OPINION - India: Overconfidence, protocol violations derail COVID-19 fight

Lessons drawn from fresh deadly COVID-19 wave in India is to list health among national and human security issues

Iftikhar Gilani   | 28.04.2021
OPINION - India: Overconfidence, protocol violations derail COVID-19 fight A makeshift Covid-19 quarantine facility set up at a banquet hall in New Delhi, India, on April 27, 2021. ( Amarjeet Kumar Singh - Anadolu Agency )


The phone calls from the Indian capital New Delhi these days send shivers down the spine. For the past few days, whenever the phone buzzed, it brought news of the death of a friend or a former colleague.

Many friends admitted in the hospitals are gasping for oxygen with their relatives running helter-skelter to arrange cylinders using every trick under their sleeves.

COVID-19 pandemic process in New Delhi

NEW DELHI, INDIA - APRIL 27: Family members of Covid-19 infected patients stand in a queue with empty oxygen cylinders outside the oxygen filling center, in New Delhi, India, on April 27, 2021. ( Amarjeet Kumar Singh - Anadolu Agency )

A caller from Faridabad, in the outskirts of New Delhi, wanted help to get his dead father cremated. There are long queues outside crematoriums, he said. The iron grills of an electric crematorium got melted due to the constant burning of its furnace. Another caller complained that there is no wood left at the crematorium to perform his uncle's funeral. Vinay Srivastava, a journalist based in Lucknow, capital of India's largest province of Uttar Pradesh, was tweeting and tagging his friends and authorities pleading for an oxygen cylinder till he breathed last.

Prominent hospitals are knocking doors of courts to ensure the supply of oxygen. At Ganga Ram Hospital, a leading health facility in New Delhi, 19 patients died as the supply dried up. Just a few hours ago, the hospital administration had sent frantic messages to authorities asking for oxygen tankers.

Father of Smridhi Saxena, a prominent radio jockey in India's commercial capital Mumbai said that despite resources and influence, she has been unable to get a cylinder for her ailing father, who needs a constant supply of oxygen. She said the cost of a cylinder in the city has shot up to 20,000-30,000 rupees ($270-$370) and it lasts for just two to three hours.

The Mother-in-law of a former colleague and senior journalist tested corona positive. Despite resources and contacts at every level, they had to make rounds to four hospitals searching for a bed. Till they could complete paperwork and find a bed, the old lady had collapsed in the vehicle. Now for the past four days, the dead body is in a morgue, as there is a long waiting list at the crematorium.

A retired judge Ramesh Chander's note in the Hindi language is circulating in social media requesting help to take the dead body of his wife to the crematorium. "My wife and I both had tested COVID-19 positive. I tried all the helpline numbers. But none responded, till my wife collapsed in the morning, "said the note.

From Varanasi, which is the electoral constituency of Prime Minister Narendra Modi, a resident Vimal Kapoor said his mother passed away in hospital as there were no beds. "I saw people being treated in the parking lots. There is no space inside hospitals. At the crematorium, dead bodies are in bundles, and prices of wood have skyrocketed," he added. Kapoor had to wait for 15 hours to get his mother cremated.

Rural India unattended

If this is the situation in metros like Delhi and Mumbai, one can imagine the state of affairs in smaller cities, towns, and rural India. According to the US-based Johns Hopkins Coronavirus Resource Center, so far, India has reported 17.3 million cases with 195,123 deaths. For the sixth consecutive day, the country reported 300,000 infections and over 2,000 deaths.

But experts are skeptical about these official figures. A reporter of a leading newspaper, The Telegraph, claimed that there was heavy underreporting of cases in various parts of the country. In one locality, where just ten infections had been recorded on the paper, the reporter found 150 cases. According to the newspaper, the infections could be surpassing 800,000, with 20,000 deaths every day.

Just last year, India had given hope to the world by acting fast and successfully stemming the spread of the virus. In January, while addressing the World Economic Forum through a video link, Prime Minister Modi declared victory against the virus. "People were predicting 700-800 million Indians getting infected and more than two million will die. But India didn't let this happen and saved humanity from a big disaster," he said. He talked about how India had built capacities in no time, the world's biggest vaccination program has been launched on the back of two "Made in India "vaccines with many more to come, and how India is now out to save the world by exporting these.

From January to March 2021, it exported 65 million vaccine doses, one million remdesivir, injections, 9,300 metric tons of oxygen, and 20 million testing kits to show its prowess and ostensibly to compete with China's health diplomacy. Now, the sudden ban imposed on exports has also put the countries dependent on India's vaccine supplies in a problematic situation.

