- Oliver D’Souza
A national lock-down to curtail the spread of the COVID-19 in India was inevitable, though not enitrely for the same reasons as in other countries. But while data emanating from various countries has shown that lock-downs have substantially helped slow the spread of the virus, for a number of reasons, in India it is doing an sinister amount of damage as anticipated good, requiring the government to come up with practical, well-thought out plan with capable men and women at the helm to handle the looming COVID-19 crisis, the economy impact of the pandemic and the humanitarian crisis – all of which have begun hitting us at the same time.
Even as a epidemiologists say a universal vaccine against the virus is over a year away, with no specific line of treatment for the infection, currently, extensive testing for early detection, social distancing, segregation and symptomatic treatment of the infected and lock down, seems to be the only comprehensive low casualty way to manage COVID-19. This has been successfully demonstrated in Germany which, although having over 68,000 infections has seen only a 0.8 per cent casualty rated as compared to the global average of 3%. Also, after the lock down and enforcing of social distancing, the number of new cases has been dropping
Explaining the reasons for the low casualty rate, Christian Drosten, director of the institute of virology at Berlin’s Charité hospital, speaking to National Public Radion INC said, “I believe that we are just testing much more than in other countries, and we are detecting our outbreak early.”
At the same time, in Germany, the average age of the infected is 45 whereas in Italy which has seen 1800 per cent more deaths than Germany despite having a far lower number of infections it is 63, indicating that the elderly are more at risk of casualty. Germany also had over 5 times more hospital beds than the other two, a extremely robust healthcare system and an aggressive testing policy.
Clearly, as has been numerous times stated by even our own top health specialists, while testing is central to contain breakouts, having extensive adequate number of quarantine facilities and hospital beds, medicines, ventilators, testing equipment, test analysis centres and protective and other ancillary gear for health workers is crucial. If the health infrastructure of any nation is able to provide these, the spread of the infection can be slowed down and the 3% global casualty rate can be brought further down by keeping the infections under manageable levels. Similar dynamics are at work in other countries too, though at a lower level,resulting in over 115,000 have recovered from the infection world-wide and many nations are over the worst.
At the same time, countries that responded early and efficiently, such as Germany, Singapore and S Korea, have been able to keep the death toll and the number of infections low and well under manageable levels. Countries like the US that did not do so despite having the resources and infrastructure have seen large number of deaths and infections. On the other hand, countries where lock down was initiated late in the day despite early reports of alarming number of widespread infections, as in Italy, Spain and US, too saw the infections spread rapidly before the lock downs. This caused a breakdown in the health system, particularly in Italy and Spain, with a large number of health workers themselves getting infected and getting put out of play, making matters worse. So far, over 7716 and 11591 people have died in Spain and Italy respectively; far more than the casualties where it originated –China, where 3304 people have died of the infection, if the figure is to be believed.
German, US, France, UK, Canada, Australia, among other nations, have also announced economic packages to support the economy and to provide people who cannot go to work because of the lock-downs. The COVID-19 pandemic is not merely about dealing with the pandemic: it is also but dealing with the inevitable economic and humanitarian fallout of the pandemic, which is enormous. The leaders of these nations have shown great foresight and astute leadership in the decision they made, leading to a more stable national social atmosphere.
When you compare how Germany and other nations have dealt with the pandemic, the Indian COVID-19 story of handling it is truly scary. We have done all the right things at the wrong time and in the wrong way, with very little application of mind. As a result, unlike the West, where the scare is only about the infection reaching unmanageable levels and thus leading to more deaths, people in India are genuinely scared of death due to the virus. And they have other good reasons to be afraid.
To begin with the government has been lying to the nation about the scale of the problem and the infections. Would any government in the world announce a national lock-down if there were only 450 cases when the lock-down was announced? The government may deny it or indulge in wordplay to do the same, as the Union Health Ministry is doing, but as emphatically pointed out to Hindustan Times by Dr T. Jacob John,, who formerly headed the Indian Council for Medical Research’s Centre for Advanced Research in Virology and is a professor emeritus at Christian Medical College (CMC) Vellore, India entered the community transmission stage in mid-February itself. This fact was again inadvertently conceded a few days ago by none other than the Union Cabinet Secretary, Rajiv Gauba.
