The Second Wave of the Covid-19 Pandemic

Where has the Government and the Public Faltered?

The Second Wave of the Covid-19 Pandemic

The second wave of the Covid-19 pandemic has proceeded to grip India through the months of March, April and May in 2021. After a brief respite in September 2020, currently there are more than 2.15 crore cases, with more than 1.73 crore recovered and 2.3 lakh deaths. On the 7th of May 2021, India reported 4.14 lakh new cases of the virus and 3915 Covid-19 deaths over the previous 24 hours, with cumulative fatalities at 36110 in last ten days, which was the highest death toll reported globally for a ten-day span till then. To the bafflement of citizens and even scientists, daily case numbers started exploding since early March, and the current peak seems to be double the first one of 2020. In fact, to some physicians, the second wave has made the first one look like a “ripple in a bathtub”. The situation besetting this country is extremely worrying, and the purpose of this article is to analyse where India has faltered in managing the pandemic, to understand how the second wave is continuing to affect citizens’ lives so devastatingly. In aid of this, it will first delineate what the government and the people did right in combatting the first wave of the pandemic that led to the brief and relative respite at the end of 2020. Eventually, it will analyse the various ways in which the government apparatus mismanaged and mishandled the pandemic over the last few months, burdening India’s by now -crumbling health infrastructure. Third, it will then relocate the onus in the general public to understand where they went wrong and consider their 2020’s experience of already having experienced the horrors of the pandemic. Finally, it will provide a case-study of Maharashtra, to summarily cognise how the nexus of governmental and public apathy embedded in a larger milieu of unsupportive social architecture has made for a state with the highest number of cases.

Combating the First Wave – A RECAP

On 24th March 2020, spurred by the preliminary decisions of various states, Prime Minister Modi imposed a 21-day lockdown that was extended over several months. To global experts, India’s swift and assertive lockdown measures when confirmed cases had crossed 500 were an appropriate response to the gradually worsening pandemic, more so, than many countries in the West. There was an element of national pride as it seemed that India was tackling the issue head-on, as almost all services, except those that were essential, were shut down in what was termed the strictest lockdown by researchers from the Oxford University who were rating these State efforts on a scale of 0-100 using a stringency index. India scored a 100. Given India’s paternalistic leadership structure, there was not much dissent from the frightened public. On the part of the citizenry, this pandemic also witnessed an extraordinary humanitarian response amidst India’s early efforts and high youth population managing to suppress the curve. Though the Indian experience mitigating the first wave cannot be categorised in a unitary manner, the government’s policy of containment zones and hotspot clusters in the major metropolitan areas did seem to genuinely better the situation. Students and non-governmental organisations also undertook a wide of measures to provide relief to the worst-affected population, with collectives like the J.U. Commune in West Bengal distributing food packets, healthcare essentials and sustenance in the rural and urban areas all over the state.

Maladministration

In the director of The Hindu Publishing Group – N. Ram’s opinion, the Modi government has not had, for many months now, any coherent policy in coping with Covid-19. India’s frightening experience with the second wave of Covid-19 pandemic is based on the government’s inability to recognise the fact that the pandemic is not over. Though the lockdown of 2020 was swift and strict, it was also eased too quickly, as the government resisted suggestions from the scientific community that some nationwide measures be reintroduced. The fact that the Kumbh Mela gathering in Haridwar was allowed to occur attracted crowds of 25 million people, ignoring Covid-19 guidelines, has astounded observers. Critics have analysed that the government refused to prohibit the gathering in order not to hurt the religious sentiments of its large Hindu vote-bank. To Laxminarayan, the blame is completely on the “complacency and lack of preparation” by the government, who failed to prepare the country for a second wave that they should have forecasted. This is apparent from the official arrogance typical to the administration, where the government seemed to have convinced themselves of the apparent facts they were disseminating and that the strictest lockdown had cured India of the virus; even as newer, and more dangerous forms of the virus were emerging all over the world.

