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Introduction: Myriad of complications were observed in post Coronavirus Disease (COVID-19) survivors, psychiatric morbidities among one of them. Recent body of research has shown that significant number of patients developed psychological symptoms following COVID-19. Most of the Indian studies have assessed psychological morbidity among COVID-19 patients during admission. However, very few Indian studies have assessed the psychological impact of COVID-19 during the follow-up period, especially in rural India. Aim(s): The study aimed to determine the prevalence of depression and anxiety and evaluate related socio-demographic (age, gender, education, occupation and marital status) and clinical factors (severity of COVID-19, presence of medical co-morbidity, Oxygen requirement, Intensive Care Unit (ICU) referral, duration of admission) in patients post-COVID-19. Material(s) and Method(s): This was a cross-sectional study conducted at Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India. among 96 patients post-COVID -19 after their discharge from the hospital. Data collection was done between July 2021 to September 2021, using a semi-structured proforma and a psychiatric diagnosis was made (based on International Classification of Diseases- 10th Edition Diagnostic Criteria for Research criteria and clinically approved by two qualified psychiatrists). Rating scales such as Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used for severity assessment. Data was analysed using Microsoft Statistical Package for Social Sciences (SPSS) version 20.0. A p-value of <0.05 was considered significant. Result(s): In 96 patients, 70 (72.91%) were males. 38 patients (39.58%) were of the age group 45-60 years. 36 (37.50%) patients had Depression. Anxiety was seen in 40 (41.66%) participants. Among the clinical variables, the severity of the COVID-19 infection (p-value<0.01), presence of co-morbidity (p-value<0.01), and ICU referral (p-value<0.01), were found to be associated significantly with the presence of depression in the participants. Among 36 depressive patients, mild depression was present in 17 (47%), moderate depression in 12 (33%), severe depression in 5 (14%) and very severe in 2 (6%) of the participants. Anxiety was associated significantly with the gender (p-value=0.02), co-morbidity (p-value<0.01), severity of illness (p-value<0.01), oxygen requirement (p-value=0.04) and ICU admission (p-value<0.01). Mild anxiety was observed in 18 (45%), moderate anxiety in 16 (40%) and severe anxiety in 6 (15%). Conclusion(s): The prevalence of depression and anxiety is high in patients post COVID-19. The severity of these disorders is significantly associated with presence of medical co-morbidity and severity of COVID-19. Hence, thorough evaluation and management of these disorders in post-COVID-19 patients can help in improving the overall outcome. Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.
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SESSION TITLE: Outcomes Across COVID-19 SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema are reported as rare complications of COVID-19 pneumonia in various observational studies. The purpose of this study is to investigate the incidence of these complications and their outcome in hospitalized patients with COVID-19 pneumonia, at our inner-city hospital system in Central Pennsylvania. METHODS: We performed a retrospective chart review of the patients admitted with COVID-19 pneumonia from March 2020 to March 2021 in 3 different hospitals located in central Pennsylvania. Data on their demographics, pre-existing comorbidities, inpatient location, radiologic findings, timeline of events, mode of oxygenation and ventilation, hematology, chemistry profile and inflammatory markers were obtained. Patients with known inciting events for barotrauma, other than COVID-19 pneumonia were excluded from our analysis. RESULTS: The mean age of patient cohort was 66 years (SD 14.07). Almost fifty two percent were obese with BMI more than 30 kg/m2 and 69.5% were male. Only 11.4% of the study population had history of COPD and majority (63.6%) did not have history of smoking. Out of 31,260 inpatients, only 44 (0.0014 %) patients spontaneously developed thoracic free air. Among them, 33 (75%) had pneumothorax, and 22 (50%) needed chest tube for the management. 18 (40.9%) had pneumomediastinum, and 20 (45.5%) had subcutaneous emphysema. These are not exclusive findings and some patients had free air in more than one location. Thirty (68.2%) patients were admitted to ICU (Intensive Care Unit), 20 (45.5%) patients needed invasive ventilation and 26 (61.4%) had in-hospital mortality. Mortality in ICU was significantly high (86.67%) compared to non-ICU patients (7.14%). The average duration of hospitalization was 28.18 days (SD 25.46). CONCLUSIONS: Incidence of spontaneous thoracic free air complication in COVID –19 pneumonia is a rare phenomenon. In our patient cohort, occurrence of these events was seen irrespective of type of oxygen delivery and ventilation. However, patients having these complications had a high rate of ICU admission. Mortality is significantly high especially in patients admitted to ICU. CLINICAL IMPLICATIONS: Spontaneous thoracic free air complication in COVID-19 pneumonia is rare but can be a marker of poor prognosis. Vaccination status of study population was unknown, therefore the role of vaccination to prevent these complications and their outcome needs to be explored. DISCLOSURES: No relevant relationships by Yi-Ju Chen No relevant relationships by Anatoliy Korzhuk No relevant relationships by Rajan Pathak No relevant relationships by Navitha Ramesh No relevant relationships by Michaela Sangillo
