Recovery and Vulnerability: Divergent Paths in the Wake of the Coronavirus Pandemic
As the nation hopefully begins its recovery from the Coronavirus pandemic through a massive vaccine rollout, assessing the speed of recovery in different arenas of life will require a better understanding of the overall impact of the pandemic and the level of willingness among individuals to get vaccinated. In spite of the opening of the economy in recent months, employment and income levels have not seen a uniform recovery. Schools and colleges have remained shut since March 2020, and classes have begun only recently in some States. Moreover, the disruption of routine health services has emerged as a major area of concern in the wake of COVID-19. The recovery appears to be taking different pathways for different people, what some have called a K-shaped recovery.
NCAER hosted Sonalde Desai and Santanu Pramanik from its National Data Innovation Centre to share the results of Round 4 of its Delhi NCR Coronavirus Telephone Survey (DCVTS-4) launched on December 23, 2020 and completed on January 4, 2021. NCAER Director General Shekhar Shah moderated the discussion
DCVTS-4 builds on the three earlier rounds of the NCAER DCVTS, which were carried out in the immediate aftermath of the pandemic in April and June 2020.
This fourth webinar will report its key findings on:
- The extent to which individuals are willing to get vaccinated and their willingness to pay for the vaccines;
- The extent to which students have been able to participate in online classes held by schools, and coaching centre-based and home-based learning during the period when schools have been closed;
- The manner in which health providers have coped in providing routine and emergency health care while dealing with the pandemic;
- Economic recovery, occupational shifts during the pandemic, and vulnerability among different occupational groups; and
- The levels of distress and financial hardship experienced by households and whether the most vulnerable households have had access to safety nets.
- DCVTS-4 resurveyed households contacted in the earlier rounds of DCVTS and completed interviews of 3,168 households (at a 61% response rate) from the rural and urban areas of Delhi NCR, which includes Delhi as well as rural and urban households from selected districts of Haryana, Rajasthan, and Uttar Pradesh. The webinar was attended by over 100 participant
NCAER DCVTS ‘Round 4’ Results and the ‘Press Release’ is available on this webpage.
Three earlier rounds of the DCVTS (April 14, May 1, and July 4, 2020) is available here.
NCAER hosted Sonalde Desai and Santanu Pramanik from its National Data Innovation Centre to share the results of Round 3 of its rapid response Delhi NCR Coronavirus Telephone Survey (DCVTS-3) launched on June 15 and completed on June 23. NCAER Director General Shekhar Shah moderated the discussion. DCVTS-3 builds on DCVTS-1, fielded during April 3-6 (results released April 12), and DCVTS-2, fielded April 23-26 (results released May 1).
From one of the most stringent lockdowns in the world, India is rapidly moving to ease restrictions even as the peak still seems far and infections to date, nationally, have crossed 6 lakhs and are growing. Delhi NCR, with its recent surge, has climbed to third place in the country, with nearly 90,000 cases to date and the highest caseload and deaths per 100,000 population in the country. The weeks of lockdowns and reopening have led to changing attitudes and practices in Delhi NCR, and to the many ways in which households are adjusting to the economic stresses that the pandemic, the lockdowns, and now the lifting of restrictions have produced. The rapid response DCVTS are designed to understand these adjustments and changing attitudes and practices.
The DCVTS team carried out Round 1 in April shortly after the first lockdown started. Round 2 gauged household reactions to a continuation of the first, stringent lockdown. The team fielded DCVTS-3 at a crucial moment when restrictions were coming off but Coronavirus infections in the NCR were accelerating rapidly and the region’s healthcare infrastructure and testing facilities were coming under historically unprecedented stress.
The DCVTS-3 will report its findings on:
- ways in which the lockdowns have affected different occupational groups
- household access to welfare measures during the lockdowns, including their coverage, targeting, delivery mechanisms and bottlenecks
- difficulties after the lockdowns in getting back to work and remaining safe
- trends in social distancing and risk perceptions as the lockdowns are eased.
DCVTS-3 resurveyed households contacted in Rounds 1 and 2, doubling the size of its sample from the rural and urban districts of Delhi, Rajasthan, Uttar Pradesh, and Haryana. The webinar was attended by over 140 participants.
NCAER DCVTS Round 3 results and the Press Release is available on this webpage
NCAER hosted Sonalde Desai and Santanu Pramanik from its National Data Innovation Centre to share the early results of Round 2 of its rapid response Delhi NCR Coronavirus Telephone Survey (DCVTS-2) launched on April 23, 2020, and completed on April 26. The discussion was moderated by NCAER Director General, Shekhar Shah. The Round 2 DCVTS builds on DCVTS-1, which was fielded during April 3 to 6, 2020. The DCVTS-1 results were released on April 12, 2020.
