lost their jobs overnight. The retail industry is expected to lose 10 million jobs, the restaurant industry 1.5 million jobs and the transport industry 5 million jobs. Fifteen million unregistered workers have been left out of a meagre government benefits package. There is no doubt that with falling incomes, this economic pandemic will increase the proportion of health expenditure that is catastrophic, thereby pushing more people below the poverty line. The COVID-19 pandemic will also result in a decrease in accessibility to healthcare as many private care providers, both individuals and institutions pull themselves out of service, both in public interest and as a measure for self preservation: this is already being seen with the postponement of elective surgeries and the closure of OPDs in several geographies. Although temporary, it is sure to cause significant morbidity and mortality from non–COVID-19 causes. This will result in an increase in out-of-pocket expenditure on healthcare and will probably worsen non–COVID-19 health outcomes as well, given the twin predicaments of a COVID-19–induced depletion of healthcare manpower and the COVID-19 burden on the healthcare system. India's chronically underfunded public health system and an unaccountable private healthcare system will make things even more difficult. These are fertile areas for future research.

India's first case was confirmed on 30 January 2020. Italy and Spain had their first cases confirmed a day later. The USA had its first case confirmed on 20 January. After almost 2 months, India has had only 20 COVID-19 confirmed deaths as against 9000 in Italy, 5000 in Spain and 1200 in the USA. There is a big question mark on the accuracy of the Indian COVID-19 mortality data in the absence of comprehensive testing of severe acute respiratory infections (SARIs). India sees 100 million cases of influenza-like illness every year, which have the same symptoms as COVID-19. That works out to an average of 27 000 cases per day. Into the final week of March, India was testing about 2000 cases per day (much higher than the 100 tests a day in mid-March): a deficit of 92%. With a mortality rate of 0.1%, the 100 million influenza cases cause 100 000 deaths every year: 273 every day. In the absence of any data on how many of these fatalities were tested for COVID-19, the possibility of underdetection of COVID-19 deaths exists. Going on, surveillance for cases of SARI would need to be strengthened to build confidence in the COVID-19 mortality data.

India has just 0.8 doctors per 1000 population as against Italy's 4.1, China's 1.8, Spain's 4.1, Iran's 1.1 and the USA's 2.6.7 India has just 0.7 hospital beds per 1000 population as against Italy's 3.4, Spain's 3, Iran's 1.5 and the USA's 2.9. In the wake of a tsunami of COVID-19 cases requiring hospitalisation, this manpower and infrastructure are going to prove inadequate. There is some hope in India that the avalanche will not come. This hope stems from two silver linings: the weather and the age demographic of the population. There is some evidence that the COVID-19 virus is weather and humidity sensitive. The spread of outbreaks of COVID-19 suggest a preference for cooler and drier climates.8 India's summer temperatures average 32–40°C with a humidity range of 50%–70% across the country. If COVID-19 actually is weather and humidity sensitive, it would slow down the spread of the virus in India. Only 6% of India's population is above 65 years of age compared with Italy's 22%, Spain's 18% and the USA's 16%. With case fatality rates for COVID-19 significantly lower among younger populations, this augurs well for India. As the COVID-19 story of death and economic destruction unspools over the next few months, Indians will be hoping that the two silver linings deliver some respite.India's effort to combat COVID-19 pandemic has been acknowledged all across the globe. However, there is cascading impact laid on various sections of society and economic cost at various levels because of the lockdown. This pandemic has led to compulsion for massive and reverse migration in large parts of the country from the urban to rural areas. Indian roads are flooded with laborers marching back to their villages to find some warmth, safety, and empathy.[2]

Workers at the grass root levels are basically the growth engine from centuries who works day and night for the economic growth of many region around the globe. Still, they are vulnerable and have no access to social security. This reverse migration from urban to rural areas will lead to significant impact on the health of society, demography, and economy of rural India.[2]

As this pandemic affected all over country, the role of primary care physician are very important as patient first reports to them for any illness related to non-COVID/COVID. They play important role in the assessment, management, and reporting to health administration about the burden of COVID in their posting/working area.