In a letter to chief secretaries of all States and Union Territories, Gauba said the gap in monitoring of international passengers “may seriously jeopardize the efforts to contain the spread of COVID-19”, given that many amongst the persons who have tested positive so far in India have history of international travel.”
“As you are aware, we initiated screening of international incoming passengers at the airports with effect from January 18, 2020. I have been informed that up to March 23, 2020, cumulatively, Bureau Of Immigration has shared details of more than 15 lakh incoming international passengers with the States/UTs for monitoring for COVID-19.”
“However, there appears to be a gap between the number of international passengers who need to be monitored by the States/UTs and the actual number of passengers being monitored,” Gauba said in his letter.
For long, it has also been accepted by health specialists that airport screening with thermal devices and questionnaires for detecting virus infection in incoming travelers at international or domestic airports is ineffective. As reported by NCBI in a 2005 study titled “Border Screening for SARS”, pertaining to Canada, it was found that thermal screening did not serve the purpose largely because the thermal scanning equipment was non-SARS specific, which is also precisely the case with COVID-19. The thermal screening equipment used in airports is non COVID-19 specific. Moreover, such equipment does not detect asymptomatic carriers of the virus.
In the case of COVID-19, a NCBI study titled “Effectiveness of airport screening at detecting travelers infected with novel corona virus (2019-nCoV)” epidemiologists, taking into account that infectious individuals with asymptomatic (sub-clinical) infection would not be detected by thermal scanning or cause them to seek medical care, concluded that “exit or entry screening at airports for initial symptoms, via thermal scanners or similar, is unlikely to prevent passage of infected travelers into new countries or regions where they may seed local transmission.”
This conclusion was backed by the real figures on the ground. A CNN investigation reported on February 20, 2020, that “While the US Centers for Disease Control and Prevention (CDC) has screened more than 30,000 passengers in the past month (February,2020), not a single US corona virus case has been caught by airport temperature checks”. The same report goes on to cite a British study which confirmed the inefficiency of airport screening, with one country even finding that the screening was so unhelpful that it abandoned screening altogether.
Dr Ben Cowling, an epidemiologist at the University of Hong Kong, and others in the profession says that airport screening is largely nothing but a charade. Speaking to ScienceMag, Dr Cowling says that “screening is often instituted to show that a government is taking action, even if the impact is marginal.” The only benefit from screening done on arrival at the destination airport is it enables the government an opportunity to gather contact information for follow-up, provided it is actually implemented to the letter.
In India, apart from the anomalies pointed out by Gabua, and the ineffectiveness of thermal scanning, the screening process at best was pathetic. There are numerous reports of people walking through airport terminals without being thermally screened, without having answered questionnaires. In a majority of the detected infection cases reported thus far in India, the infected persons have either traveled abroad or have been in contact with someone who has done so. None of the travelers were detected during screening at the incoming airports.
But that is only part of the story; you also have many cases of people being infected without such direct contact. Today (March 31), the government told the Supreme Court that there is a possibility that of 3 out of 10 people moving to the rural areas from cities were carrying the virus. A total number of 20 crore such people moving across states to their rural homes. Considering that many of them would not have come in direct contact with an infected traveler, Dr John is spot on when he says community transmission began in mid-February. The Indian Union Health Ministry may keep patting itself on the back over keeping the casualty numbers at below 3%, is only misleading the nation because in the interim many people have died of respiratory illnesses and pneumonia around the country, without being tested for COVID-19. Respiratory failure is one of the main debilitation caused by the virus leading to death.
Given that the there was existing knowledge about the ineffectiveness of airport screening to weed out infected travelers, it may have been in order to have airport screening to gather traveler information for tracking, but besides doing an obviously poor job at screening and subsequent follow-up as admitted by Mr Gabua, the big blunder was to put all eggs in that basket.