Maladministration Info 1
Maladministration

The Centre announced that India, with its massive vaccine export, has become the “pharmacy of the world” amidst its much-vaulted ‘vaccine diplomacy’ while the Union Health Minister declared that the country is in the “endgame” of the pandemic. Not only was this optimism premature, but it was also contrary to the opinions of scientists. Though vaccines were approved in December 2020, the first shots were not given until January 2021. The ongoing vaccine shortage besieging India is also an effect of the hypernationalism of the government, that provided political boosting to the indigenously developed Bharat Biotech Ltd.’s Covaxin, even though the trial data of Phase III was unavailable, while simultaneously hindering the implementation of Pfizer Inc. and Johnson & Johnson’s vaccines through scientifically unviable “bridging trials”. Even the Russian-origin Sputnik V vaccine was authorised only in April 2021 and will take over 5 months to make any significant contribution to the market. The government also utilised populist regulatory price controls on the private sector enterprise: Serum Institute of India, by forbidding for months that it produce the vaccine for the private market, even though the company declared that it would continue to provide the government with AstraZeneca Plc. for Rs. 400 each. Due to the lack of governmental support, based on an insular worldview emphasising State control, the Serum Institute was unable to fulfil its contracts with AstraZeneca, and could not procure the cash flow to ramp up its manufacturing to beyond the current 50-70 million shots a month. Instead of investing in an industry that will be able to manufacture vaccines swiftly, the government has also been slow to sign the purchasing contracts with the Serum Institute, as by January 2021, the latter had stockpiled 50 million doses for which the government refused to sign a purchase order and bought only 11 million doses. There has also been an intense political storm over the company’s differential pricing model for private hospitals, even as P. Chidambaram has criticised the Modi government for fostering unhealthy market practises and profiteering by failing to price for the states at the same level that the Centre had originally negotiated with the company. Indeed, though there have been demands to “ramp” up the vaccine production, the government is hesitating on providing emergency funding to the Serum Institute. The vaccine shortage was, therefore, completely avoidable on the part of the government, and the artificially created dwindling of supply is a consequence of an unprepared government paying more heed to nationalism and public perception. This is coupled with the shortages of useful lifesaving drugs like remdesivir and tocilizumab, which inevitably require the government to issue compulsory licences as currently they are only being produced by a few Indian companies on agreements with patent holders. India has a massive population of 1395.57 million people, and if the goal is to vaccinate everyone without exceptions, it becomes difficult to achieve amidst the crumbling health infrastructure and governmental inefficiency.

The fact that there is a serious lack of government transparency, as details of the vaccine have been kept shrouded in mystery, further complicates the matter. Even though the Covishield (Oxford/AstraZeneca) vaccine of the Serum Institute has been approved for emergency use according to immunogenicity and safety data, and Bharat Biotech’s Covaxin got “clinical trial” approval in January 2021, the complete information regarding them has not been shared publicly, making it problematic for citizens to trust the efficacy of the vaccine. Even though more than ten crore doses have been administered of both Covaxin and Covishield, it is barely enough to achieve universal vaccination or even a target of 60-70% if herd immunity is to be reached. Amidst these difficulties, it is the unfortunate reality that the novel coronavirus is a swiftly mutating virus (the newly-detected double-mutated variant termed B.1.617 with two mutations- the E484Q and the L452R), that may lead to serious side effects like blood clots in the brain leading to strokes (as has possibly happened with some rare cases of the AstraZeneca and the Johnson and Johnson vaccines), and, thus if enough information is not provided to the public on the basis of accountability and transparency, it is obvious that the public will be reluctant to take these vaccines. The monitoring and follow-up of side-effects and associated deaths is inappropriately focused on in India, and since foreign-made vaccines are slowly occupying the Indian market, the Indian government has to be answerable to the concerns of scientists and experts instead of dismissing them as sedition. Indeed, according to international observers, the true death tolls may have been falsified in some states to aid harmful policy of fostering boosterism and forcing the normalcy bias. The right policy decisions, therefore, needs to be taken based on scientific evidence, openness and transparency.

