Covid 19 – Going for broke

by March 23, 2020 0 comments

In a country with our population density to claim that hundred per cent source identification or tracking is even feasible is akin to believing in Santa Claus

We are going through a time of uncertainty, fear and gloom, though stories of human resolve, courage and sheer determination do give us hope for the future. We live in unprecedented times of which we have no previous experience, little knowledge and even lesser understanding. There are none here who have survived either the Spanish flu pandemic of 1918 that killed 33 million people (including approximately six million from the sub-continent) or the Bengal famine of 1942 that killed 10 million. What is, however, absolutely clear is that we are in a global war against an unforgiving and unseen enemy who respects no borders, ethnicity, class, age, religion or caste.

If we are to beat this enemy, not just physically but psychologically, socially and economically as well, we have no choice but to work together as a global community and act with compassion, forbearance and courage not just in our own self-interest but for the community at large. It finally boils down to this, if we are to call ourselves civilised. Most importantly, the time for political posturing or playing games is way past. In war, as is often said, there is no place for the runners-up.

If the information available in the public domain is to be believed, the Government has done a sterling job in limiting infections and fatalities for now, through its rapid response. Unfortunately, the figures being bandied about are coming in for increasing scrutiny for a variety of reasons. The question of what is the policy governing testing and how many tests are being done is at the crux of the controversy.

As per information available in the public domain, the existing capacity to test for the virus is 500 per day, which is being ramped up in the coming days. Thus, at present only those coming from affected countries are being screened and if their condition seems doubtful, are being tested. Those cleared in screening are expected to undergo either supervised or self- quarantine before being allowed to mingle. Tests are also being done on those who may have fallen sick after coming in contact with someone returning from abroad. In addition, the Government has also done 800 tests as on date on random patients across the country who, are at present admitted in hospitals with acute respiratory disorders.

On the basis of these tests having turned up negative the Government insists that there have been no cases of community spread. Therein lies the rub, as many known positive cases, leave aside those who are asymptomatic, have deliberately escaped from quarantine, no doubt infecting those they may have subsequently come in contact with, who in turn will infect others, which is what community spread is all about. In a country with our population density to claim that hundred per cent source identification or tracking is even feasible is akin to believing in Santa Claus. Of course, there is the possibility that the Government is aware of the true picture and hiding it from the public to avoid any onset of panic.

If that be the motivation, the Government is making a huge error as most of us are well aware as to what is happening in different parts of the world. As a matter of fact, conservative studies on the subject suggest that actual cases are about ten times the numbers that have been identified and given that the cases are doubling every three days, the number of people infected will be 1,024 times the present number within a month as simple mathematics suggests. This in our context, with total identified cases as 169 as on March 19 that has increased by one-third along expected lines on the March 20 will, in all likelihood, range between 1.7 lakh and 17 lakh by April 19, depending on which figures we wish to believe, if we do not take further steps that are needed to halt the spread. From within these numbers, as seen elsewhere, 15 per cent will require Intensive Care Unit facilities and two-three per cent will not survive.

The problem with hierarchies and the bureaucracies that run them is that they abhor vacuums, as that condition requires them to assert themselves, avoid accountability for obvious reasons and can only think and act linearly given their long-standing ethos and organisational architecture. An emergency of this kind requires lateral thinking, taking of risks and forceful interventions, all of which fall in the realm of the political leadership that now needs to step forward, provide clear directions, impart the momentum required and most importantly, accept accountability. While Prime Minister Narendra Modi has certainly shown his interest in assuming a leadership role his known dependence on the bureaucracy is a distinct disadvantage at this time.

Thus we have adopted the bureaucratic playbook to tackle the issue. As a result our response has been bureaucratic, admittedly much quicker but still along plodding linear lines with each agency and department attempting to show how efficiently they are handling challenges that they face. Forget the “All of country” model that is absolutely necessary, we have not even been able to put an “All of Government” approach in place. This is best brought out by the Prime Minister’s address to the nation on March 19. It was a motivational talk with no substantive future course of action being announced, except for a voluntary one day national “Janta (public) curfew”, which probably will be a harbinger of tougher measures in the future. In all truth, the time for motivational talks is long past, what we now need is a general who will lead us into battle. Moreover, such an approach is unviable, because by the time we take the next step another week would have passed and numbers of those infected quadrupled, adding to avoidable stress on our healthcare system and to fatalities.

It is essential that our political leaders and the average citizen comprehend the nature of the beast that we are at war with and face facts that have either emerged from experiences elsewhere or are peculiar to our situation. First, there is no getting away from the fact that we have a population of 1.3 billion and the cost of testing and providing the necessary support facilities are humungous. Obviously, no Government, whatever its efficiency, can ever provide cover for all our citizens. Second, social distancing, which include forcible quarantine, despite its flaws, appears to have emerged as the only viable alternative for keeping the Coronavirus under check and in reducing the rate of infection, till a suitable remedy is found.

The world around us has completely changed and yet we seem to be living in a time warp, hoping to avoid having to face the dragon that has felled much of the world. Let us face reality and accept that in these circumstances there is no time for half measures. Imposition of Section 144 of the CrPC, as has been done in some places, or hoping to enhance testing facilities in the coming days, which in any case is unavoidable, are measures that are simply not enough and are just too little and too late. In military terms, we need to launch an immediate blitzkrieg and in fact, have little choice but to immediately adopt measures that the Chinese and Italians did only as a last resort.

It is essential that a nationwide curfew for a minimum of 14 days be declared soonest along with other measures such as reducing the frequency of mass transit systems, banning taxis and only permitting minimum essential personnel to move out of their homes.These measures must be strictly implemented by deploying the military, assisted by the Central Armed Police Forces (CAPF), on the streets. While these are harsh and desperate measures with dire economic implications, we have no option, as we will otherwise find ourselves overwhelmed with the possibility of serious social disruptions.

Undoubtedly, the biggest problem will be faced by those whose very livelihood is dependent on their daily earnings. As in any major natural disaster this would require the Government to provide the requisite relief to all those impacted at their place of residence. This in effect requires that the armed forces be fully mobilised and deployed and tasked for conducting internal security and humanitarian and relief operations.

Time is of the essence here and discussions and committees have little meaning now and in fact these measures needed to have been implemented yesterday. 

To enable the military to mobilise and deploy would require a minimum of three-four days, in which time we must remember, the numbers of those infected would have doubled. Implementation of such measures with a warning period will also allow citizens to stock up on essentials. For those who believe that such drastic action is uncalled for, would do well to study the impact of a graduated response in countries like Italy, Spain, the United States and France. By going for broke, if nothing else, we would certainly avoid much of the stress that the healthcare infrastructure of those countries were put through, infrastructure that we are woefully short of and have little ability to scale up.

(Writer: Deepak Sinha; Courtesy: The Pioneer)

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