As the WHO has pointed out, the Indian government depended on weeding out the carriers at airports to contain the spread of the virus, even though this method has repeatedly been proven to be ineffective. This is something the Union Health Minister and the ministry officials should know by virtue of their job and should have instead focused on effective measures. The WHO and every health specialist worth his salt has pointed out that the only way to deal with the pandemic was to do extensive testing, strengthen the health infrastructure and to enforce social-distancing and qualified lock-downs. This is what the government should have been at since December, when pandemic of COVID-19 fears were being raised all over the world and we also have a lot of Indians who travel to the affected areas. It should have started testing form late January itself and the Lock down should have been put in place before mid-February.
Instead, rather than look after the welfare of the people, the government was busy looking after its own political and ideological interests during this crucial phase. While by early February the whole world was focused on containing the virus, the entire senior ruling political leadership of the party in power was busy with Delhi elections, to win it by hook or crook. After losing the elections, till the end of Februray, it was further embroiled in the Delhi riots triggered by its won cadres. Delhi, besides Mumbai, Bangalore, Kolkotta, Chenna and Thiruvanthapuram are the main entry points for air traffic in India, with Delhi and Mumbai being the principal ones. How much local transmission and subsequent community transmission has taken place in Delhi between the election results and end of the riots when mobs operated shoulder to shoulder is anyone’s guess, particularly considering that we entered community transmission in mid-February as pointed out by Dr John.
It is pertinent to note that the first case of COVID-19 infection was reported in India on January 30, the WHO had already put out a’ global health emergency warning’ on February 20, and on the same day Congress MP, Rahul Gandhi and other concerned opposition leaders had put out repeated tweets cautioning the government of the oncoming onslaught of the virus. All of this was not only ignored by the government but the warnings were ridiculed by the government and its trolls, which is its standard response to anything which exposes its inefficiency, failure and incompetency. The government wantonly and completely disregarded the warnings of the WHO and the opposition, neglecting the welfare of the Indian population. It’s obsession for power and furtherance of its majoritarian ideology overrode all its constitutionally mandated responsibilities to the people. By this time, the virus had already entered the community transmission stage.
That’s not all. Thereafter, despite the rest of the world working overtime to strengthen health infrastructure to cope with the inevitable pandemic and prevent its further spread, the attention of the ruling leadership and its resources were once again given to illegally toppling a democratically elected Congress government in Madhya Pradesh, which was accomplished by March 10. Between January 30 and the announcement of the lock-down, the government had plenty of time to strengthen the health infrastructure, build quarantine centres, procure or manufacture equipment and other essentials necessary for testing, while also preparing to keep its population adequately fed during a needed lock down. When the first case in India was reported on January 30, the writing on the wall was clear: the virus had entered India and considering its performance in other countries by then, there was no doubt that the pandemic was going to hit the nation.
The only governments that seem to have taken the outbreak seriously and acted very early and very comprehensively, addressing all connected issues, are Maharashtra and Kerala which put in place nearly 6 weeks earlier the same measures that the Union government later did nationally. Whereas, in states like UP, Karnataka and MP, the CM’s themselves were openly violating social distancing mandated by the Union government. You had Yogi leading religious rituals in Ayodhya with a lot of people in tow, Yediyurappa attending a marriage attended by 2000 people and Shivraj Chouhan strutting MLAS all over the place, ignoring all social-distancing requirements. Ironically, right now the BJP is targetting a Muslim group that flouted social-distancing laws and using it to divert attention from its complete mishandling and neglect of the COVID-19 threat. Yet, the same government has done nothing about the CM’s who violated the same social distancing, with various politicians also participating in large parties.
Then came poorly organized and thoughtless,sudden 21-day lock down, which unlike the rest of the world, as per the governments own admission to the SC has resulted in the transmission jumping to stage 5- pandemic.
The claim is being made that the decision for a nationwide lock-down was taken after consulting the CM’s of all the states, but not a single CM has attested this claim, while the fact remains that no CM in his right mind would agree to a total national lock-down with 4 hours notice.