The dire consequences of COVID-19

This unparalleled pandemic comes with many dire economic prospects. The harsh reality of divergence in countries like India is that as social distancing is difficult to follow poor people are more likely to become infected with the coronavirus. They have less access to health care facility, are more likely to lose their job, and are more susceptible to hit with spikes in food prices.[2],[3]

Due to the population burden, the low reporting of COVID-19 cases as per the health infrastructure will result in the community spread of the novel virus. The reverse migration of labors will also create excess pressure on rural economy and the agriculture which will lead to number of people to fall into trap of poverty. COVID-19 will have both short- and long-term effect on various aspects of economy in India.[3]

mortality rate in India below 3% is the country's large percentage of young population. 27% of India's population is below 14 years, which marks the significant difference in comparison to major countries of the world.[4] There seems to be a high association between percentage of above 65 years population and the mortality rate. Italy, Spain, France, UK, and Belgium all have a very high percentage of their population in this specific category with alarmingly high fatality rates.

In comparison, India has relatively low overall mortality rate of just 2.71% because of just 6% of its population being above 65 years. There are several other factors which could also be deemed responsible for the low mortality rate in India—the stringent lockdown, BCG vaccine, hot temperature, high percentage of rural population, to name a few. But having a large proportion of the young and a very low percentage of the old may have just saved a lot of lives for the country.[4]

While the past few months have changed lives of enormous number of individuals completely, no other group has been more affected by the pandemic and uncertainties revolving around it, than children. A recent report titled "Upended Lives," the United Nations Children's Emergency Fund (UNICEF) has said that an extra 2,400 children in South Asia could die every day as an indirect repercussions of the pandemic. The report adds that the pandemic is vanishing decades of progress made on health, education, and other areas.[5],[6],[7]

With reduced access to healthcare systems, life-saving medicines, proper nutrition, and education and movement restrictions, children—both young and adolescent—may pan out worse this pandemic.[5]

Delayed vaccination and healthcare

A study which got published in Johns Hopkins Bloomberg School of Public Health in the Lancet Global Health Journal, because of reductions in routine health service coverage levels, disruption in life-saving vaccination activities, and an increase in child wasting, up to 3,00,000 children could die in India alone in the next 6 months. The agitation of contracting the virus at clinics and the shutdown of medical facilities has led to delays in the administration of essential vaccinations and accessing healthcare facilities in case of emergency. This intensifies the risk of a child getting infected with the disease that the vaccine was meant to protect against. A widespread delay in vaccination could also menace social immunity that has been developed against many diseases, over time.[5]

Food insecurity

Malnutrition has been a muted killer in India, even before the pandemic. As per the Global Nutrition Report 2020, India is home to half of the world's malnourished children or those who suffer from low weight for height. Over 40 million children are also chronically malnourished and wasted. This has been aggravated further because of the pandemic. The report from Independent Accountability Panel (IAP) projects that debilitation because of malnutrition could increase by 10–50%, because of COVID-19. With the shutdown of schools, 370 million children worldwide are missing out on mid-day meals, which, in many cases, are the sole nutritious meal these children probably have in a day. In India, while some states are trying to continue mid-day meals schemes by give out ration to school children, dry ration cannot replace warm cooked meals provided in schools. Furthermore, with many losing their income and with pay losses and dwindling economics, families are enforced to chop corners financially, often at the value of nutritious food, which children may have otherwise had access to.[5]

Domestic violence

Among the foremost alarming indirect effects of the lockdown, there is an increased amount of violence on children, where they ought to be safe—their own homes. With job losses, pay cuts, and psychological state problems induced by isolation and curbs placed on movement, overall frustration and anxiety levels have increased. In many cases, this is often directed toward children, who are subject to physical, mental, and sexual assault.

