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Breathless in India: The price of inaction

India finds itself caught in the wake of exceptionalism and premature triumphalism.

Published: 25th April 2021 07:30 AM  |   Last Updated: 25th April 2021 08:48 AM   |  A+A-

A health worker moves oxygen cylinders at a hospital in New Delhi on Friday.

A health worker moves oxygen cylinders at a hospital in New Delhi on Friday. (Photo | Parveen Negi, EPS)

On May 20, 2020 the Ministry of Health issued a press statement. It said, “15 countries with highest number of Covid-19 cases, with almost same (sic: cumulative) population as India, have reported 34 times cases and 83 times deaths.” Less than 60 days later India touched a million Covid-19 cases.

On February 21, 2021 the BJP National Executive applauded the government’s management of the pandemic. It said, “Not only did India keep running a successful fight against Covid, but it set an example in front of the world for what work can be done during Covid.”  On Friday, two months later, India recorded its highest ever tally of 3, 46,786 cases and 2624 deaths — that is, 240 cases a minute and over 100 deaths an hour. 

India finds itself caught in the wake of exceptionalism and premature triumphalism. Arguably the political applause was prompted by the dip in caseload and the rise of recoveries. Equally it is clear that experts, those tasked with public safety, were blinded by hubris and chose to read from the popular hymn sheet. The fact is countries like the UK, Germany, the US and those who opened economic engagement saw a second and even a third wave. India too had opened up its economy, a new variant B 1617 was out. Ergo the wave was inevitable. Indeed the graph shows India’s case load had begun rising from February 9.

The parade of pathos is unrelenting. India is paying the price of inaction. The images beamed across living rooms reflect the stark reality of thousands left breathless. Courts are taking suo motu cognisance of state failures. Social media has become the Covid helpline as individuals and institutions plead for help. Twitter is clogged –a Jaipur hospital with 200 patients declared “Oxygen supply to last only an hour now”, another declared discharge of patients while others petitioned for police protection.

There has been a blitzkrieg of criticism of the Centre’s handling of the crisis. This column in previous weeks has commented on the ‘Politics of Not Leading by Example’ and the ‘Epidemic of Wilful Blindness’. There has been course correction — for instance on efforts to bring drug and oxygen supplies on board. However, there is no disputing the systemic sloth afflicting governance. The March 2021 report of the Parliamentary Standing Committee examines a litany of issues. One factoid is illustrative. The Department of Health Research deals with epidemics and outbreaks. Of the 42 sanctioned posts 24 are vacant.

Success in public policy calls for planning and execution. On Saturday, nearly eight weeks into the second wave, the government called on start-ups for details on oxygen concentrators and sought details from government hospitals in urban metros to set up extension hospitals. Must good ideas for scaling capacity wait for the eleventh hour of a crisis? Indeed, many of the issues popping up are inexplicable — for instance the import duty amidst a pandemic for the much sought after Remedisivir and its raw inputs (which was waived off this week) or the 12 per cent GST imposed on medical-grade oxygen.

The Union government has much to explain but that cannot be an alibi for ineffectual record of state governments. The aggravating factor in the magnitude of the surge of the second wave has much to do with the failure of state governments in getting their act together. Almost every state witnessing the haplessness of people screaming for oxygen experienced the oxygen scarcity last year too and should have had a plan B for the ‘if and when’ contingency. Delhi, Maharashtra, Uttar Pradesh and Madhya Pradesh which went through oxygen shortages in the previous wave were just as unprepared this time. In fact the Centre’s initiative to expand oxygen capacity with grants is pending in most states.

It has been argued by some that the second wave was catalysed by ‘poor management’ of infection and transmission by Maharashtra. Be that as it may, did other states leap to action? Given the transmission risks, other states should have tightened protocols for residents and visitors as early as in February.  The irony is that those visiting Maharashtra were required to present RT-PCR clearance but those travelling from Maharashtra to other states were not obliged to do so. 

It was always going to be a challenge for India to combat the pandemic — notwithstanding its younger demographics. My book, The Gated Republic, chronicles the history of seven decades of failed promises and continuing apathy. Many of the issues afflicting public health highlighted by India’s first health survey, catalysed by none other than Florence Nightingale, are yet to be addressed. India’s beds per 1,000 ratio places it in the company of Benin and Uganda. The country has barely 12.89 lakh allopathic doctors for a population of 139 crore – Uttar Pradesh, expected to touch over one lakh daily cases by the end of April, has 89,286 doctors for 22 crore people. 

India’s quest for immunity is at the intersection of rising infections and accelerated vaccination. The economy scarred badly last year yet again faces downside risks and rating agencies are indicating a downgrade of GDP forecast. A $ 2.8 trillion economy can scarcely afford the crisis it faces and quibble about funding vaccinations. There will always be a cost to doing things and indisputably a price to pay for inaction.

Shankkar aiyar
Author of The Gated Republic, Aadhaar: A Biometric History of India’s 12 Digit Revolution, and Accidental India
shankkar.aiyar@gmail.com



Comments(3)

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  • Raahul T

    If this is such a dramatic increase
    1 year ago reply
  • Pratyush

    This Aiyar is forgetting that Health is a State Subject. Yes Central Govt has taken lead in providing the vaccine and other infra but it does not dissolves the state responsibilities. One has the question states also as they are simply putting all the states work also to center and they themselves only playing politics... If Modi is doing good does not mean u push all work to him only...
    1 year ago reply
  • dr chiranjeevi

    wonderful article.central and state governments have never given adequate importance for public health and strengthening medical care.this apathy continued for the last six decades.
    1 year ago reply
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