Policymakers at the Centre and in the States are grappling with many questions in making difficult decisions between continuing to suppress the virus and restarting economic life. There are dangers on both sides: open too soon and a second-round pandemic could be more costly, open too late and rebuilding the economy will be more costly. After more than a month into India’s lockdown, how are Indian households coping? How is their perception of the risk of infection changing as economic and social hardships deepen for many with every passing lockdown day? How has social distancing changed, if at all? What activities will households resume, or not resume, once the lockdown is lifted? What has been the financial, domestic, and logistical impact of the lockdown and of heightened health fears on households? How differently have farmers, businesses, salaried workers, and daily-wage workers felt these impacts? What has been the experience of households receiving relief from government? How has support for the lockdown changed since early April? Round 2 of the DCVTS answers some of these questions.
Round 2 of the DCVTS interviewed a representative random sample of some 1,885 adults in Delhi NCR comprising 31 rural and urban districts in Delhi, Rajasthan, Uttar Pradesh, and Haryana. The DCVTS will be repeated roughly every three weeks with questions chosen to reflect key issues that seem important for this fast moving pandemic. The webinar was attended by over 110 participants.
NCAER DCVTS Round 2 results and the Press Release is available on this webpage
NCAER hosted a webinar by Sonalde Desai, Santanu Pramanik, and Dinesh Tiwari from its National Data Innovation Centre to share the results of its rapid response representative telephone survey in the Delhi NCR. The survey launched on April 3, 2020, 10 days after the lockout started was completed on April 6, 2020. The discussion attended by over 150 participants was moderated by Shekhar Shah.
Three weeks into the world’s biggest lockdown, the Coronavirus pandemic continues to pose moral, ethical and practical dilemmas for India. Epidemiologists rightly want to continue the lockdown to push out the peak and flatten the curve, buying time to prepare for peak hospitilisations with more personnel, beds and ventilators. Others are deeply concerned about the lives and livelihoods that will be lost from starvation, poverty, and other diseases, and from the destruction of farms, enterprises, and supply chains.
Policymakers are grappling with questions about how social distancing can be combined with safety nets for the vulnerable. How can the blow to informal workers and industry be softened? How do people perceive the dangers of the pandemic, and how are they adapting to the physical, social and emotional challenges of the lockdown?
To begin to answer some of these question, the NCAER National Data Innovation Centre launched its Delhi NCR Coronavirus Telephone Survey (DCVTS) to understand:
- people’s knowledge of the Coronavirus
- people’s attitudes and perceptions towards the risk of a Coronavirus infection
- preventive and control measures, especially social distancing, and the feasibility of adhering to them
- the impact of the Coronavirus pandemic on people’s livelihoods, income, social life, and access to essential items
- and their support for extending the lockdown.
Round 1 of the DCVTS, completed in four days, interviewed a representative random sample of 1,750 adults in Delhi NCR comprising 31 districts in Delhi, Rajasthan, Uttar Pradesh, and Haryana. The DCVTS will be repeated roughly every three weeks with the questions chosen to reflect key issues that seem important for this fast moving pandemic.
The DMAS study provides detailed background data on the DCVTS Round 1 households making possible further in-depth study of these households
- NCAER DCVTS Round 1 results and the Press Release is available on this webpage.
- Dr Santanu Pramanik from NCAER spoke with Shereen Bhan of the CNBC TV18 to discuss the results of this survey. The recording of this television interview can be viewed here.
NCAER hosted a seminar on “Quality of Care and the Bypassing of Primary Health Centers in India—Implications for Ayushman Bharat” with Krishna Dipankar Rao, Johns Hopkins University. Shailender Swaminathan, Principal Economist, Leveraging Evidence for Access and Development (LEAD), KREA University, was the discussant. The seminar was attended by members of the NCAER Research Team, and invited guests from various eminent institutions including, Bill & Melinda Gates Foundation, Integrated Research and Action for Development, Federation of Indian Chambers of Commerce and Industry, International Food Policy Research Institute, and IDinsight.
Dr Rao pointed out that India is among many low- and middle-income countries that have invested substantial resources for strengthening facility-based and community-based primary health care services to provide affordable care for improving population health. Yet, patients in India often bypass the nearest government health centres offering free or subsidised services and seek more expensive care, often from private service providers. Dr Rao focused on the quality of care (clinical and structural) and its implications for new efforts to strengthen primary care through the Government of India’s recently launched Ayushman Bharat initiative. While tracing the genesis of the primary health care system in the country, he highlighted various issues that have brought this sector into recent focus, including the predominantly informal nature of primary health care and non-availability of certain crucial services at the primary centres; lessons from the National Rural Health Mission; the role of Accredited Social Health Activists (ASHAs) in the health care system, particularly in rural areas; and wide variations in competencies for health care across the country.
The discussant, Dr Swaminathan stressed the need to mould the primary health care system to align with the goals of Ayushman Bharat. He also suggested the introduction of competency scores for various health centres to assess the quality of services delivered by them and to determine the actual drivers of health-seeking behaviour among patients, especially the factors motivating them to veer towards private health care providers.
Krishna Dipankar Rao is an Associate Professor in the Health Systems Program, Department of International Health, Johns Hopkins University. He is also Research Advisor, National Health Systems Resource Center, Ministry of Health and Family Welfare, Government of India. His research interests lie in the areas of health systems, primary health care, human resources for health, health financing, and economic evaluation. He teaches two graduate courses at Johns Hopkins– economic evaluation, and health financing in low- and middle-income countries.