The IAP report also projects that 15 million more cases of gender-based violence might be anticipated for each 3 months of the lockdown. Furthermore, thanks to delays within the execution of programmes to finish such harmful practices, 2 million additional cases of female genital mutilation (FGM) could happen over subsequent decade.[5]

Increased screen time

The shift from physical to virtual classrooms has increased screen time for youngsters, who are forced to remain ahead of their mobile phones or laptops for prolonged periods of time. Added on to it, in present scenario, the time already spent is on excessive playing video games, watching television, socializing with friends, or completing online activities. The dangers related to excessive screen time are well documented—it's been known to hamper learning capacities in children and cause attention deficit. It could also cause several disorders like obesity, eye damage, hypertension, and disrupted sleep patterns.

With more children getting online at younger age, and without the required purpose to protect themselves, children are at a heightened risk of falling prey to cyberbullies and sexual predators. Cybercrime are available in many forms—those circulating unwanted material, spreading morphed photos of youngsters, sending threatening emails or messages or emotionally blackmailing children. As per expert suggestions, it's always advisable to monitor the devices their children are using, and spend more quality time with their children to mitigate the negative effects that added screen time may have on children.[5]

Mental and physical health

As per reports, 30% of youngsters or parents who are under quarantine or isolation, suffer from acute stress disorder, depression, and other problems. Reduced mobility, inappropriate accommodation facilities or having to measure in cramped quarters, lack of social life, no physical school, stress and violence reception and therefore the inability to continue with outdoor activities has led to increased cases of isolation and aggressive behavior among children as well as in adolescents.[5] The pandemic has negatively impacted diet, sleep routines, and physical activity among children, heightening the danger of obesity. This is more so within the case of youngsters who already suffer from obesity. During the lockdown, physical activity decreased by quite 2 h every week, while the intake of sugary food, sodas, and processed food increased.[6],[7]

Inequality in education

In India, as per the UNICEF, the lockdown has impacted around 247 million children enrolled in primary and education, aside from the 28 million children who were undergoing pre-primary education at Anganwadis. This, the report states, is additionally to the quite six million children who were out of faculty pre-pandemic. While many faculties, in India and worldwide, have tried to continue educational programmes online and through other e-platforms and TV channels, many students who don't have access to any digital media lose out.[5],[6],[7]

Effect of COVID on education

Impact of COVID epidemic in current time on every segment of primary, secondary, university, technical, and medical education is very vast whose effects might be seen in future. Primary education is suffering most as children of poor parents are not getting education and rich parent's children are getting overwork through online education.

They have side effects of psychological stress, physical inactivity, eyes and neurological problems, headache because of prolonged screen time at the age when visual system is still developing. How and in what pattern child is learning, after effects on parent's productivity, child care, nutrition, physical and mental status, the consequences will come late in future.

On secondary education which is based on boards exams because of closure of schools and college study pattern now changing to online classes and self-study will be changing the pattern of quality of education and results.

The professional education is very important as professional skills are based on practical training because of the closure of college and institute, incomplete or improper training will lead to various negative impact in medical, engineering, nuclear, biological areas, etc., while training and working. In the same way university education will lag behind by online and inappropriate teacher student communication. As human development had occurred by passing information to generation by persons' contact, we do not know what are and will be the consequences on overall education by non-human contacts.

The new normal

Everyone is talking about the "new normal" brought on by the coronavirus pandemic. But what aspects this new normal bring for enterprises, governments, and consumers lies in the future ahead. The new normal has increase the rapid adoption of emerging and new technologies, with technology becoming prevalent across industries and markets.[6]

Human resources

Greater emphasis will be on automation, mechanization, and off-site fabrication. Alternate strategies to reduce overdependence on labor, technology will play a critical role in tiding over manpower and demand mismatch, providing better on-site facilities (including health and hygiene) to migrant labor; attempt to stop reverse migration in future, splitting work teams (smaller crews and longer, staggered shifts).[7],[8]

