If you have only a hammer as the solution, everything before you will appear to be a nail.
Corona Epidemic threat in India has exposed the deep fault lines of “governance” in India, exemplified by the current RSS-BJP govt. led by Modi-Shah duo. This epidemic threatens lives of millions and to begin with, the precautionary steps urgently needed to involve these millions of helpless, deprived Indian in its management and control.
Some facts to start with
A. The first exposure with Corona came to light in China’s Wuhan province on 7th January 2020 (some say Dec, 2019). By 12th its scare was already in discussion and China did well to share with the world to genome in order to help all countries prepare for it testing and management.
B. Corona spread to almost all of Europe and USA, also Japan, Iran and South Korea, but to a few countries below the Tropic of Capricorn. It is possible that the strain of the virus that reached India, Africa and Latin America was less virulent. Virus attacks are known to become less virulent over time, as they multiply and possible impact of temperature is also there. Close trade contact between Wuhan and EU and US were the main reasons for early spread there. Certainly this late and low spread in India, Africa, Latin America was not due to better screening, better care of contacts, better health of the people, etc.
C. China contained impact of Corona by sealing Wuhan town first and the province Hubei later and by mobilizing the resources of the country to make provisions. Closed factories were made to shift production and stitch masks, make sanitizers, respirators and other medical equipments on a large scale which was distributed far and wide. South Korea went on early wide based screening and testing, containing the infected and their contacts and with mass distribution, hygiene, etc. Social distance was widely promoted and practiced.
D. For most of the first two months, till March 5, Modi govt. remained in denial, its ministers even making fun of the seriousness of the problem. It failed to ban tourists who were the only vehicles of transmission of this virus. It failed to screen and test all the people coming from abroad, failed to set up such facilities and to quarantine persons arriving from abroad in all of its several international airports. It will be fair to believe the govt. knew well in advance the seriousness of this killer virus that is spreads only through international travel, majority of those doing so are upper class and high officials, who often frown on attempts at being disciplined. They may actually have been the reason for this casual attitude. WHO had warned of the seriousness in December itself.
E. In India the govts’ active steps have only surfaced after tourists and VIPs were caught with the disease and they tested positive. Then the Govt. immediately resorted to mass lockdown, curfew, creating mass hysteria through propaganda of the devastating nature of this infection and blaming the common people for not following the strict instructions. The PM said since you are not following Janata curfew, so we will impose it. The police has been most vigorous in implementing measures to fight this ‘health’ scare, not the doctors, health and food department officials.
F. Observe carefully the more the member of VIPs that are caught violating precautionary measures, the stricter are the restrictions on common people, even when they are not to blame for the spread that has so far taken place. The Parliament was to be seen as working, it has worked till 24 March, VIP gatherings are on, big hotels continue to function, partying continued, President’s breakfasts were on, Madhya Pradesh swearing in continued, as did the Ram Lala Puja till 25th, in which the CM is taking part – all without masks or physical distancing. But for the common people there is complete lockdown, factories, shops, hospitals (almost complete), transport, trains, even coming out of the house with the police using batons, confiscating vehicles, lodging FIRs to drive people home.
People in several villages are petrified due to lack of work, earning and no shops or facilities being open. The worst condition is in large metros where millions of migrant workers are trying to get out and return home to far off villages in order to beat the unemployment, unhygienic crowded living conditions, fear of an epidemic spreading and sickness/ death looming over their heads in foreign land. There hutments are the most unsafe places for spread of Corona, though they may be as unconscious of this as they are of the dangers of Corona infection. But yes, these are the biggest potential sources of the Corona infection getting into stage of Community spread and becoming endemic (high disease rate in a geographically bound area). And then there are jails, for which the SC fortunately has given some orders to decongest. Airlines incidentally were the last to be locked down and private cars are still not in lock down.
G. On paper emergency supplies of food, health are on and some paltry payments of Rs 1000 per worker has been promised for the entire month. The govt is to send supplies to homes, but there is no structure in place for that. With such a clampdown all backend supplies are bound to choke and the panic is bound to intensify. As per reports ‘percentage of customers unable to buy essential goods via e-commerce services between March 20 and 22 were 35% and it shot up to 79% on March 23-24. And percentage of customers unable to buy essential goods via retail stores was 17% on March 20-22 and 32% on Mach 23-24”. (ET, 25.03.2020). Delhi Noida Border has already seen a road jam due to cars being stopped. We are living in an unprecedented situation and if the deprivation lasts, there may be very genuine outbursts from deprived people, whose need for food and treatment will have become more important than safeguarding from Corona than the fear of ‘hammer’ of Modi’s police.