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Introduction: In 2015, H. Lee Moffitt Cancer Center & Research Institute (MCC) launched a lung cancer screening program for high-risk individuals based on National Comprehensive Cancer Network guidelines. To identify successes and barriers of this program from the patient perspective, we conducted a survey study to measure patient experiences and satisfaction with lung cancer screening. Methods: In August 2020, a survey and cover letter were mailed to 576 patients who completed one or more lung cancer screenings at MCC. In addition to demographics, smoking history, and impact of the COVID-19 pandemic to get screened, the survey included 34 quantitative questions using a 5-point Likert scale and six open-ended questions. The quantitative questions measured patient satisfaction and experiences across 6 domains: appointment process, clinical staff interactions, communication, visit with the provider, screening results, cost, and clinic facility/overall satisfaction. Results were quantified using descriptive statistics. The six open-ended items elicited barriers and facilitators related to returning for screening, experiences with other cancer screenings, positive and negative experiences with the low-dose computed tomography (LDCT) visit, and suggestions for improving the process of LDCT screening visits. Content analysis using the constant comparison method was applied to the text and coded based on the a priori codes of the open-ended questions. Results: Among the 212 patients (37% completion rate) who completed the survey, 97.6% were white, 48.6% were female, and the mean age was 69 years. In the communication domain, 81.1% “strongly agreed/agreed” that the lung cancer screening process was clearly explained, 92.5% “strongly agreed/agreed” that the potential harms and limitations were clearly explained and 76.9% “strongly agreed/agreed” that the process for follow-up screening was clearly explained. For the provider questions, 71.7% “strongly agreed/agreed” that the provider was willing to listen carefully and 68.4% “strongly agreed/agreed” that the instructions were easy to understand. For results and costs, 78.3% “strongly agreed/agreed” the screening results were clearly explained and 70.8% “strongly agreed/agreed” that the cost of the screening was justified. Regarding overall satisfaction, 88.2% “strongly agreed/agreed” they would recommend lung cancer screening at MCC. Patients who had Medicare insurance or paid out-of-pocket had higher agreement about helpfulness of the staff who assisted them with billing or insurance compared to patients who had private insurance coverage (79.4% Medicare coverage, 60.0% private, and 75.0% self-pay: P-value=0.025). In the qualitative findings, respondents provided generally positive comments about their lung cancer screening experience. Negative comments were related to desire for more information about results, long wait times for results, and billing issues. Conclusions: This study provided insights about patient experiences and satisfaction with lung cancer screening which are important, given the low uptake of this life-saving modality. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates. Keywords: survey, screening, patient satisfaction
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Background: SARS-CoV-2 is a positive-sense single-stranded RNA virus and its replication begins after the synthesis of virally encoded polymerase complex that is required for replication and transcription of genomic RNA (gRNA) within the infected cells. Despite the global interest in the study of SARS-CoV-2, the kinetics of SARS-CoV2 RNA replication and transcription during the early phase of viral infection is poorly understood. Here, we used the single-molecule RNA fluorescence in situ hybridization (smRNA-FISH) for sensitive detection of SARS-CoV-2 at single molecule level and to determine the replication of genomic RNA (gRNA) and sub-genomic RNA (sgRNA) in the infected cells, at very early stages of infection. Methods: We designed highly specific smRNA-FISH probes targeted to gRNA and Spike gene sgRNA of SARS-CoV-2 virus, using stellaris method and optimized the method to simultaneously visualize these two RNAs at single cell and single molecule level. Because of the high sensitivity of our probes, we applied smRNA-FISH technology to detect SARS-CoV-2 positive cells from autopsy samples obtained from diseased COVID-19 patients. Furthermore, we used high-resolution and high-speed scanning microscopy to detect extent of infection in cell models of SARS-CoV-2 and in COVID-19 patient samples. Results: A time course analysis SARS-CoV-2 replication indicated that single molecules of gRNA could be detected as little as 30 min to 2 hr. post-infection. Distinct "Replication Centers" (RC) began to appear one to two hours post-infection and the sgRNAs began to migrate out of these RCs. Replication after the initial delay appeared to be rapid and gRNA and sgRNAs dispersed throughout the cell within 4-5 hours post infection forming multiple RCs. We found that our RNA-FISH correctly detected the SARS-CoV-2 positive samples from patient autopsy samples that were characterized by qRT-PCR or immunological detection methods. The signals of spike gRNA and sgRNA along with the spike proteins co-localized within the same cells of the SARS-CoV-2 infected patients within the cells of lung, kidney, and heart autopsy samples. Conclusion: We propose that the specific probes and the methodology that we have developed will be highly applicable to the study of SARS-CoV-2 replication in depth and to characterize SARS-CoV-2 infection in COVID-19 patient samples. This study may open a novel direction towards COVID-19 pathophysiology, drug screening and diagnostics.