Almost every CM knows that his state has a large number of migrant workers. Most of these workers, numbering in the millions, are employed in the construction industry, in hotels and hospitality services and in menial jobs. Most of them are dependent for accommodation on their employers, while others pay exorbitant rents out of meager earnings, which are impossible to sustain without income. Most of them are also daily or weekly wage earners, living hand-to-mouth. A nationwide lockdown without considering the largescale displacement of this section of the population under lock-down conditions, was at best a poorly organized. The total lock-down which included the transport system, resulted in millions of such workers in Delhi and other cities all over India walking to go to their homes hundreds of kilometres away where they would be at least assured shelter and food. In the failure of the PM to spell out a clear plan, it also triggered panic and fear among these workers.
Why did the government indulge in such out of the blue action? The foremost reason is that there is very little concerning the masses that this government has done right, highlight its incapability to run the nation as it needs to be run. Whether it was demonetization, GST, developmental policies, CAA, NRC, NPR, human rights, religion; the government has done it all wrong.
Secondly, it is also likely that the government realized too late in the day that it had neglected timely and right action, that it had wasted the window of opportunity it got between January and March and that it all along knew that community transmission was taking place. It seems, being bereft a strategy to deal with the pandemic, on seeing that other nations were imposing lock downs, it just followed suit without any thinking and planning going into it, which was done before other nations enforced it.
Thirdly, the government also seems to have got things all mixed up. Social distancing is not the only and primary reason for a lock-down. The consonant vital idea is also to buy time to prepare the health infrastructure to handle the inevitable large number of cases of infections due to the nature of the ultra-virulent nature of the virus. This is how lock-down is being utilized in other countries.
Whatever the reasons, what should have been a tool to stop the spread of the virus, by the government’s own admission, has resulted in large numbers of people carrying the virus from the cities to the rural areas. So it will always remain a mmot question as to how much the lock-down has actually helped in the struggle against COVID-19.
All this could have been avoided if the government had acted responsibly right from the start, with timely action and proper planning. The government in active consultations with each state could have come up with a comprehensive plan to prevent the COVID-19 spreading displacement that we are now seeing across India. The government completely failed to understand the full purpose of a lock down. If not it would not have indulged in it in a manner that forced over night displacement of infected people (3 out of 10) across the nation.
That’s not all. As a result of the lock down, over 450 million daily wagers are hit the worst. These are people who work during the day, receive their wages and buy food for the ensuing day. The lock down has meant that none of them has a source of income. The government announced a financial package for these sections but when you analyze the package it is another con job typical of this government.
Professor Jayahthi Gosh the Wire, JNU, told The Wire, “In macroeconomic terms, the total amount mentioned (Rs 1.7 lakh crore) is only around 0.8% of estimated GDP, and therefore as a fiscal stimulus it is tiny and will do little to counter the absolute declines in income resulting from the lockdown. In any case, this total is also the result of window-dressing, since existing schemes like PM-KISAN have been included even though amounts have not been increased. It suggests that the central government has no idea of the depth of the unfolding economic collapse. More measures and much larger amounts will certainly be required for the target groups mentioned, and also for other sectors.
Considering that the economy has already been in the dumps for over four years with the government simply unable to put things back on track, we now are not only facing a COVID-crisis, but also a massive humanitarian crisis and an economic collapse. As someone has said, if India survives all this and comes out intact, it is going to be “entirely due to the effort of the states and despite the Union government”. And even here, the BJP ruled states are likely to face far worse consequences because these states are not ruled by people who are competent to run it, but of those who are in position becaue because they have a certain ideology which they used to deceive the masses to get into power and having got there have no clue how to run their states.
In all of this, serious questions also rise about the National Disaster Management Authority (NDMA). This body has done commendable work in many post-disaster situations such as floods and earthquakes, but disaster management is not only about post-disaster relief. It includes foreseeing disasters, including health disasters and preparing for them in advance. The NDMA has failed to do this. In fact it is not even visible in the unfolding humanitarian disaster in the country. It should have been ready with all sorts of plans for migrant workers stranded in the streets, bylanes and higways with no food and water.
The hope now entirely rests on how well the government utilizes the resources at hand, more importantly human resources. Clearly, the Union government, its leadership and officials are completely out of its depth in handling the various criris precipitated by COVID-19. It would not be a humiliation for the PM to handover the management of the cris to others who have done it efficiently, the Keral CM Pinarayi Vijayan in particular.