INDIA – A CASE STUDY ON DISASTER MANAGEMENT

Chander M. Lall

11 June, 2020

Arvind Kejriwal, the Chief Minister (CM) of Delhi estimates that Delhi could have in excess of 5,32,000 coronavirus positive cases by end of July. Already, each one of us is hearing of cases closer to home, in every sense of that word.  When one looks at how a country of 1.3 billion and a city of over 11 million is being administered in these times of crises, one can only read the word disaster in the disaster management. This, I say in the backdrop of the Lt. Governor of Delhi Anil Baijal (LG), just two days ago having overruled the Chief Minister’s recent decision to reserve Covid-19 only for residents of Delhi. One would have thought that they both would have discussed such crucial decisions before making them public, but clearly, the Centre and State governments not seeing eye to eye is not idyllic in such situations. Sadly, this incident is not an aberration.

My anxiety about the mismanagement of the crises peaked when I read that the Delhi Government had, at the beginning of this month, initiated action against 8 testing laboratories.  Their offence was that they had conducted tests on asymptomatic patients. One of the 8 included the prominent government lab of the National Centre for Disease Control (NCDC). These tests, the Delhi government asserted, resulted in patients testing positive taking up hospital beds in private hospitals instead of going home for home isolation.  This, according to the government, led to a shortage of beds for those who actually need them. This action was initiated by the Delhi government on 3 June. My anxiety turned to intrigue as only a day before, the CM had announced the launch of an online app through which Delhi residents could easily determine the availability of beds in hospitals.  According to the statement of the CM, out of the 6,731 beds available in hospitals in the city, 4,100 are lying vacant.  One can only hazard a guess why a government would be spending valuable resources in initiating actions against laboratories conducting tests, when it is commonly known that the best way to control the virus, in the words of the Director General of WHO, is “test, test test..Test every suspected case”.

Some reports also suggested that such a direction was necessitated owing to a shortage of testing kits. When I researched more, I read a report where C.K.Mishra, the environment secretary of the government of India gave a press statement that whilst in the first fortnight of April, the country was struggling with little supplies of testing kits, “but today, that has changed in two ways – the supply has improved and we have also proactively taken measures to reduce the dependence on imports for our testing.”  According to him, now India is procuring 75% of its testing kits from domestic manufacturers. Self-sufficiency in testing kits forms an important part of the strategy of the central government, said Mr. Mishra.  One can only wonder why the Delhi government is facing this so-called shortage of testing kit. Having said, I even wonder why the environment secretary would be making such statements and not the health secretary, but then I am no expert on administration.  

Another interest aspect of testing was that the Indian Council of Medical Research (ICMR) had in May capped the price of testing to Rs. 4,500 to be charged by private laboratories. One would have thought that this cap was the upper limit so as to ensure that private labs did not overcharge while testing.  As it turns out, in a press statement of 25 May the ICMR has declared that the prices of testing kits in the country have dropped, and for that reason they are removing the capped rate of Rs. 4,500 and have permitted states to “fix up mutually agreeable prices”.  This could only mean that the earlier cap was to encourage labs to charge higher prices, which could now be lowered. I would not hazard a guess on why the ICMR would do what it did. Testing, testing, testing could clearly not be part of this agenda, and perhaps for this and other reasons testing in India is at abysmally low levels compared to other nations.  It is approximately 1700 tests per million of population as compared to over 36,000 per million in the U.S.A. and over 50,000 per million in Italy. One need not speculate why the government would want lesser tests conducted.  

I am a lawyer by profession and it repeatedly tugged on my conscience that I was just being an armchair critic.  When I learnt that the Delhi High Court was seized of public interest litigation dealing with the App and the aspect of availability of hospital beds in Delhi, I requested my colleague Nancy Roy to intervene in the matter and I appeared as counsel for her. Vide an order dated 8 June a Bench of the Chief Justice and Prateek Jalan has directed the Central Government as well as the Government of NCT of Delhi for testing to be carried out by the Central Government as well as the State Government run hospitals, as far as possible, subject to availability of testing kits with priority given to the persons approaching for test on the recommendation of a doctor.  

Another aspect that we raised in the aforementioned writ was the decision of the government to declare hospitals as Covid-19 Hospitals. This includes large hospitals like Sir Gangaram Hospital, Apollo Hospital and the entire Eastern block of Max Saket. This not only impacts patients who were using the hospital facilities for other treatments like dialysis and chemo, but also ensures that Covid-19 positive patients do not get the benefit of specialist doctors.  I spoke to a paediatrician friend in the U.S. who informed me that Covid-19 is known to affect children for different organs requiring specialist help in pulmonology, cardiology and nephrology, to name only a few. The High Court has directed the state and central governments to consider making available multi-speciality facilities for the coronavirus patients.  Hopefully, these directions will correct some of the infirmities in the coronavirus management.

