July 12, 2020

Modi’s Pandemic Mess

THE Covid pandemic in India reached a landmark on July 5 when India became the third country, after the United States and Brazil, with the largest number of Covid cases in the world. It is no coincidence that the top three countries in this regard are being run by rightwing authoritarian leaders. India at present is also registering the highest number of cases per day along with these two countries. Currently, a hundred thousand (one lakh) cases are being added every four to five days. The death toll, which is understated, has crossed 20,000.

All these point to the all-round failure of the Modi government in tackling the pandemic. It looks as if the government has run out of options and is reconciled to the pandemic running its course. The daily briefings given by the health ministry have ceased for weeks now. Only some lame explanations such as the recovery rate is improving, or the fatality rate is still low compared to other countries are made desultorily. To cite a rising recovery rate is meaningless because ultimately 98 to 99 per cent of those affected by the virus will recover. As for the crude mortality rate, which is the number of deaths per million based on the population of a country, India’s record in deaths is bad compared to many countries in Asia and Africa.

The overall policies to tackle the pandemic and their implementation only underline the mess created by the Modi government.  The  lockdown would have been useful if it had slowed the pace of infection and if the time had been utilised for expanding the infrastructure of the  public health system, ensuring adequate  medical equipment, PPEs and other supplies. But the record shows otherwise. The increasing rate of cases began two weeks after the lockdown and there has been a surge after the stringent lockdown ended on May 31.

As far as expanding capacities and medical equipment in government hospitals are concerned, the steps taken were limited and totally inadequate. Only Rs 15,000 crore was allocated for the health sector out of the so-called Rs 20 lakh crore package. Even this is to be spent in phases. The government should have directed the administrative takeover of selected private hospitals to make them part of the Covid treatment plan. But this was not done. 

The manner in which the lockdown was implemented subverted the very aim of containing the virus.  The fact that millions of people had to be cooped up in tiny quarters and slums made physical distancing impossible.  The draconian effect of the lockdown on the livelihoods and sustenance of more than a 100 million migrant workers led to the unplanned and forced exodus to the villages and with it the spreading of the virus to new areas.

The central government has not adhered to science in its approach. It has not relied on health experts and epidemiologists to formulate policies with regard to testing, contact tracing and isolation of people affected by the virus.  It refused to provide adequate funds to the states who had to put into place the Covid-treatment plans.  All states have complained about the lack of resources to execute these plans starting with the availability of testing kits.  The PMCARES fund was set up and functions in an opaque fashion without any official accountability. The funds collected from corporates are being used to fight the Covid pandemic as per the political interests of the prime minister.

All these have resulted in distressing scenes of families frantically trying to get Covid patients admitted into hospitals; of the inability to get Covid tests done; the lack of PPEs for health and frontline personnel and private hospitals charging exorbitant fees. The plight of lakhs of ASHA workers and sanitation workers with no adequate protective gear is pitiable.

The Modi government seems more interested in making some short-term political gains out of the Covid crisis.  Having failed to put in place a science-based method and plan, ultimately it is the home ministry which is now directing the battle against Covid.  In the process, institutions like the ICMR have been denigrated and utilised as an instrument of the government.

The ICMR had conducted a serological survey and reported that only 0.73 per cent of the population was exposed to the virus by the end of April.  The ICMR, however, did not submit this report to peer review nor did it spell out what are the implications of the study. For instance, if 0.73 per cent of the population was afffected, it would have meant, according to a well known epidemiologist that ten million people had been exposed to the virus by April end.  With the conclusions of the survey, the ICMR should have projected what would be the scale of the infection in the next three months and drawn up a plan to meet this challenge.  But the institution seems to have abdicated any independent role.

The ICMR persisted with trials for hydroxychloroquine and recommending it as a precautionary drug for use by doctors and frontline health personnel. This it stuck to, even when the WHO concluded the drug has no beneficial effects. Trump seems to be the guiding light in such matters for India’s premier medical research body.  As for the Modi government, it has refused to issue a compulsory license to produce Remdesivir, the drug which has shown some efficacy in Covid treatment but which is not available in India.  It is owned by an American pharma company which has handed over all its supplies to the US government. The compulsory licensing route would allow the drug to be produced by Indian companies.

Recently, the ICMR issued directions to 12 hospitals asking them to complete clinical trials of the vaccine candidate, Covaxin, by August 15. To complete the three-phase trial within one and a half months is a political target, not a scientific one. This directive of the ICMR has been strongly criticised by scientists and health experts who have all pointed out how the whole process will take at least six months.

This incident exhibits a worrying feature of the Modi government.  Given its lack of commitment to science and public health, the Hindutva rulers are prone to unscientific methods and gimmicks which can boost the image of a strong leader.  Such an approach bodes ill for the health and welfare of the people.

The Covid pandemic is still in its early stages around the world.  We are in for the long haul until an effective vaccine is developed. The government has to get its priorities right – strengthen the public health system on a war-footing; test, trace and isolate on a large-scale in a systematic way; provide all the wherewithal to the state governments who are the ones who have to bear the brunt of the work involved and at all times keep the people informed and elicit their full cooperation.  This of course has to be complemented by an economic plan which results in cash transfers for the needy, free supply of food grains, expansion of MNREGA and reviving livelihoods and incomes.
(July 8, 2020)