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All hell broke loose in the Corporate world in March 2020 when India went under total lockdown in a matter of days. The equation between Work (How work gets done), Worker (Who does it) and Workplace (Where work gets done) was altered at the fastest pace in Human history. This paradigm shifts also coincided with the Appraisal/Year End Cycle. Most of the Indian corporates follow the Financial Year cycle (April to March) for their annual performance appraisal/management process. Human Resources department was at the forefront of every Board Room's agenda within the corporates of the National Capital Region (NCR) of India. The challenging and interesting part about life of an HR professional is to help business take the hard decisions in the most objective yet humane way possible. Therefore, perhaps rightfully, there wasn't one single solution or a clear thought process emerging across participating organizations. And to borrow from Gabriel Garcia Marquez “Our code of ethics supposes that we doctors are made of wood” - there is similar thinking on HR as well. Hopefully this time it will not be so. This paper presents an overview of the changes to the PMS system and its outcomes undertaken by HR managers in Corporates of National Capital Region. HR managers of 117 corporates were surveyed through a structured questionnaire between the period 5th April, 2020 through 15th April, 2020. The main objective of this publication is to document and contribute to the body of knowledge changes that were introduced due to an unforeseen calamity. © The Electrochemical Society
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Purpose: Over the years, public sector reforms in emerging economies have focused on improving national budget systems and financial management practices to promote sustainable development. In the context of the COVID-19 crisis, this article examines whether the strength or effectiveness of national budget systems and related financial management practices moderates the impact of fiscal policy measures on economic recovery and resilience. Design/methodology/approach: The article uses bivariate correlations and difference-in-difference analyses to examine the relationship between budget system effectiveness, government stimulus measures and forecasts of economic recovery and resilience. The analysis uses data from the Public Expenditure and Financial Accountability (PEFA) program, International Monetary Fund (IMF) and World Bank. Findings: The article finds that estimates of economic recovery and resilience are higher in countries with more reliable budget processes and more transparent public finances. Also, the strength or effectiveness of the budget system before the pandemic appears to moderate the impact of government stimulus measures on economic recovery and resilience over a medium-term forecast horizon. Research limitations/implications: This is a prospective analysis based on economic forecasts from the IMF, which are subject to change in the coming years. In addition, the analysis uses subjective budget system indicators, which present measurement challenges that often influence this area of research. Better comparative data in the future, for example, large administrative datasets, will enable researchers to explore these issues with less estimation bias. Practical implications: The findings are relevant for policymakers and budget officials in developing countries in Africa who are engaged in plans to improve national budget systems and enhance resilience to crises, such as the COVID-19-induced economic crisis. The findings also have implications for developing countries beyond Africa with similar economic and fiscal conditions. Social implications: The findings have implications for economic and budgetary planning for the social sector as well as the efficient delivery of public services in developing countries. Public managers have a critical role to play in adapting national budget systems and financial management reforms within complex and evolving economic circumstances even after the coronavirus pandemic. Originality/value: The authors use novel and latest data on country responses to the COVID-19 pandemic as well as medium-term economic forecasts to examine the relationship between national budget systems and post-pandemic economic recovery and resilience in the African context. Previous research has only addressed these issues in the context of industrialized countries, and a limited number of empirical studies examine these relationships. The findings also have significant value for policymakers outside Africa who are facing similar challenges related to the coronavirus pandemic. © 2022, Emerald Publishing Limited.
