Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

A Comprehensive Review of the Cross-Disciplinary Impact of COVID-19 in India

Version 1 : Received: 8 June 2020 / Approved: 11 June 2020 / Online: 11 June 2020 (11:39:49 CEST)

How to cite: Dhawal, P.; Kakodkar, S.; Pawar, R.; Bhome, S.; Barve, S. A Comprehensive Review of the Cross-Disciplinary Impact of COVID-19 in India. Preprints 2020, 2020060131. Dhawal, P.; Kakodkar, S.; Pawar, R.; Bhome, S.; Barve, S. A Comprehensive Review of the Cross-Disciplinary Impact of COVID-19 in India. Preprints 2020, 2020060131.


A novel coronavirus (2019-nCoV) responsible for a severe acute respiratory disorder (SARS-CoV-2) in humans, with its epicentre in Wuhan, China emerged in December 2019. This coronavirus, by far, has hit >200 countries, affecting 7 million worldwide accounting 11% death of the affected population. The transmission is majorly caused by human-to-human contact and, through fomite. In view of the increasing number of COVID-19 cases and the absence of definitive treatment or vaccinations, WHO has deemed the viral infection a pandemic of international concern. In such grave situations, there is a need for expanding the health sector workforce, government and police workforce, sanitation and prevention strategies. The current article describes the virology aspect, control of COVID-19 and revisits the various treatment options available at present this deadly infection. Epidemiology of COVID-19 is also discussed to further understand the pandemic status of India. The article also discusses implicating quarantine or social distancing, and in extreme cases, lockdown or alternative approaches such as herd or indirect immunity, as a measure to control the pandemic. Lockdown or social distancing will give rise to economic, emotional, political and social downfall in the country. It is estimated that a lockdown period will set back the country, possibly, by $240 billion, yet it stands unavoidable in the spread of control of infection. Thus, policymakers should strategize economic revival depending upon the best possible data and critical understanding.


COVID-19; SARS-CoV-2; Social Distancing; India; Economy; Education


Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Comments (1)

Comment 1
Received: 20 June 2020
The commenter has declared there is no conflict of interests.
Comment: It's an important contribution to make an overall assessment of health impacts and combine this with an assessment of economic impacts - congratulations on that.

I think you could improve. Maybe seek an economist as co-author, and rather than citing the Economic Times, cite original economic data? To strengthen your case, consider the health impacts of loss of income, loss of housing, secondary deaths due to unavailable health care and interrupted vaccines, TB treatment, mosquito and locust control, interruption of fruit and vegetable supply chains, worse nutrition, impaired maternity services? The term you need is "all-causes mortality" and the crucial period is the medium term ie. the mortality impact over the next 2 years. Governments have to focus on immediate priorities, but as academics you can take more time and consider cascading impacts, secondary deaths, indirect effects of lockdowns etc.

You can support the case for smarter, localised lockdowns with special provision to ensure that farmers can get fertiliser and seeds, can be confident that markets will function, and that they will be able to get to their fields and back safely with help from police.

You can consider work on food vouchers by CGIAR and others.

Your goal seems to be to address government and economic policy, so it could be good to have a health economist and a general economist in your team. To build confidence in the economy among educated people, it will be necessary to take really effective health measures. The most sure measures are telehealth, nasal oxygen, dexamethasone for more serious cases, rapid triage via telephone and in front of every hospital and clinic, community cooperation as undertaken in Dharavi and Kerala, really good PPE and negative pressure rooms for doctors, open air treatment centres as in Mumbai.

Most countries will take an economic blow over the next 2 years and this can't be prevented, but you can help prevent things getting worse ie. prevent collapse and food system problems / escalating malnutrition. It's true that globally there are good stocks of rice and wheat, but that isn't enough to keep people healthy. So this is a tremendous opportunity to expand social safety nets or try basic income as in Brazil, focus on agriculture and primary health care.

One of the most certain and achievable and consequential things we can and should do is prevent the unnecessary death of nurses and doctors, like the young Chinese doctor who died (and we now have too many examples in India and USA too, often South Asians)

We can also reduce final death tolls, even if everyone is exposed to the virus over the next 3 years and no viable vaccine is forthcoming, in the following ways:

- by ensuring health work on other diseases (childhood vaccinations, cancer, heart disease, malaria, childhood deaths, childbirth deaths) isn't obstructed or reduced

- by asking modellers and health economists to try the very difficult but hugely important task of assessing medium term all-causes mortality of various policy options (ie. considering health impacts of loss of income, home, unemployment, involuntary migration, worse nutrition, crowding) and how this might be modulated by various mitigations such as food vouchers to enable lockdowns or distancing to happen in ways that prevent these secondary deaths

- by investing in good and affordable nasal oxygen kit and well-evidenced treatment that improves steadily as RCT evidence and better/larger cohort study results comes through

eg as we have seen with dexamethazone, proning, nasal oxygen, good physiotherapy, maybe anticoagulants

Advantages of successful treatment over vaccination are that you only have to treat the people who get sick (which most people with covid don't) and there's a reasonable hope that recovered people will be immune for 6-12 months at least, whereas initially with vaccination we just won't know, and by the time we do, the waves may be over, which is what happened when there was a SARS-1 candidate to trial

- by really doing a good job for our hospital staff on triage, ward ventilation or open air treatment centres like in Mumbai in 2020 and 1919, PPE, PPE fitting, low cost negative pressure room kits etc

- by taking South Asian and NRI higher-than-expected mortality and possible links to low serum D3 and zinc seriously.

UK, Indonesia and other countries are doing so.

This is especially an issue after reduced sunlight exposure during lockdown, and for doctors and medical students who anyway don't get much chance for daily full body sunlight exposure, especially in these hot days.

An advantage of secondary prophylaxis over primary prevention with PPE is that with PPE there are few side benefits, whereas with improved nutrition or micronutrient fortification or supplementation there are many other benefits. (NB I'm still in favour of good PPE!)
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