Table 2

Assessment of Indian national lockdown (1.0 and 2.0) from 24 March to 3 May 2020 for the performance with regard to policy indicators

Ethical principlePolicy monitoring and evaluation indicators for response measuresPerformance of indicatorDid response measures adhere to the principle?
Harm and necessity
  • Presence of scientific evidence indicating harm (eg, human to human transmission, mortality)

 ✓Yes
  • Decided metric for harm measurement (eg, death count, case count)

Justifiability
  • Presence of prior peer-reviewed scientific publications on the effectiveness of restrictions

Yes
  • Successful historical precedent (any instance before)

  • Presence of a dedicated response team for review of literature, adequate data collection, impact evaluation and situational monitoring to continuously determine the effectiveness of the restrictions

Proportionality
  • Matching stringency of restrictions with the growth of cases and deaths in the epidemic

    In case of COVID-19: most restrictive measure (national lockdown) at least 2 weeks before 100th case and least restrictive measure (travel bans) at least 1 week before first case

 ✕No
Least restrictive means
  • The number of steps between the least (travel bans) and the most restrictive (national lockdown) measures

7Yes
  • Whether sufficient time intervals are given for every restrictive step to show the maximum effect

✓*
Utility efficiency
  • Does the analysis of trade-off (eg, cost–benefit analysis) between loss of livelihood and other losses against deaths averted and cases averted show net positive benefit?

No
Reciprocity
  • Cost and population coverage

INR 21.7 trillion (US$294 billion) covering 420 million peoplePartially
  • Tax and loan payment concessions

  • Postponing non-essential routine activities (eg, examinations, sports events, etc)

  • Anti-discriminatory mass media practices

  • Guidelines in place for responsible news media reporting to avoid discrimination and reduce stigma

  • Presence of helplines to deal with mental health issues that may arise

  • Surveys for awareness among people about avoiding discrimination

  • Presence of grassroots ventures that help the impoverished groups

Transparency
  • Presence of press conferences in local languages

Yes
  • Frequency of COVID- 19 press conferences

On average 1 in 40 days
  • Presence of outreach methods and materials that are easy to understand, in local languages, and widely distributed

  • Presence of a public record of justification for the quarantine that is conveyed to lay people in local languages

Relevance
  • Presence of public opinion polls

Yes
  • Presence of people’s representatives in the decision-making process of dedicated response teams

Equity
  • Presence of food and shelter security for the below poverty line and low-earning unorganised labour groups affected by the restrictions

Partially
  • Presence of domestic violence helplines for women and children

  • Availability of healthcare access for the chronically ill and elderly groups

Accountability
  • Presence of grievance redressal and feedback portals

No
  • Presence of public platforms to challenge the restrictions by speaking to authority figures

  • Presence of laws that allow for a process of appeal

  • Uninterrupted and autonomous working of the judicial system for fast-tracking the restriction-related appeals

  • Mechanisms for demanding reparations in case of life and livelihood losses due to restriction

Cost and feasibility
  • Presence of laws that allow the implementation of restriction

Yes
  • Presence of a police force for restriction (eg, confinement) implementation

  • Ability to create places of confinement for restricted (eg, quarantined/isolated) individuals

  • ✓=yes or present; ✕=no or absent.

  • *Sufficient time interval given for every restrictive step to show the maximum effect was derived from31 which calculated the time taken for travel restrictions, school/workplace/public place closures and lockdowns to show maximum effect. No recommendations were given for social distancing measures. Of the three restrictive measures, India followed the minimum time requirement for travel restrictions and lockdown but not for school/workplace/public place closures. Since more than half of the available minimum time standards were met, we considered this indicator to have ‘yes’ as the response.

  • INR, Indian rupee.