Material management

Sourcing selection to gain more prominence identifying alternative suppliers, greater awareness of geography related supply chain pitfalls, building in sufficient flexibility to counter potential disruptions in supply chain, risk mitigation- data analytics driven mobilization, sensing, configuration, and re-configuration of the entire operating cycle.[7],[8],[9]

Monetary aspects

Continuous assessment of profitability in low revenue environment, greater importance on cash flow reserves, revolving credit lines supporting day to day working capital requirements, refinancing of debt, although avenues will remain constrained in times of industry wide crisis, contractors and developers expected to assess contract provisions, insurances, and compliance commitments with much more maturity and foresight.[9] Menus

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COVID-19, India, lockdown and psychosocial challenges: What next?

Mahaveer GolechhaFirst Published June 13, 2020 Letter Find in PubMed

https://doi.org/10.1177/0020764020935922

Article Information Open epub for COVID-19, India, lockdown and psychosocial challenges: What next?

SAGE ChoiceOpen AccessCreative Commons Attribution 4.0 License

A world pandemic threat COVID-19 mitigation is crucial to the human life and for reducing distortion of livelihood. The COVID-19 pandemic has swept into more than 200 countries with considerable confirmed cases and deaths and has caused public panic and mental health stress (Huang & Zhao, 2020). Most of the nations across the world have implemented complete lockdown with stringent social distancing measures for breaking the chain of transmission. The current outbreak of COVID-19 is heavily impacting the global health and mental health. Despite all resources employed to counteract the spreading of the virus, additional global strategies are needed to handle the related mental health issues (Torales et al., 2020). This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally (Torales et al., 2020). To protect people and prevent the spread, it is critical that public mental health paradigms and measures are usedCOVID-19 has not left any part of the world untouched and India is one of the worst affected countries in the world. The cases in India are rising steadily with each passing day. As of August 10th 2020, India has over 2.3 million (the second million coming in exactly three weeks since the country hit a million infections on July 16, with 42 percent of the new cases coming from Andhra Pradesh, Karnataka, Uttar Pradesh, West Bengal and Bihar) confirmed COVID-19 cases and 46,188 reported deaths. The worst affected states of India include Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi and Uttar Pradesh. Another growing concern is that interior parts of the country are emerging as new hotspots. Four states in eastern India, namely, Odisha, Bihar, Assam and West Bengal are increasingly reporting positive cases. The two main reasons being reported for this surge in cases in rural areas are the returning migrants from major cities who did not undergo screening or were asymptomatic and the poor healthcare infrastructure in the rural settings. Out of a total of 739 districts in India, 13 districts (across 8 states and a union territory) account for 1 in seven Covid-19 deaths. The 13 districts are: Kamrup Metro in Assam, Patna in Bihar, Ranchi in Jharkhand; Alappuzha and Thiruvananthapuram in Kerala, Ganjam in Odisha, Lucknow in UP; North 24 Paraganas, Hooghly, Howrah, Kolkata and Maldah in West Bengal, and Delhi. These districts account for nearly 9 percent of India's active cases and about 14 percent of COVID-19 deaths. Over the spring and summer, the COVID-19 situation in India has really deteriorated and could get much worse on the current trajectory with around 60,000 cases being reported per day and around 900 daily deaths.

