Saturday, March 21, 2020

Covid 19 infection and what India needs to do

How will a one day curfew (Sunday from 7 am - 9 pm) prevent Covid 19 spread in India? What happens to the virus spread after that? Even more important is, what is happening before that?

The number of incidents, of people skipping quarantine and taking trains or even flights to travel long distances within the country, are cropping up every day. The latest one, being the UK returned actress, who attend a dinner party that was also attended by some so called VIP's who then went around to meet many others. And now that the actress has been found to be corona positive, after two days, the number of people who have put themselves in self-quarantine include not only those who were with her at the dinner, but many others, whom they met over the course of the next few days, including the President of India who hosted a breakfast, two days ago, where one of the persons from that dinner was also present.

Or the case of a UK returned son of an IAS officer, who did not quarantine himself because of his assumed 'VIP' status and also delayed the testing for corona virus, while his mother, went routinely to the secretariat in West Bengal (same building where the Chief Minister also sits) and attended a number of meetings, only to find that the son is corona virus positive after a couple of days.

These and many other similar incidents point to the lack of adequate information among the public and an overall lackadaisical attitude, in spite of the alarming global situation Covid 19 has triggered. What makes us think that there are not already hundreds and thousands of people moving around with the virus, without being aware of it?

Time is of essence in tackling this infection. The PM's address took place finally on the 19th of March. The speech in itself seemed geared towards the rich and at best the middle class standard upwards of perhaps the larger cities. The idea of people coming to their Balconies for five minutes to clap, ring bells or play upon metal plates to thank all those working during this time, taken from Spain and some other European countries, seems appealing. However, there are far more urgent tasks that need to be undertaken.

The other key point, the 'Janta curfew' by the people, is scheduled for Sunday. The hyper-nationalism that we have all been a witness to off late makes the idea of ‘by the people’ a bit uncomfortable. If it were to be considered a ‘preventive distancing between people’, scheduling it for Sunday (3 days later) means not only losing precious time it also raises other questions on the overall preparedness.

There seems to be no clear plan for the homeless people who constitute at the very least 1.8 million of the Indian population? Where shall they go during this curfew? The daily wagers: the ricksha pullers, auto drivers, the small shop / dhaba owners and their workers, the labourers, the sex workers, the ragpickers, the people who beg for food and those living under other dire circumstances and below poverty line etc. etc., would number in millions. Has the government a blue print to ensure that atleast food can be ensured for everyone on this Janta Curfew Sunday, and if such measures are to continue, then even beyond?

The middle class and upwards on the socio-economic ladder are likely to happily loiter around their houses, cook nice meals and post social media statuses about how they creatively engaged in some hobby and felt great and also made noise on their balconies to exude their patriotism to the hilt. The sport stars and other celebrities are likely to express and endorse this further.

However, millions who neither have a balcony nor another similar space, if they do have a house at all, will be lucky if they manage to store some food for themselves or their children to pass over the Sunday. And who will ensure that a poor man, woman or child, who may step out to find food or due to some other necessity or who may be unaware of the janta curfew, will not incur the wrath of someone high on nationalistic pride that we have witnessed quite a bit over the last few years?

The need:
The government cannot afford to lose time on a crisis like this. Instead of endorsements by Sport stars and celebrities, what is needed right now is a serious engagement with public health experts, epidemiologists, health policy researchers, social scientists and the likes, to ensure a robust plan to tackle the problem. It needs an action plan with atleast two clear focal points: 1, Social and 2. Medical.

On the Social front, the first and foremost is to ensure food for all the homeless, the daily wagers and other such people in need. It must be followed with shelter for those who need, with enough space and proper sanitation to prevent the spread of Covid 19. This is important to also be able to follow up or ensure quarantine in case a person catches the infection. A coherent and relevant information flow right down to the last person to keep the people informed, assured and avoid needless panic. It is important to understand that no matter which part of the socio-economic strata the infection explodes in, the crisscrossing of the Indian society is such that it may be difficult to prevent the spread all across, right up to the top.

On the medical front, the entire health system needs to be swiftly reorganized to deal with the crisis. Testing, quarantine, treatment of the severely ill and care and safety of the health professionals themselves should be the cornerstones. Safety of the health professionals is an important lesson to be learnt from Wuhan medical professionals who have flagged this issue as it can weigh heavily in the fight. And from Spain we need to learn to bring the private health care system under the government’s purview, atleast until the situation gets back to normal. Every single hospital and its resources will be needed to check the explosion of the infection, if that happens in India. Being unprepared would only amplify the impact and the blame will be on ourselves.

To sum up, the government needs to realize that populist measures will not help in prevention of Covid 19 infection. Time is of essence and acting swiftly can save the population as well as the economy from a huge burden. It may seem like a difficult task, but India, with all its resources and more so, man power, can rise to the occasion.

(The author is an erstwhile medical doctor who currently lives as an artists and filmmaker and remains concerned with public health issues.)

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