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The COVID-19 outbreak has thrown the entire world into an unanticipated unpleasant scenario, bringing the lives of people all over the world to a pandemic level and claiming thousands of lives. According to WHO, COVID-19 has spread to 220 nations and territories, with the number of infected cases and deaths reaching 167 million and 3 million (as of May 25, 2021) (WHO dashboard, https://covid19.who.int [1]) and has a serious impact on the public health system. The key hurdles in containing the present COVID-19 outbreak are early detection and diagnosis. As a result, it is critical to screen COVID-19-affected individuals as soon as possible. Otherwise, it will spread quickly. In this case, screening can determine whether or not a patient has COVID-19 pneumonia. One of the most effective methods for reaching this goal is through chest X-ray diagnosis. It is the one that is most easily detected. This study provided a deep learning model of a convolutional neural network solution for detecting COVID-19 pneumonia patients using chest X-ray pictures. We used a publicly accessible chest X-ray dataset from Kaggle (Dataset link, https://www.kaggle.com/tawsifurrahman/covid19-radiography-database [2]) to train the model, which included 10,006 photos with COVID-19 pneumonia and normal images separated into train, test, and validation sets. This proposed model has a classification precision of 96% on the test set and 97% on the validation set, which is rather good for classifying COVID-19 pneumonia and normal patients. Along with this, we add the functionality of suggesting medicine based on symptoms. We build this suggesting model using machine learning model with accuracy 79% of 120 rows of dataset developed by our own to show it is possible to suggest medicine based on symptoms. We have developed an application using the flask framework. This application may be used on any computer by any medical professional to detect COVID positive and negative patients automatically using chest X-ray images in a matter of seconds and recommends some medicine that currently threatens the COVID-19. This application can reduce the number of false positives and false negatives in the detection of COVID-19. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Over the past century, apart from COVID-19, human civilization has seen five other significant pandemics such as the H1N1 outbreak in 2009, Ebola outbreak in West Africa in 2014, and subsequent outbreak in Congo in 2019, Zika outbreak in 2016, etc. However, of all these outbreaks, perhaps the COVID-19 pandemic is unparalleled due to the global proportions that it has assumed. The severity of the epidemic can be seen in terms of the number of lives lost and the multi-dimensional impact that COVID-19 has had upon the economies of nations and lives of people. Beyond the physical sphere of human life, COVID-19 has also impacted human life's social, mental, and economic aspects. This study was conducted to understand the livelihood challenges faced by the residents of 5 villages in Mulshi taluka during the lockdown period. In-depth interviews were conducted with three respondents from each village (15 respondents). The study drew upon the insights given by key opinion leaders in the towns such as Sarpanch and elected members of the gram panchayat, ASHA workers, ration shop owners etc. Identify the livelihood challenges faced by the people during the lockdown imposed due to COVID-19. Describe the strategies adopted by the people to overcome the challenges to livelihood faced by the people. The residents of the village's studies faced various challenges related to agriculture such as lack of manpower to harvest produce, lack of transportation facilities to transport produce to markets, lack of storage facilities to store agricultural produce etc, loss of employment faced by daily wage laborers due to non-operational status of small businesses during the lockdown period and challenges due to reverse migration.
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Background: The 'Aarogya Setu' mobile phone application (app) is designed to inform people regarding the potential risk of COVID-19.Alimited amount of information is available about awareness and usage of the app. Objective: To assess awareness, opinions, and usage of the 'Aarogya Setu' app amongst out patients of three clinics in Mulshi taluka of Pune district. Methods: Convenient sampling technique was used. A total of 234 patients were interviewed who visited the clinics over five months. The interviews were conducted on phone using a pre-tested questionnaire. Additionally, 15 indepth interviews were conducted with the participants who had previously used the app. on the telephone using an interview schedule. Quantitative data were analyzed by calculating frequencies and associations. An inductive approach was used to analyze qualitative information. Results: Around one-third of the participants (33.8%) were aware that the 'Government of India' (Gol) has developed an app named 'Aarogya Setu' to fight against the pandemic. A significantly higher percentage of awareness was observed in the participants less than 35 years of age. The app was mostly known and used for 'obtaining the number of nearby COVID-19 patients'. Overall, the participants believed in the purpose of the app. Concerns were raised about the reliability of the data gained from the app. Conclusion: Awareness of the 'Aarogya Setu' app needs to be enhanced amongst all age groups. Trust building in the app must be strengthened simultaneously.
