Inadequate infra, public negligence caused India’s COVID outburst

India surpassed Brazil to become the country with the second highest number cases of COVID-19 infection. While the numbers had comparatively remained under control during the lockdown period, their increment have known no bounds since the country’s ‘Unlockdown’ began. Urban Update organised a Webinar on the topic “Is India becoming the COVID capital of the world?” to discuss the reasons for such a drastic increase in COVID cases. Shailaja Chandra, former Secretary, Ministry of Health and Family Welfare (MoHFW), Government of India; Dr Subroto Kundu, former Chief Medical Officer (CMO), Central Health Service; Dr Sylvia Karpagam, Public Health Policy Expert; Dr Antony Kollannur, Health and Nutrition Specialist, UNICEF; and Dr Mathew Varghese, Orthopedic Surgeon, St Stephen’s Hospital, Delhi were part of the Webinar’s panel. It was moderated by Kumar Dhananjay, Consulting Editor, Urban Update.
Dhananjay began by stating COVID-19 related data and said that in India, the fatality count has breached the 75,000 mark while the total COVID positive cases have exceeded the a total of nine lakhs. “Is the sudden surge in cases a result of aggressive testing or because people are tired of the social restrictions and are opting to not follow them?” asked Dhananjay.
Shailaja Chandra began by stating that while discussing COVID-19 data, the size of the Indian population must be kept in mind. She said, “We must analyse COVID’s fatality in India by measuring the deaths per million and not by just looking at the deaths in total.” She stressed that taking steps to control the pandemic is not the the responsibility of the central government solely. According to the Indian Constitution, public health is a state subject. Thus, the state government is equally responsible for arresting the spread of coronavirus. She added that the current situation may gradually improve if safety precautions continue to be imposed strictly.
Dr Varghese started by explaining the importance of wearing masks and maintaining social distancing at all times. “A major share of the problem would be addressed if people simply followed basic COVID appropriate behaviours,” said Dr Varghese. He then went on to talk about how hospitals have solely focused on addressing COVID positive patients while ignoring the needs of non-COVID patients. He added, “The government should have worked on strengthening the health infrastructure in the country. Not doing that has also led to the death of a number of healthcare workers.”
Dr Antony talked about Kerala’s success in controlling the spread of the pandemic with the help of various committees on disaster and epidemic relief and active tracing of patients. Other states failed to learn the knack and hence suffered badly. He said, “Banning international trave in time by the central government would have worked better instead of imposing a sudden nationwide lockdown.” He went on to talk about the issue of the pandemic-induced labour migration and said that the government was unable to handle the issue efficiently. This was also a reason for a spike in India’s COVID tally despite the lockdown.
Dr Sylvia addressed Government of India’s failure in managing the pandemic. She said that due to the absence of proper public transport, rural areas were incapable of staying safe from the pandemic. Moreover, government record of COVID fatalities is also unreliable as they show discrepancies and loopholes in the data collection process. Communalisation of the issue and stigma against the Muslims added to the difficulties in managing the situation. Dr Sylvia added that the government was unable to address the issues of daily wage workers, who were forced to choose between starving or being exposed to COVID-19 while going back home. She said, “Community is not solely responsible for this uncontrolled spread of COVID-19 in India. The government had an equal, if not bigger, role to play.”
Dr Kundu commented on Delhi’s situation and said that the state government’s preparedness is better than most other states. This is in part due to the adequate budget allotment of the public health sector in Delhi. Due to the stranded migrant labourers across Delhi, the pandemic could have worsened. The public health infrastructure was however, equipped appropriately to manage the excess inflow of COVID patients. The only drawback was that since the government directed a majority of the hospitals to treat COVID patients, care of patients with other ailments was neglected.
Dr Varghese answered a question regarding the role of the World Health Organisation in tackling the pandemic. He said, “Their role is to guide the countries. The on-ground work still lies with the concerned medical, municipal and administrative authorities.” He emphasised that authorities need to understand the learning and loopholes in the public health system and work on that in order to be prepared in case another pandemic strikes. Lastly, Dr Sylvia answered a question regarding her study on the COVID-19 situation. She said that asymptomatic cases were majorly responsible for spreading the pandemic in India. Delay in implementing a model of aggressive testing and discrepancy in contact tracing were the major reasons. Moreover, lack of adequate infrastructure to handle the vast inflow of COVID patients led to neglect of patients with severe symptoms.