India faces a severe oxygen crisis, as critically-hit states like New Delhi are attempting to move large quantities of medical oxygen through the air, rail and road. Medical oxygen supplies are not reaching hospitals in time, and several hospitals are there that do not have sufficient infrastructure to produce oxygen. To analysts, these delays are a result of a stretched distribution network with manufacturers located in the industrial zones of the eastern Indian states of West Bengal and Odisha, in addition to a crisis in the federal system. Delhi especially is facing the brunt of the shortage, as Covid-19 cases are also engulfing its neighbouring states of Chandigarh and Haryana, and it is becoming impossible to meet local demands. Oxygen supplies are having to be transported over 1000 kms, and given the hazardous nature of liquid oxygen, it must be transported in a limited number of specialised tankers, requiring advance notice and cautious movement. These impediments are further worsened by local officials in some regions disrupting the movement of supplies in order to secure them for themselves, and as a result of such corruption based on vested interests, adequate supplies are not reaching on time. The health system is completely overloaded as there are several reports of individuals unable to find hospital beds and other medical supplies. It is essential that all state governments coordinate and collaborate to allow the smooth transit of vaccines, and it seems that government officials are being unable to prioritise the lives of citizens over its compulsion to score political points. The problem is located in bureaucratic inefficiency because it is not that India does not have the capacity to produce the oxygen that is required. In fact, India has a daily production capacity of at least 7100 tonnes, which is enough to meet the current demand of 6822 tonnes daily. Though the Indian government has begun to utilise the Indian railways, the Air Force’s cargo planes and the armed forces to move multiple tankers to and fro from production hubs and refilling points to where it is most needed; it is essential that there be instituted a proper blueprint of planned coordination between states and the Centre to ensure that the supplies reach their destinations without any hindrance.

Reasons behinds Oxygen Crisis Info 2
Reasons behinds Oxygen Crisis

Observers are also aghast at the fact that even as the winter session of the Parliament was cancelled in December 2020 due to Covid-19, campaigns and electioneer continued for several months, reinforcing a multi-state, multi-phase poll schedule plan, to the complete ignorance of Covid-19 guidelines. The ministerial actions of freely campaigning for specific parties, while also truncating Parliament and budget sessions in lieu of the same, oppose the very nature of Indian democracy, and make it clear that these officials rank their allegiance to their party and political office, over their duties to the citizenry. Since December 2020, numerous political rallies were held across states, flouting pandemic, Covid-19 protocols and amassing large crowds. Towards the end of February 2021, the Election Commission announced key elections in five states with a voting population of 186 million people, beginning from 27th March. The election campaigns continued to happen ignoring the Covid-19 protocols regardless of the second wave of the Covid-19. Here, it should be noted; it was not that elections could not be held during the pandemic. For instance, the United States of America, albeit tumultuously, successfully held its nationwide Presidential Elections last year. The difference between it and the case of India was that they vehemently followed the COVID-19 protocols and the government worked to synthesise their objective of securing political power with maintaining the safety of the people. In India, the Election Commission, though had issued an order on 22nd April 2020, prohibiting further public rallies or roadshows, experts opine that it was too little and too late.