Lockdown and travel bans due to COVID-19 have impacted almost every sector including tourism, hospitality, and education. To deal with the coronavirus crisis, the central government has undertaken various initiatives like monetary relief package under Pradhan Mantri Garib Kalyan Yojana, Uttar Pradesh Rojgar Abhiyaan, Atma Nirbhar Abhiyaan etc. The state governments have also undertaken various initiatives like Operation SHIELD, 5T Plan, Mission Fateh, Snehar Paras etc. We describe these briefly. Some regions in India have successfully contained COVID-19 like the state of Kerala, the district of Bhilwara in Rajasthan and the slums of Dharavi in Mumbai. In order for a strategy of containment and recovery to succeed, it is vital to keep using public health measures to suppress the epidemic, that is to drive R < 1. Besides the infection rate, it is vital to closely monitor the positivity rate and the case fatality ratio (death rate) and rely not so much on the recovery rate which is what seems to be happening currently. Eventually, in all likelihood, as the pandemic subsides, close to 97 plus percent cases are likely to recover implying a 2 or 3 percent death rate. India needs a epidemic control strategy to be developed and put in place to control and contain the spread of the infection in the country, something that is not being done currently. Due to COVID-19, while most countries are facing the twin crises of public health and the consequent economic downturn, India has an additional challenge to deal with, namely a massive migrant workers crisis. While it is hard to say what long-term impact this home migration might have, but some trends were quite clear so we made a few recommendations to the government in May that we list along with some lessons for India to learn from elsewhere. On the economic front, a deep and prolonged economic slowdown is inevitable.

Coronavirus disease 2019 (COVID19) pandemic, caused by SARS-COV2, is of unprecedented global public health concern [1]. To combat the disease, the Government of India imposed a lockdown in most districts of the 22 States and Union Territories where confirmed cases were reported from March 24, 2020 onwards. Currently, the lockdown has been extended till May 31, 2020. The Government of India has claimed success in the fight against the coronavirus pandemic, stating that the number of cases would have been more if the nationwide lockdown had not been imposed. However, this view is now being contested, as recently numbers of COVID19 cases have surged.

In this brief review, we aim to discuss the impact of the lockdown in response to the COVID 19 pandemic on social, economic, health, and National Health Programs in India.

COVID-19 has not left any part of the world untouched and India is one of the worst affected countries in the world. The cases in India are rising steadily with each passing day. As of August 10th 2020, India has over 2.3 million (the second million coming in exactly three weeks since the country hit a million infections on July 16, with 42 percent of the new cases coming from Andhra Pradesh, Karnataka, Uttar Pradesh, West Bengal and Bihar) confirmed COVID-19 cases and 46,188 reported deaths. The worst affected states of India include Maharashtra, Tamil Nadu, Andhra Pradesh, Karnataka, Delhi and Uttar Pradesh. Another growing concern is that interior parts of the country are emerging as new hotspots. Four states in eastern India, namely, Odisha, Bihar, Assam and West Bengal are increasingly reporting positive cases. The two main reasons being reported for this surge in cases in rural areas are the returning migrants from major cities who did not undergo screening or were asymptomatic and the poor healthcare infrastructure in the rural settings. Out of a total of 739 districts in India, 13 districts (across 8 states and a union territory) account for 1 in seven Covid-19 deaths. The 13 districts are: Kamrup Metro in Assam, Patna in Bihar, Ranchi in Jharkhand; Alappuzha and Thiruvananthapuram in Kerala, Ganjam in Odisha, Lucknow in UP; North 24 Paraganas, Hooghly, Howrah, Kolkata and Maldah in West Bengal, and Delhi. These districts account for nearly 9 percent of India's active cases and about 14 percent of COVID-19 deaths. Over the spring and summer, the COVID-19 situation in India has really deteriorated and could get much worse on the current trajectory with around 60,000 cases being reported per day and around 900 daily deaths.

As children and parents stay confined to their homes, parents are finding it difficult to focus on different aspects of their child's overall development.

Let's take a closer look at some of the major challenges parents are facing during the Covid-19 pandemic.

1. Helping children with online classes and schoolwork

The Covid-19 pandemic has made parents the de facto homeschool teachers and tuition teachers. Unfortunately, they are finding it difficult to keep their children on track and help them with assignments.

The difficulty becomes multifold if the children happen to be in different grades. Ensuring that children attend the online classes as per the timetable, complete their homework and send it to the teacher and prepare for the next day's class has been a cause of worry for many parents.

To be continued

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