H. It is important to note the specific aspects and scientific advisory to prevent its spread. It spreads by droplet infection, not as an airborne disease. That means it is important that droplets released by a patient or carrier can infect another victim. These droplets travel up to maximum of 1 meter when a person sneezes and the virus remains alive in the air for up to 2 to 3 hours. Open air is the best place to be in to fight the droplets, as they dissipate fast and virus concentration is the least in open spaces. These droplets may travel through the hand, mobile phones and other surfaces where the virus remains alive for longer periods of 1 to 2 days. One important factor to be highlighted is that people need not be scared that even one virus entering their body will cause the disease as disease is caused only when there is a sufficient dose of the infective agent which the body’s natural defense cannot fight back. This virus readily spreads in immune compromised patients and is more fatal in patients of heart disease, diabetes, hypertension and asthma and in old people. Lastly in fighting all viral infections, role of nutrition well being is of upper most importance in building peoples’ natural defense.
Prevention needs to include a) Social distancing up to 1 metre between common people and up to 2 metres from patients, b) use of masks by all persons, c) washing hands by all persons when they enter their homes and before they eat, with scrubbing for at least 20 seconds, d) isolation of all patients prone to be attacked and all old people, e) decongesting single room dwellings, f) nutritional care of the entire population and g) proper medical backup.
Since long duration measures, may be needed for months, all precautionary steps should have been planned to ensure that the entire society is able to accept and implement it, not just the haves. It must be kept in mind that most people live in congested colonies and very small houses. These steps are:
1. There should have been a complete ban in foreign tourists with all non tourist arrivals being tested and quarantined at least since February, since the virus began spreading to Europe.
2. Decongest the slums and jails. Release all prisoners accused of minor crimes. Allow people to travel back to villages in trains sparsely filled. Ensure enough trains run and people don’t panic. Shift excess persons from congested slums to vacant and under construction buildings temporarily. Instruct all old and sick persons to be in houses. Rally the youth for the various tasks necessary for taking care of society.
3. Ensure high nutrition diet to all poor by providing them with extra protein diet foods like eggs, meats, pulses or with extra funds to buy these. Put in place supply chains. This will also build their confidence in cooperating.
4. Take emergency measures for production of masks, soaps, sanitizers in each block/ village by organizing the village committees. Send teams of village youth to each houses to distribute these, two masks for each person, soaps and sanitizers to each house and to educate and demonstrate to each household the value of this and of keeping distances. Develop production and supply claims for above items on war footing.
5. If a community spread breaks out these measures will be required for months and several hospitals/ medical care will be required. So if the govt is serious it should convert empty schools into make shift hospitals, by establishing such set ups in villages and bastis, equipping and training personal for this.
What should not have been done:
1. Shut down as has been done is bad. It reflects the response of a nervous govt, unsure of what to do now after it has failed to act in time. It is already spreading panic due to fear of the ‘unknown’. Population already burdened with poor facilities and resources, now deprived of even their jobs and means to reach home are in greater panic. Even officials, including the police, apart from pushing people back in to their homes, are nervously rubbing alcohol on their hands and praying repeatedly. With the approach spelt out above, officials and common people could have been and should have been inspired and rallied together to fight the menace.
2. The govt. has given direction to its political planning by asking people to come together on March 22 at 5 pm to beat thalis and blow conch shells as a social drive, basically to drive people towards exorcist measures of ‘driving away the virus’ ghost. Baba Ramdev is advocating Surya Namaskar twice a day. Some RSS persons are advocating Gau Mutra and others vegetarianism. All these are being promoted to divert peoples’ attention away from the real cause, i.e. failure of the govt to ensure steps that will take care of the prevention steps as well as the great impending requirement of food and care, which the govt. has no plan to implement. The more the crisis aggravates, the more it is likely to intensify this obscurantist drive as well as ‘nail’ the peoples’ protests with the police ‘hammer’.
Dr. Ashish Mital