HISTORY OF MISMANAGEMENT

Hindsight, they say is 20/20 and I write with that benefit.  I also acknowledge that Covid-19 is a pandemic of unequivocal magnitude and perhaps could not have been predicted or planned for.  I say this, despite the release of the now popular series on Netflix ‘Pandemic: How to Prevent an Outbreak’, the release date of which in January 2020 was very eerily timed.  Conspiracy theories aside, the release date was co-incidental. Episode 2 was appropriately titled ‘How to Prevent an Outbreak’.  The series was filmed in the 2018-19 flu season and in the trailer there are discussions of a virus which within one month ‘can spread throughout the country, a month after that, widespread around the world’. It made a positive claim about the next pandemic that is going to start ‘…we don’t know where, or how, but we know it will’, and it will pose ‘an existential threat as a species’. That was not hindsight, but foresight, and in hindsight we can call it a prediction, a prophecy that came true.   In the series Dr. Syra Madad is seen pleading for resources for a pandemic preparedness. 

But for the outbreak, perhaps the series would have failed as yet another apocalyptic depiction. There have been others of this genre including These Final Hours (2015), This is the End (2013), Seeking a Friend for the End of the World (2012) and others based upon viruses and diseases including Retreat (2011) and Daybreakers (2009).  I am not even mentioning The Wandering Earth (2019), a Chinese film now on Netflix which is one of the highest grossing films of 2019, lest that fuels a conspiracy theory.  

The mysterious virus first raised its ugly head in Wuhan, China, late in December 2019.  Before mankind could react, by end of January, 2020, the virus had spread to the whole of mainland China. The virus was serious enough for China to cancel its most important holiday of the year scheduled to start on January 25, 2020, the Chinese New Year, resulting in 2020, the year of the Rat, being brought in with little pomp and fanfare. The World Health Organisation (WHO) woke up to the pandemic on 31 January by declaring a “Public Health Emergency of International Concern”. The declaration was on the advice of the Emergency Committee convened by the Director-General of the WHO which took place on January 30, 2020.  The Committee report read:

“It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoVinfection, and to share full data with WHO.” 

The virus was formally christened as Covid-19 by the WHO on 11 February.  

Italy, another country hard hit by the novel coronavirus, by January 31, 2020 suspended all flights to and from China and declared a state of emergency.  The quarantining process in Italy started by 22 February by declaring red zones. Schools were closed in several municipalities.  Famous buildings such as the Duomo in Milan and Basilica Di San Marco in Venice were closed.  Sporting events including the Coppa Italia football matches were suspended.  The last two days of Carnival of Venice were cancelled as were the last three days of Carnival of Ivrea. By 9 March all of Italy, a country of more than 60 million people, was placed under quarantine. Virtually all commercial activities in the country were suspended on 11 March.

By 30 January, the first coronavirus case was confirmed in Kerala. The second and third cases were also reported from Kerala on 2 and 3 February respectively.  All three were students returning from Wuhan, China. The US by 1 February had already eight confirmed cases.  One would have thought that these were sufficient pointers for the two countries to be forewarned. However, preparations in both countries continued for the famous Namaste Trump tour of President Trump on 24 and 25 February. Instead of worrying about the coronavirus, the Indian government was busy beautifying the route between the Kheria airport to the Taj Mahal. With no fears of the virus, on government orders, millions, including over 15,000 school students were asked to line up close together on the convoy route of President Trump from the airport. President Trump had proclaimed that there would be “millions and millions of people” and had estimated “five to seven million just from the airport to the new stadium (Motera Stadium)”.   Prime Minister Modi was obliged to produce at least a million. 

It took the country another two and a half weeks to detox from the Trump visit. Immediately following the Trump visit, a man who hosted his son’s birthday party at the Hyatt hotel of Delhi was reported to be corona positive. The party was attended by many young children. This resulted in the Hyatt staff being asked to quarantine and at least two private schools in Noida cancelled their classes. The incident received must attention by the Press.

In early March reports of coronavirus positive cases started to appear from all over India, through travellers not just from China but from Italy and other destinations like the United Arab Emirates.  Foreign nationals from Italy who had been traveling all over India started to test positive in Delhi and in Agra.  Between early and middle of March coronavirus positive cases were reported from Jammu to Ernakulum and from large cities like Mumbai, Bangalore and Kolkotta. 15 March was the fateful day on which the Bollywood singer Kanika Kapoor landed from London and immediately proceeded to a party in Lucknow attended by the glitterati which included members of Parliament including BJP MP Dushyant Singh and former Rajasthan Chief Minister Vasundara Raje. Kanika Kapoor tested positive and Dushyant Singh post the grand party attended Parliament, not only spending time at the Central Hall but also attended a breakfast meeting hosted by the President. The coronavirus scare now reached the Parliament as also the Rashtrapati Bhawan. The novel coronavirus was finally declared as a “notified disaster” in India on 14 May, only a day prior to the Lucknow bash.  What were these politicians doing at such a large gathering at such a sensitive time is anybody’s guess.

