Tamanna Inamdar: Why you feel the need to pose these questions? Why you are worried about another round of lockdowns in Maharashtra, at a time when numbers are surging?
Rajiv Bajaj: Simply because I am speaking with you from Pune – which is one of the country’s hotbeds of COVID-19 – where we are apparently staring at the prospect of another lockdown. Although we do not know much about the exact nature of this proposed lockdown, we all do have to ask ourselves what we are going to do differently, so that we don’t end up with the same result that we’ve seen over the last 12 months. While reflecting on the eight questions I’ve realised that we need the answers to these so that we can go from unfounded reactionary fear to responding to unshakeable facts.
Tamanna Inamdar: You asked about actual incremental mortality. How do you calculate incremental mortality? What we do know is a 169,000 Indians have died of COVID-19 since the pandemic began. Is that number not scary enough to justify taking whatever means possible to save lives?
Rajiv Bajaj: Well, as far as I know, pre-pandemic it is said that 7.5 lakh people die in India every month for varied reasons, and as far as COVID-19 is concerned the count has been about 1,69,000 over the last 13 months – an average of 13,000 people a month – now, what this suggests is that at maximum, incremental deaths are 13,000, which means every month instead of 7.5 lakh people, 7.63 lakh people have died.
However, when I speak with local doctors in Pune they insist that 70% of such deaths are people who had various comorbidities – ranging from obesity, hypertension and diabetes. This has been talked about ad nauseam, which means that the maximum incremental death is not just under 2%, it is probably well under 1%, closer to 0.5%. This seems to mirror exactly what Delhi Chief Minister, Arvind Kejriwal, said in an interview – as far as Delhi is concerned, he finds that the mortality rate is a third of what he saw in previous months during the first wave or the second wave, as he called it. Now I am not for a moment suggesting that every life is not precious. As someone said, one death is a tragedy but a million deaths are a statistic. Every life is important. But, if we have another hard lockdown like we did last year, we know the repercussions, we know the number of people who needed medical assistance but couldn’t get it. Those are also lives lost. So, that’s why this question is important, for me. What is the actual incremental mortality, whether at the national level or specifically at the state level, and how does that compare with people who perhaps otherwise lost their lives because they could not get help.
Tamanna Inamdar: The question then becomes, how would this change outcome of what the government decides to do? What about the fact that a majority of our cases are asymptomatic?
Rajiv Bajaj: Absolutely, I agree with you. So, the case severity profile seems to suggest that almost 95% people are either asymptomatic and test positive as a result of testing and tracing or are mildly symptomatic and can be treated at home. In fact, I would like to mention that I take my hat off to our Chief Minister and those in the administration here – like BMC Commissioner Mr Chahal – who have been extremely proactive and extremely transparent.
But, having said that, if the vast majority are indeed asymptomatic or mildly symptomatic, then should one really impose a lockdown on the 130 million odd people of Maharashtra who will suffer because they will lose their jobs, their income and sometimes even their sanity.
Let us look at the specific issue of hospital capacity that has been talked about so much, which is my third question. Local doctors over here suggest that a large number of hospital admissions are to do with the VIP syndrome – of which I am equally guilty.
This happens every day in the hospitals of Pune, there are people admitted out of fear, there are people that are admitted out of sheer convenience, when all of them could actually be treated at home and frankly, I have to make the point that some hospitals are not exactly complaining about the patients.
For instance, a close friend’s domestic staff needed to be hospitalised last week, and was kept on in the hospital for much longer than required. This gentleman was in the general ward and the bill at the end of his treatment was Rs 4.36 lakhs. So, not all hospitals have a problem with this. That makes me curious about what the exact criteria for hospitalisation is and I’d like to ask or suggest that maybe if hospitals are more than 70% full, perhaps we might need to randomly audit them and see whether all the people who are there really do need to be there.
