Covid 2 & governance deficit-2: Wallowing in fault finding: Whither accountability?

By Prof Ujjwal K Chowdhury*
While the second surge of Covid is ravaging India, it is important to dwell upon the reasons of its lethality, for posterity and delineate good governance in public health, hopefully in future. Carrying forward from the first part on this theme, we look into the other issues compounding the crisis.
For six weeks now, the entire nation has been reporting lack of oxygen, essential drugs like Remdisivir and ICU beds, with acute situations in Delhi, several cities of UP, Ahmedabad, Pune, Mumbai and Indore. Several media have graphically shown that failure to act, refusing to act, or acting far too late are behind these crises across the nation. The citizens’ voluntary Covid helplines are proving to be more active in this hour of crisis in reaching out to the masses in distress, while even politicians in Maharashtra and Gujarat have been seen hoarding essential drugs and oxygen to sell to the chosen few and at any costs available, which is illegal.
Many in this second Covid surge are dying more due to the lack of oxygen than due to the virus per se. So far, only in Delhi hospitals, more than a hundred have died due to lack of oxygen, including two doctors. Many more outside the hospitals. The Delhi High Court virtually threatened coercive action on central officers to ensure 700 tonnes of oxygen supply to Delhi gasping for breath. Worse situation in many other cities.
In October 2020, quite late in the day, Modi government announced 162 oxygen producing units in 150 district hospitals across India, with around Rs 200 crore from the PM CARES fund. But six months later, today, only 33 have been installed. These were to be procured by a central medical supplies process which acted too late too little, whereas in many cases the hospitals and the governments of the states where they are located have been sitting ready with allocation of space and resources.
Till date, Essential Commodities Act has not been invoked against hoarding or black marketing of essential drugs or oxygen etc. by the states or the central government and predatory business is on the rise, including charging abnormally by ambulance services for even short distance travel with patients or corpses. These are quick low hanging steps that could have been taken early in the crisis. Only the Chief Ministers of Delhi and Andhra have fixed rates of even private services.

Poor genomic research

The scale of the current crisis may have been driven by more-transmissible variants, though data are limited because of a lack of widespread genomic sequencing. The virus moves quickly through the multigenerational households that account for 4 in 10 Indian homes. Chronic underfunding of the health system over decades has also left hospitals ill-equipped to deal with the surge.
B.1.167, the Indian origin double mutant strain of Covid-19, is believed to be behind the current Covid surge. It was detected on October 5, 2020. No immediate genome sequencing was resorted to by the government and its funded bodies to understand the strain better and modify Indian vaccines to counter this deadly strain. But, as late as in January 2021, a Covid Genomic Consortium, INSACOG, network of 10 labs, was set up to speed up genome sequencing with a budget of Rs.115 crores, which was not allocated by the central government and the biotech department of the government had to find money on its own to which it could manage some 80 crores as late as March-April, 2021. Precious time was lost due to a policy paralysis and lack of political will at the highest level.
India has a history of successful, large-scale immunization programs for diseases like polio and tetanus, first-rate scientists, highly trained doctors and powerful networks of community health workers. What has been lacking, experts say, is the political will to get ahead of the crisis—and to use data and science to its advantage.
A team of the Council for Scientific and Industrial Research – Centre for Cellular and Molecular Biology scientists published a paper on their findings – “SARS-CoV-2 genomics: An Indian perspective on sequencing viral variants”. The Hyderabad-based Institute has been studying the evolution of the virus, its mutations and strains ever since the pandemic hit the country. The paper stated, “India has so far not been sequencing SARSCoV-2 isolates to full capacity, having deposited only about 6,400 genomes of the over 10.4 million recorded cases (0.06 percent).”

Large religious congregations

Rather than intensifying public-health messaging and ramping up interventions like banning mass gatherings and encouraging mask wearing, PM Modi and his government did the opposite. They and other regional parties held mass rallies ahead of elections in Bengal, Tamil Nadu, Kerala and Assam, and promoted the Kumbh Mela, a Hindu pilgrimage that drew millions of worshippers to a single town, which had anything between 40 to 50 lacs of visitors, and has emerged to be one of the biggest super-spreaders in the world. 

