Based on the results of the extended SIER model, and a potential status quo in infection control and prevention measures and additional over 490,000 deaths are projected in the study in India between October 2020 and September 2021. It means that India need additional mitigation measures to prevent such a large number of additional deaths.

With sharp rise of infections, number of hospitalizations and ICU admissions in the country are also going to have a spike, from the lowest level of infections and death in February 2021, as we can see this in the latest trend in the country. To handle this we urgently require to strengthen the healthcare system in the country immediately. The report says that instituting all mitigation strategies could reduce the numbers of deaths due to COVID-19 by 83 per cent. In absolute numbers it may be reduced to 85,821 deaths from 491,117 deaths under the no-additional mitigations scenario. ICU admissions could similarly be reduced by 75 per cent with additional mitigations strategies apart from the present deployment.

India would need to spend a huge amount to prevent such a large number of additional deaths by September 2021. The study has estimated that India is expected to bear the largest share of these costs in South Asia with the country having to spend more than US$ 7.8 billion on testing, and US$ 1.7 billion on healthcare utilizations due to COVID-19 infections leading to death. Although there will be costs associated with implementing COVID-19 mitigations strategies, such as households having to spend money out-of-pocket purchasing masks and hand sanitizers, these cannot be measured with any specificity. However, any costs associated with increased use of masks and hand sanitizers will likely be much lower than what will be needed to spend on COVID-19 healthcare untilization.

Even if government of India decides to stick to no additional mitigation it would have to spend US$2.3 billion on testing. Hand Hygeiene would cost the country around US$659 million, smart lockdowns (ie local lockdowns) US$ 1.1 billion, masks US$ 845 million. The all additional strategies would cost the country about US$404 million. It is clear that India would need additional amount, much more than what is provisioned in the Budget 2021-21, which had not visualized the deteriorating conditions ahead. States are financially in very bad shape and it has already been reported that some of the states are not able to spend what is required in successfully containing the spread of the disease. Union government would thus need to enhance the centre’s financial support to the states. Private hospitals are now leading the vaccinations programme of the country, and therefore, many people who could afford it may prefer the private sector, as they are preferring them for their treatment. People should also be ready for such a scenario in which they may need to spend from their own pocket.

Maternal and child mortality and nutrition will be going to deteriorate. Even before the WHO declared COVID-19 a pandemic on March 11, 2020, the coverage for essential SRMNCH services for child and women were being affected. The observed and estimated disruption is expected to have substantial impact or women and children’s mortality. The anticipated death in India would be greatest in South Asian countries with 15 per cent increase, which is 154,020 is absolute terms. The number of stillbirths are also predicted to increase. Again, the largest increase in the number of stillbirths is expected in India, which is going to increase by 10 per cent, about 60,179 in number. The highest number of maternal death is also anticipated for India which will increase by 18 per cent, about 7,750 in absolute number.

Due to the observed and expected reduction in coverage of modern contraceptive methods during the pandemic and its containment measures, more than 3.5 million additional unintended pregnancies are expected in the region, with the highest number in India, which would be around 3 million. The number of unsafe abortions are also expected to increase by more than 50 per cent, because healthcare facilities would not be available during the pandemic.

The report has tried to explain the COVID-19 challenge in 2021. The authors have made conservative estimates due to continued gradual upsurge in India during initial months of 2021, which has lately rising sharply, since mid-February. It has also noted the deployment of vaccine which is not widely available for people of the country. The report has assumed that service coverage across SRMNCH services could be increased somewhere only between 10 to 20 per cent in the first half of 2021.

School-age child and adolescent mortality among 15-19 age group females are also going to increase, because many of they would be married off during the pandemic. They are out of school because of closure. The greatest increase in death is anticipated in India that has been estimated at 643. Nutrition related problems would also increase due to closure of schools and unavailability of mid-day meal. A rise in communicable disease-related adolescent mortality would likely to increase. India is expected to be hit hardest in this matter with an estimated additional 3,412 adolescent deaths.

As a result of prolonged school closures in response to COVID-19, almost 9 million primary and secondary school-aged children are expected to permanent dropout of schools in South Asia, with the highest number over 7 million will be from India. The disruption will have a considerable economic cost over the long term. It would lower their lifetime earnings by 15 to 23 per cent. It would cost India US$ 52.8 billion.

In this scenario India needs many additional measures to tackle the challenge ahead, which has already impacted enormously the lives and livelihoods. Millions of people are pushed to extreme poverty and millions have been uprooted in terms of livelihoods. It is time to act fast. (IPA Service)