Another week passed by and it was time, (22 March) for the Prime Minister to call for a 14-hour voluntary curfew called the ‘Janata Curfew’.  By now Italy was already 11 days into a country-wide lockdown. A video from Italy that went viral showed Italians standing on their balconies and singing or playing instruments in an effort to boost their morale.  Some used pots and pans and wooden spoons to add to the symphony, in the hope of creating a bond through music.  This action by the Italians seems to have found favour with PM Modi who called upon all Indians to stand in their doorways, balconies or windows at 5 PM and clap their hands or make a sound with their pots and pans. It was Modi’s way of giving tribute to those delivering essential services. The faith in the Prime Minister elected by a popular vote could be seen across the country with Indians devotedly complying with the directions.  

The purpose of the ‘Janata Curfew’ was, in the words of the Prime Minister, to enable us to prepare for the forthcoming days. Who knew that the forthcoming days would mean the announcement of a nationwide lockdown for 21 days. The Prime Minister visited us through our television sets at 8 PM on 24 March. The streets of Delhi had never been so empty, all glued to their television sets only to hear the Prime Minister announce a nation-wide lockdown to be effective in less than 4 hours’ time.  With effect from 12:01 AM a nation of 1.3 billion people were directed to be locked down with a total ban of coming out of ones homes. Every State, every District, every lane, every village was put under the lockdown.   One would have thought that the Prime Minister would have made some arrangements for those who were not in their homes, their villages, their Districts, their State, but that was not to be, as became apparent from the events that would unfolded later.  

The nation-wide lockdown was the first time that the provisions of the National Disaster Management Act, 2005 (NDMA) were invoked.  Interestingly, the NDMA itself does not either define the words “pandemic” or even “epidemic”, but it does broadly define a “disaster” as a ‘a catastrophe, mishap, calamity or grave occurrence in any area, arising from natural or man made causes, or by accident or negligence which results in substantial loss of life or human suffering or damage…’   The National Policy on Disaster Management, which was approved by the Union Cabinet on October 22, 2019, in its preamble itself recognised that “disasters disrupt progress and destroy the hard-earned fruits of painstaking developmental efforts, often pushing nations, in quest for progress, back by several decades. Thus, efficient management of disasters, rather than mere response to their occurrence, has in recent times, received increased attention both within India and abroad…..good governance in a caring and civilised society, needs to deal with the devastating impact of disasters.” Clause 7.9.1 of the Policy also recognised the need for a “quick and effective” medical response “to prevent an outbreak of epidemics.”  

The lockdown, announced less than four hours before midnight, brought the livelihoods of many Indians to a standstill, literally overnight. Those who had savings could sustain, but what of those who relied upon their daily activities i.e. daily wagers.  For them no-work meant no-pay and this marginalised class were left to their fate. At that point, there were only 500 confirmed coronavirus positive cases in the country and if the lockdown had been properly planned, perhaps they could have all reached their homes safely. Unmindful of this, as if in a state of panic, the Prime Minister announced the complete lockdown, which included the sealing of the inter-state borders and with all transportation brought to a halt.  There were no buses, no trains, no trucks to take these workers back to their homes.  Many of these workers live on construction sites. Their daily wages earn them their daily food and rations. Their power of sustenance is very short, as they live from hand to mouth at the best of times. They were now asked to spend 21 days in their non-existent homes without work or an income.  One recalls reports of police beating them with sticks if they tried stepping out of their spaces even to purchase necessary supplies. 

Even prior to the announcement of the nation-wide lockdown, the government on 22 March announced a suspension of passenger services of the Indian railways. This was perhaps the first time in 167 years that India’s rail network had been suspended. Even hardened criminals who are jailed for heinous crimes, in their confines are given food, water and basic clothing.  The confinement for the estimated 120 million migrant workers was however without these basic necessities. Their only crime was that they were poverty ridden and despite their pitiable state were helping the country reach its target of becoming a $5 trillion economy and a global economic powerhouse by 2024-25.

In his speech televised on national television at 9 PM on 3 April the advice by PM Modi this time was for citizens to turn off all lights on 5 April for 9 minutes at 9 PM and light a candle or a diya or even the flashlight on one’s mobile device.  This was exactly the nourishment that social media addicts locked up in their homes needed for entertainment. Many wondered, through humorous memes, on the confusion that the virus was experiencing in seeing the warm welcome that Indians were giving it by clapping their hands and welcoming it with lighting of candles and diyas. 