Why Essential Commodities Act has not been invoked against hoarding or black marketing of essential drugs or oxygen?

Two chief Mahants of the leading Akharas have died due to Covid, and hundreds of sadhus at Kumbha are infected, many dying with every passing day. Even the former King and Queen of Nepal, who were at Kumbh Mela, returned Covid infected. Earlier in March, the widespread Holi celebrations by the Indians was also misplaced and allowed unhindered by the governments.
On April 17, after India had overtaken Brazil to become the second worst-hit country in the world, Modi gloated in a rally in West Bengal that he was “elated” to see such a large crowd (most of whom in close proximity and without masks). Only five days later, he was forced to suspend all physical rallies due to the surge, Madras High Court admonition of the Election Commission, and widespread media criticisms.

Misplaced priorities in big ticket spending

Some of the big ticket spending by the central government include the following, and their timing during the pandemic has been rightly questioned.
Two B777 VVIP planes with state-of-the-art missile defence systems called Large Aircraft Infrared Counter-measures (LAIRCM) and Self Protection Suites (SPS) costing Rs.8400 crores were finalized by the central government during this pandemic for the protected use of President, Prime Minister and Vice President. One of them has been delivered on October 1, 2020.
Then there is the Central Vista Redevelopment Project. It refers to the ongoing redevelopment to revamp the Central Vista. Scheduled between 2020 and 2024, the project first aims to revamp a three kilometre Rajpath between Rashtrapati Bhavan and India Gate, convert North and South Blocks to publicly accessible museums by creating a new common Central Secretariat to house all ministries, a new Parliament building near the present one with increased seating capacity for future expansion, new residence and office for the Vice President and the Prime Minister, and convert some of the older structures into museums. The project began with ceremonial laying of the foundation stone of the new Parliament building in December 2020. The government stated that the entire project costs ₹20,000 crore, and the parliament building alone costs ₹971 crore.
Ironically, the total cost of vaccinating 101 crores of adult population of India with the current Covishield cost to the central government being at Rs.150 per jab, it is less than Rs.16,000 crores! Opposition parties and former civil servants have questioned the need to spend money on the project during a pandemic, even if independent India is turning 75 years in 2022.

Information war & Infodemic

Many say the government has lost sight of its priorities. As cases soared to record highs in April, the government ordered Twitter and Facebook to remove posts critical of the authorities. Independent journalists have scrambled to identify the massive discrepancies between official figures and actual deaths. The UP government ordered attaching properties of those “who spread rumour” in social media on the crisis, and the police arrested a young boy desperately pleading all in social media to get oxygen for his out-of-breath grandfather who finally passed away. On the other hand, a series of false narratives have been built in the last two months by the IT Cell of the ruling party to save the face of the government. The Chief Minister of UP had openly and falsely claimed that there was no crisis of beds, drugs and oxygen even when thousands were suffering, and his government was being pulled up by the Allahabad High Court.
To the relief of the aggrieved citizens and journalists at work, a Special Bench of Justices DY Chandrachud, L Nageswara Rao and S Ravindra Bhat of the Supreme Court recently said on record that any move by any State to punish citizens who take to the social media to seek help for oxygen cylinders, Covid-19 drugs, beds, hospitalisation, etc., amid a rampaging second wave would attract contempt of court action.
Rightly observes the Lancet, “India squandered its early successes in controlling Covid-19. India must now restructure its response while the crisis rages. The success of that effort will depend on the government owning up to its mistakes, providing responsible leadership and transparency, and implementing a public health response that has science at its heart.”
What we now need is not managing perceptions, but managing the actual crisis by coordinating all possible government and non-governmental resources, domestic and foreign support, and correcting the past mistakes noted above, apart from severe restrictions in affected areas for two weeks, while the capacities at every level are enhanced. Rather than wallowing in fault finding, which for accountability is important, we need to move forward with managing oxygen, drugs and beds on one side, and massive national universal free vaccination on the other.

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*Educationist, columnist, television panelist, working currently as Pro Vice Chancellor of a Kolkata- based university. Click here for first part