The Flaws

While studying the flaws in how the public has dealt with the pandemic, it is important to view that against the larger environment of increasing economic inequalities and destabilizing everyday developments that have affected the poor disproportionately. According to the Centre for Monitoring Indian Economy’s Consumer Pyramids Household Survey, unemployment rates in 2020 rose 23% over the 2019 rates, as women, small indigenous industries, and informal sector workers unduly bore the brunt of the pandemic. The first issue has been the widespread civic irresponsibility that arose out of an erroneous assumption that the worst of the pandemic has passed. This was also prompted by ambiguous messages from the government regarding the same. As lockdown restrictions started easing, individuals returned to crowding marketplaces, public transport, and other public areas. Indeed, there are several reasons why this was inevitable. This is an overpopulated country, and there simply isn’t enough space or civic infrastructure to practise physical distancing in markets and public transport. It is also unfair to condemn individuals for stepping out of the house on these grounds because generally, due to the demands of employment and subsistence, the poor, who were already devastated by the lockdowns, had to go to work regardless of the obvious dangers. Nevertheless, it is undeniable that the amalgamation of misinformation and lack of responsibility led to people abandoning their masks and any Covid-19 protocols sooner than they should have. The psychological trauma of the sudden lockdown had the spill-off of individuals fleeing out of their homes the first opportunity they had. The enduring tradition of religious fatalism has also worsened the situation, as parts of the population simply do not believe in either the threat of the pandemic, or do not believe in its cure being located in science.

Widespread civic irresponsibility Info 3
Widespread civic irresponsibility

Observers have found it surreal that amidst these dangers, weddings and religious gatherings have continued to see large attendance. The Kumbh Mela with surging crowds is one such example. The second, and more socially incapacitating concern has been that of the stigma attached to the virus that has rendered the lives of many frontline workers including domestic help and healthcare professionals difficult. This has manifested through the stigmatization of individuals, groups, or nations that are considered to be the source of the virus, leading to otherization and the loss of social capital amidst an environment of fear and uncertainty. The consequences attached to the disease have been so devastating, where the infected have been treated as untouchables, taunted and publicly humiliated, their residences termed “corona wali gali” (corona street), scapegoating the poor, the migrant workers, and the daily labourers; that individuals have balked at even reporting Covid symptoms or seeking medical help. This, when coupled with the persistent social mingling of people in cramped spaces, had made it impossible to contact trace and prevent the spread of the virus. The brunt of the discrimination and violence has been borne by individuals residing in Northeast India working in the mainland; by doctors, other health care professionals, police officers, and municipal workers; of the Muslim religious minority; of migrant workers toiling in urban centres far from home; and, during burials and cremations of Covid-related deaths. This stigma has not only widened the abyss between the wealthy and the impoverished but also has led to tremendous physiological and physical trauma. Under these circumstances, individuals continued to avoid reporting symptoms, and the disease was able to become an unhindered contagion.

A Case Study

Maharashtra reported its highest seven-day average in Covid-19 cases and fatalities between April 15-21, 2021, recording 67013 new cases on 22nd April, taking its tally over 4 million in terms of the Case Fatality Ratio and the Test Positivity Rate. Though the state is currently under strict Covid-19 restrictions, it is crucial to understand how the situation deteriorated to such an extent. Though not unanimous, the general conception is that the public had stopped following any Covid-19 guidelines, and had stopped wearing masks, or practising physical distancing; with crowds at events and restaurants (not local trains) being the main cause of the upsurge in cases. Bombay also has an extremely urbanised demographic profile, and it seems that the virus is affecting the middle-class and the upper-middle class more than the slum-dwelling poor. Given its large population, Maharashtra has been unable to develop either efficient surveillance and monitoring mechanisms to ensure adherence to rules or adequate public health infrastructure to serve the public. The political rallies and gatherings led by the ruling party of the state, and the crowding experienced during the gram panchayat elections in January 2021 also seem to have worsened the spread of the virus.

References

  1. (2021, April 2021). Of Vaccine Shortages and Transparency. Economic and Political Weekly.
  2. Farrer, M. (2021, April 21). Why is India seeing such a huge surge in Covid-19 cases? The Guardian.
  3. Schmall, E. (2020, November 27). India’s Economy Shrinks Sharply as Covid-19 Slams Small Businesses. New York Times.
  4. Sinha, A. (2021, March 16). Explained: The new Covid-19 high in Maharashtra. The Indian Express.
  5. https://m.timesofindia.com/india/all-time-high-india-records-4-14-lakh-new-covid-cases-in-a-day/amp_articleshow/82449520.cms

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