80,000 Hours Podcast with Rob Wiblin

#84 - Shruti Rajagopalan on what India did to stop COVID-19 and how well it worked

80,000 Hours Podcast with Rob Wiblin

When COVID-19 struck the US, everyone was told that hand sanitizer needed to be saved for healthcare professionals, so they should just wash their hands instead. But in India, many homes lack reliable piped water, so they had to do the opposite: distribute hand sanitizer as widely as possible.

American advocates for banning single-use plastic straws might be outraged at the widespread adoption of single-use hand sanitizer sachets in India. But the US and India are very different places, and it might be the only way out when you're facing a pandemic without running water.

According to today’s guest, Shruti Rajagopalan, Senior Research Fellow at the Mercatus Center at George Mason University, that's typical and context is key to policy-making. This prompted Shruti to propose a set of policy responses designed for India specifically back in April.

Unfortunately she thinks it's surprisingly hard to know what one should and shouldn't imitate from overseas.

Links to learn more, summary and full transcript.

For instance, some places in India installed shared handwashing stations in bus stops and train stations, which is something no developed country would advise. But in India, you can't necessarily wash your hands at home — so shared faucets might be the lesser of two evils. (Though note scientists have downgraded the importance of hand hygiene lately.)

Stay-at-home orders offer a more serious example. Developing countries find themselves in a serious bind that rich countries do not.

With nearly no slack in healthcare capacity, India lacks equipment to treat even a small number of COVID-19 patients. That suggests strict controls on movement and economic activity might be necessary to control the pandemic.

But many people in India and elsewhere can't afford to shelter in place for weeks, let alone months. And governments in poorer countries may not be able to afford to send everyone money — even where they have the infrastructure to do so fast enough.

India ultimately did impose strict lockdowns, lasting almost 70 days, but the human toll has been larger than in rich countries, with vast numbers of migrant workers stranded far from home with limited if any income support.

There were no trains or buses, and the government made no provision to deal with the situation. Unable to afford rent where they were, many people had to walk hundreds of kilometers to reach home, carrying children and belongings with them.

But in some other ways the context of developing countries is more promising. In the US many people melted down when asked to wear facemasks. But in South Asia, people just wore them.

Shruti isn’t sure whether that's because of existing challenges with high pollution, past experiences with pandemics, or because intergenerational living makes the wellbeing of others more salient, but the end result is that masks weren’t politicised in the way they were in the US.

In addition, despite the suffering caused by India's policy response to COVID-19, public support for the measures and the government remains high — and India's population is much younger and so less affected by the virus.

In this episode, Howie and Shruti explore the unique policy challenges facing India in its battle with COVID-19, what they've tried to do, and how it has gone.

They also cover:

• What an economist can bring to the table during a pandemic
• The mystery of India’s surprisingly low mortality rate
• Policies that should be implemented today
• What makes a good constitution

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Producer: Keiran Harris.
Audio mastering: Ben Cordell.
Transcriptions: Zakee Ulhaq.

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