In March, Prime Minister Modi had gifted 1.2 million vaccine doses to neighboring Bangladesh. The country also purchased 30 million doses from an Indian facility and started vaccinating its population. It had placed orders of a further 40 million doses. The deteriorating situation in India, which led to an export ban on all medical items, has left Bangladesh, Maldives, and many African countries in an unpleasant situation, as they had pinned hopes on vaccine supply from India.

Gasping for answers

There are no answers as to why India was caught napping as the second deadly wave had shown its fangs in mid-February itself? The government's own serosurveys gave ample warning of a second wave. In its 120-page document in the first week of March, a parliamentary panel listed actions that needed to be taken, including stashing enough medical oxygen. Incidentally, the double mutant virus first appeared in the provinces of Kerala, Punjab, and Maharashtra -- all of them ruled by the opposition. Instead of helping them to contain the virus, the blame game began with questions being were raised about the efficacy of their administrations.

Overall the experts believe that the overconfidence of leaders that led them to allow the conduct of assembly elections in five provinces and religious gathering of Hindus at the banks of the holy Ganga River in Hardwar, 213 kilometers from New Delhi, washed away all the precautionary measures observed over past one year. The Madras High Court held the Election Commission singularly responsible for the second wave and even observed that its officials should be booked for murder. It did not enforce leaders and the public to follow COVID-19 protocols. So far, four candidates contesting the ongoing assembly polls in West Bengal have died after testing positive for the disease.

At the Hindu religious gathering, 4.6 million devotees had gathered to take a dip in the river. Within days 2,000 infections were detected in Hardwar town, which have now spread through devotees in the far-off corners of India.

The leniency to allow this gathering was in contrast to last year when the government and mainstream media launched an all-out assault against members of Tablighi Jamaat -- a transnational Islamic missionary movement headquartered in the capital Delhi -- for allegedly spreading coronavirus. Such was this campaign that many resident welfare associations (RWA) banned the entry of Muslims into their localities.

Another reason that led to failure to tackle the second wave was lack of transparency in the utilization of the Prime Minister's Citizen Assistance and Relief in Emergency Situations Fund or PM Cares Fund, which was created on March 27, 2020, following the COVID-19 pandemic. Many government departments and corporates generously contributed to the fund. But the opposition parties allege that since contracts for producing medical equipment were given to favorites, their quality has been compromised. The opposition ruled Rajasthan government returned ventilators, as 90% of them were not working. Eight months ago, tenders were floated to set up 150 medical oxygen manufacturing plants. Except for the southernmost state of Kerala, which increased its capacity of oxygen production and storage by 58%, in the rest of the provinces, it remained confined to files. Instead of increasing the capacities of hospitals at various places, the COVID-19 facilities were closed.

An investigation carried out by the Mumbai-based newspaper the Mid Day a fortnight ago had found that airport authorities were letting passengers from foreign lands escape compulsory seven-day institutional quarantine by allegedly taking bribes of 10,000 to 12,000 rupees ($133-$267).

Underspending in health sector

The Health Ministry had asked for an allocation of 1,218 billion rupees ($16.3 billion) for the 2021-22 annual budget. But it got 712.6 billion rupees ($9.5 billion), 58.48 % less of the projected demand. The parliamentary panel had warned in March that this massive shortfall in budgetary allocation will hamper the scaling up of various healthcare systems.

The decades of underfunding have left the health sector in a poor state in India. The annual public expenditure on health is still just 1.8% of the country's GDP. At present, India has eight doctors per 10,000 people. Neighboring Pakistan spends 0.9% of its GDP on health in contrast to 4.4% in Turkey and 6.6% in China.

According to Laxman Kumar Behera, a research fellow at India's prestigious Institute of Defense Studies and Analysis (IDSA), the pandemic has shown that national security is not just military. "Its (pandemic) impact in terms of loss of human lives, extreme suffering of the population living on the margins, loss of jobs and other serious economic setbacks are no less than the ravages inflicted in an inter-state war," said Behera, a former member of the government's Defense Modernization and Self-reliance project.

While armies all over the world keep doing exercises to prepare themselves for any eventuality. Most of the countries keep stashing strategic oil reserves besides ammunition dumps to help them to prepare for wars. The lesson drawn from the fresh COVID-19 wave in India is that there is a need to have a similar strategy to deal with health issues to stock enough medicine and medical equipment to combat pandemics. It is imperative to include health also in matters related to national and human security.

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