Let me tell you why, assume for a moment that my anxiety is unfounded and let us say everybody that is in the hospital causing a shortfall needs to be there, then perhaps the government needs to tell us that if they lockdown for 14 days, how they will achieve increased medical infrastructure capacity, which they could not achieve in 14 months?
Most importantly, the staff – trained doctors, nurses and paramedics – would have to be replenished, tired from the copious amounts of extra work they have been doing for the past year and half.
Tamanna Inamdar: Are you saying that in the year since COVID-19 hit, not enough has been done to prepare for a second wave, and we’re worse than when we started?
Rajiv Bajaj: Well that is part of it, but what I am also trying to suggest is to do something different. Someone said, insanity is when you do the same thing again and again and expect a different result. And I am asking my government – fortunately I can ask this of my state government because all my interactions with them suggest that they are very open minded, very objective, they listen and they care – what is it that you are doing differently now, which will produce a different result.
We are talking about all the mutations of the virus. Sitting in Pune and Aurangabad I have seen all the mutations of the lockdown, as well. I have seen the 10-day lockdown. I have seen the seven-day lockdown. I have seen the weekend lockdown. I have seen the overnight lockdown. I would like the administration to share with me some information on this and tell me how effective those were and if they were not effective, then what is your reason to do more of the same all over again.
Tamanna Inamdar: I want to know what concerns you have for
facilities in Pune, right now? Are you facing the impact of the second wave? Are restrictions affecting you?
Rajiv Bajaj: The short answer is that as of now, there are a lot of concerns and anxiety but there is no actual impact because nothing has changed. We are, apparently, awaiting a decision later in the week and before I answer your question let me say this that I don’t pretend to have the answers.
I started by saying that I have some questions and hopefully these are valid questions now, and as far as RT-PCR is concerned my perception is that we may have a cure that is almost worse than the disease, I mean, it seems to me a classic case of overregulation where we want to test everyone and deny the needy the ability to be tested.
Let me give you a specific example, in the office or in the factory or on the shop floor if a person is positive, that unit must be shutdown or the section must be shutdown and sanitised and then only work can start again. Now, I am unable to understand the simple thing that if someone feels unwell, am I suppose to shut down immediately? Because at that point of time he hasn’t been tested and I am not sure whether he/she is suffering from COVID-19 or just some flu. Thanks to what has been mandated right now – that every 15 days all employees must do the RT-PCR test – other people have taken a cue from that, asking for tests to go in and out of housing societies. That just increases the load on lab capacity and kit availability, meaning a person who is feeling unwell on the shop floor or in the office today will probably not get his result for the next 48 to 72 hours, putting them in a weird limbo. By the time the result comes and we shut down the place, others might’ve been infected.
Tamanna Inamdar: Another important one you asked was what is the ability of the government to extend lockdown support, like western countries do? Over this weekend Bogota, Argentina, France, Germany have had different kinds of lockdowns? What is the model you propose?
Rajiv Bajaj: No, not at all. You see, the nations that you name are all western countries with a very different immunity profile from that of India, which is much more like the ASEAN countries. You’d find a lot of answers if you looked at what Thailand, Vietnam, Malaysia and Cambodia have done, I’m not suggesting that lockdown is right or wrong but that lockdown is a coin that has two sides – one’s locking people and the other’s providing real, tangible immediate support to the people you’ve locked down. Not just to big companies like Bajaj. Today, my partners in the UK – Triumph – and in Austria – KTM – have received significant direct support from their government. For example, 80-85% of wages of their employees have been compensated but I am not even asking for that I am asking the question on behalf of the millions of MSMEs and the so called informal sector, the little restaurants, the shops, the gyms, the spas and salons.
I think at the time of crises, more than any other time, our leaders should lead by example. I mean, you’re asking people to wear masks when your leaders are canvassing for elections without wearing masks half the time, you are asking people to distance when people were seen this morning dipping at the Kumbh Mela to which you are inviting people from all over the country. How can we have this kind of dysfunctional behaviour and then expect alignment in the country for a lockdown which is actually hurting the lives and livelihoods.