As spring turned to a scorching Indian summer, PM Modi through his speech on 14 April on national television announced the extension of the lockdown till 3 May.  This time his speech was at 10 AM.    The hapless migrant had reached levels of starvation by now. The doors of the haves not only attempted a shut out of the coronavirus but also the sound and sight of the misery of the millions who helped build those very homes, those very doors.   The migrants had been left with little option but to start the long trek home, with their children and meagre belongings to be carried on their selves.  Many described this the greatest exodus since the partition between India and Pakistan in 1947 when over 15 million are estimated to have been displaced. The numbers were exponentially higher this time around.  These were homeless refugees in their own country, their own land.  Many died of hunger and thirst, others of diseases and some even crushed under a train. Was this the good governance in a caring and civilised society that the National Policy on Disaster Management anticipated?

It appears that our government was either unmindful of the enormity of this human crises or didn’t care.  Prime Minister Modi in his speech of 14 April, with a wry smile on his face, declared that the lockdown had ensured that India is in a much better position than other countries. According to the Prime Minister, the number of Corona virus cases in the country had just crossed the 10,000 mark, a small number compared to the 2 million cases worldwide.   To his credit, the Prime Minister did allude to the problem of food as also the burden of staying away from home by many.  It was a passing reference with no indication that it was in fact a disaster.  

The Press started to fill with heart-rendering visuals of weary migrants trudging along national highways of the country. The nation was witness to this arduous journey of many, with particularly disturbing visuals of feet burnt and charred by walking on hot tarred roads with little or no footwear. It was not till latter part of May that there was some semblance of movement on the government front to help the migrant workers get home by arranging for buses, that too after a suo moto intervention by the Supreme Court. The government’s response was through the Solicitor General of India giving his own interpretation of the crises by comparing it to the 1994 Pulitzer prize winning photograph of “The Vulture and The Little Girl”. The government hid its fallibility by damning the journalists who posted pictures of the crises.   

The lockdown continued to be extended from 3 May to 17 May in the third phase. This phase was introduced by flying a sortie of helicopters of the armed forced. Whilst, all other forms of transport were stopped, helicopters of the armed forced were allowed to fly.  Before you jump to any conclusions, I will clarify that these sorties were not for transporting workers or to provide them with food or essentials, but to shower flower petals on the front-line workers fighting the pandemic.  

The coronavirus situation had stabilised during the first phase of the lockdown, but had deteriorated between the second and third phase.  The country had not only suffered on account of the virus, but also had been severely affected on the economic front.  With rising coronavirus cases and falling economic activities, it was time for the central government to pass on this rather hot baton to the state governments. To boost the economy, some relaxations were made on the inter-state movement of goods and on the manufacturing and distribution of essential items. PM Modi now realised that perhaps the state governments are the best in judging what should or should not be permitted.  The restrictions in states were to be based on the incidence of the coronavirus in the region and to identify different regions. The entire country was colour-coded into red, orange and green zones. Then there were the containment zones ensconced over the three.  

The fourth phase extended the lockdown till 31 May.  The virus baton by now was scorching hot with the cases rising exponentially.  It was time to hand over major responsibilities to the states who were now given a larger say in the demarcation process of areas in green, orange and red zones. They would now be permitted to even further divide the red zones into containment and buffer zones.  The central government was slowly washing its hands off this coronavirus issue. Of course, this washing of hands is very different from what is advised to prevent the virus from spreading. 

As the virus continued to spread its tentacles and the economy continued to spiral down, it was time for action. People were fed up with the term lockdown and yet there was a need to extend it beyond 31 May till 30 June. It was time to rechristen it as the first phase of unlock.  The virus was now in a sprint mode. So perhaps it was time to forget about the virus and concentrate on the economy.  Livelihood started to take precedence over lives. It was indeed a time for the country to go into a phased period of unlock, with many of the restrictions being lifted.  By 8 June the shopping malls, religious places, hotels and restaurants would be permitted to reopen.  Domestic air travel upto 33 percent was restarted after being stopped for over two months on 25 May.  Inter-state travel was permitted by the central government.  

As the reins of the virus were handed to the state governments, it immediately became obvious that the numbers infected by the coronavirus pandemic had to be controlled. The state government in Delhi took the bull by the horn, or should we say the virus by the testing resulting in the action initiated against the eight labs, an aspect I have alluded to in the beginning of this piece.

And with that I conclude my case study on disaster management. One disaster leading to another owing to poor administration and management, and all at a time when the biggest disaster of all times has hit humanity. The only saving grace is the opening of religious establishments with effect from 8 June. Hopefully god will intervene.