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Background: In 2014, Moffitt Cancer Center (MCC) in Tampa, Florida launched a lung cancer screening program for high-risk individuals meeting USPSTF inclusion criteria. To reveal successes and potential limitations of this program, we conducted a survey to measure lung cancer screening patient experiences and satisfaction. Methods: In August 2020, a survey was mailed to 576 patients who completed one or more lung cancer screenings at MCC. The survey collected demographics and smoking history and measured patient satisfaction and experiences in 6 domains: the appointment process, clinical staff interactions, communication, visit with the provider, screening results and cost, and the clinic facility/overall satisfaction. There were also questions on the impact of the COVID-19 pandemic. A 5-point Likert scale was used to measure satisfaction with clinical staff and clinic facility/overall satisfaction (1= excellent to 5= poor) and other domains (1=strongly agree to 5=strongly disagree). Results were quantified using descriptive statistics. Results: Among the 160 patients that completed the survey, 96.3% were White, 93.1% were non-Hispanic, 46.9% were female, 78.1% were former smokers, and the mean age was 69 years. For the appointment process, 91.2% "strongly agreed/agreed" it was easy to make an appointment and 92.5% "strongly agreed/agreed" the clinic check-in process was efficient. Next, nearly 93% reported the courtesy of the clinical staff was "excellent/very good". For communication, while 90% "strongly agreed/agreed" that the lung cancer screening process was clearly explained, 63.2% "strongly agreed/agreed" that the potential harms and limitations were clearly explained and 71.2% "strongly agreed/agreed" that the process for follow-up screening was clearly explained. For the provider questions, 71.3% "strongly agreed/agreed" that the provider was willing to listen carefully and 66.3% "strongly agreed/agreed" that the instructions regarding follow-up were easy to understand. For results and costs, 79.4% "strongly agreed/agreed" the screening results were clearly explained and 70% "strongly agreed/agreed" that the cost of the screening was justified. Regarding overall satisfaction, 87.6% "strongly agreed/agreed" they would recommend lung cancer screening at MCC. Finally, 10.6% of patients were concerned about getting a lung cancer screening during the COVID-19 pandemic and only 8.1% reported that the COVID-19 pandemic prevented them from getting a lung cancer screening. Conclusion: Generally, for all 6 domains, patients reported favorable satisfaction and experience with lung cancer screening at MCC. However, higher rates of "neither agree/disagree" and "prefer not to answer" were observed for items related to communication and visit with the provider items suggesting improvements may be warranted, particularly related to future visits.
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Background: In 2014, Moffitt Cancer Center initiated a lung cancer screening program for high-risk individuals who meet USPSTF inclusion criteria. As of January 2020, 576 patients have completed one or more lung cancer screenings. However, approximately 40% of lung cancer screening patients were noncompliant with their recommended follow-up. To understand reasons for lack of follow-up screening and to determine patient satisfaction and experiences, we conducted a survey with open-ended items to assess patient experiences and satisfaction among lung cancer screening patients. Methods: In this analysis, we report on findings from the qualitative portion of the survey. Six open-ended items elicited barriers related to returning for screening, experience with other cancer screenings, positive and negative experiences with the LDCT visit, as well as suggestions for improving the process of LDCT screening visits. Content analysis using the constant comparison method was applied to the text and coded based on the a priori codes of the open-ended questions. Results: As of November 2020, 190 people responded to the quantitative survey and 77 provided responses to one or more open-ended questions. Thirty-five respondents provided general positive comments about their lung cancer screening experience with typical responses of "positive" and "good experience". Twenty respondents mentioned that the staff was "caring", "knowledgeable", and "great staff". Ten respondents mentioned that they were "always treated well", "treated with respect", "high quality care". Negative comments were provided by 32 respondents in the areas of: "wanting more information on results" or "waiting too long for results" (N=7), "inefficient scheduling issues" (N=6), and billing issues (N=5). Additionally, six patients reported COVID-related issues impacted their lung cancer screening experience. Suggestion for improvements included: on-line appointments or text or email reminders (N = 10), lower costs (N=6), and uncertainty about remaining qualified for lung cancer screening due to age or current/prior medical conditions (N=5). Conclusion: Overall, findings provide insights about patient experiences and satisfaction for lung cancer screening. Suggestions for improvement centered on better scheduling systems and appointment reminders as well as the ability to speak to a clinician to better understand results and future eligibility. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates.
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The emergence of Covid-19 pandemic has resulted in a massive impact on entire human population, causing a sudden change in their lifestyle, with social and economic consequences. Lockdown measures were implemented in several countries to limit the spread of this pandemic. However such restrictions and confine- ments could precipitate unintended negative consequences on lifestyle behaviors. We reviewed the data avail- able on the impact of this pandemic. The main objective of this review was to assess the effect of imposed lock- down on the changes in general population all across the globe. The data available todate indicates that the society has undergone changes during lockdown to mitigate the spread of infection and such changes have be- come part of the lives of people- hygiene and health consciousness, work from home, online teaching, digital shopping, changing internet habits are just a few to name. This pandemic may have both positive and detri- mental impact on the psychological health and various other aspects of lifestyle behaviors of people.
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COVID-19 has severely impacted millions of lives around the world. In this note, we explore the impact of COVID-19 on the electricity consumption of 93 households across two tier-2 cities in India. Given the work from home restrictions, we would expect electricity consumption to increase as people spend more time at home. Contrary to the expectations, we found that electricity consumption decreased during the lockdown as compared to previous years. On further follow-up with households, we found several reasons for decreased usage: i) inability to get air conditioners serviced due to movement restriction, ii) advisories on minimising AC usage, and iii) reducing energy to compensate for reduced income. © 2020 ACM.
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Purpose: This article examines the fiscal challenges the coronavirus pandemic poses in African countries, using Ghana as a case study and summarizes the country's immediate monetary and fiscal responses to the pandemic. The article also discusses the potential impacts of coronavirus-related shocks on the Ghana economy and policy options the national government may pursue to counteract the pandemic's adverse long-term effects. Design/methodology/approach: The article uses daily and monthly economic indicators to assess the immediate impact of the pandemic on Ghana's economy. The article also uses latest data from the Ghana Living Standards Survey (GLSS) to simulate potential shocks to the economy related to the coronavirus crisis and examines the outcomes from a potential government response that expands spending on an existing direct social assistance program. Findings: The authors find that the coronavirus pandemic is associated with a significant increase in Ghana's poverty measures over time, and an expansion in government spending under an existing cash transfer program would partly offset the economic shocks related to the crisis and improve outcomes for poverty and inequality. The authors also argue that other well-targeted expenditure and revenue policies will support long-term economic resilience. Research limitations/implications: The research suggests that a temporary expansion of the existing program of direct cash payments to poor households may be an effective social protection policy, as are well-targeted revenue and spending policies that support economic recovery and long-term fiscal sustainability. Practical implications: The findings imply that while the pandemic might cause severe shocks in the economy, well-targeted spending and revenue policies that are anchored in sound macroeconomic management can promote economic resilience and long-term fiscal sustainability. Social implications: Public managers must ensure that national policy responses to the coronavirus pandemic consider socio-economic indicators, such as poverty and income inequality. Originality/value: The authors present research that uses novel household-level data and an evidence-based microsimulation framework to articulate potential public policy strategies that can guide national responses to, and recovery from, the coronavirus pandemic. © 2020, Emerald Publishing Limited.
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Purpose: This article examines the preliminary impact of the Sars-CoV-2 pandemic on India's economic and budgetary landscape – the most affected developing country from the first wave of the pandemic. It also includes a discussion of the monetary and fiscal responses adopted and the challenges faced in formulating the response to the pandemic. Design/methodology/approach: Using high-frequency economic and fiscal indicators, this article evaluates the economic impact of the pandemic on the Indian economy. Further, it uses data from government sources and news to highlight the measures adopted at the national and subnational level in response to the pandemic. Findings: The difficult economic conditions prior to the pandemic limited the fiscal space available to the government. As a result, the national and subnational governments have been cautious of accumulating excessive debt and have primarily responded with liquidity-enhancing measures, in addition to some fiscal measures for the most vulnerable. Overdependence on consumption taxes has led to unprecedented revenue shortfalls prompting the exploration of new avenues for revenue generation and implementation of austerity measures – some of which may be counterproductive in the long run. Originality/value: The paper highlights the policy response of the largest democracy that has been hit hard by the pandemic. It also highlights various institutional and resource constraints that influenced the policies adopted. India's experience in responding to the virus could provide lessons for other developing countries. © 2020, Emerald Publishing Limited.