Pandemic Revisited~II

Considering 2021 alone, the Government reported 3.32 lakh deaths due to Covid-19, but there were 21.5 lakh excess deaths in 2021, for which there is no explanation ~ except Covid-19.

Reasons like maturer reporting processes leading to higher registration levels are offered to explain the annual increase in deaths registered in the Civil Registration System (CRS), but an increase of 25 per cent in a single year is statistically too significant to be attributed to any routine reason. Since the Registrar General’s report is only a compilation of the statistics supplied by States, it may be instructive to analyse State-wise data. Gujarat rep orted 5,800 Covid-19 deaths in 2021 but nearly 2 lakh excess deaths were reported which would mean under-reporting by 33 times; Madhya Pradesh under-reported deaths by 18 times, West Bengal by 15 times, and so on.

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It would appear that Governments were economical with the truth, probablywith a view to justify their response to the rampaging pandemic. India has some of the world’s finest doctors, hospitals and medical staff. India is also the world’s largest producer of vaccines and an exporter of medical grade oxygen. So, theoretically, we had adequate resources to fight the pandemic. But our managerial capacities are such that we often turn opportunities into adversities.

So, ironically, but not surprisingly, India faced huge shortages of both vaccine shots and oxygen leading to heartrending stories of patients dying for lack of oxygen, doctors themselves succumbing to Covid-19 infections, over-full hospitals turning away seriously ill patients, endless queues of am – bulances waiting outside hospitals and devastating fire accidents in ICUs.

The rampaging Coronavirus pandemic fully overwhelmed our healthcare system; the first wave of the pandemic left us gasping, and the second wave totally submerged us. Our weaknesses in governance, planning, healthcare, civic amenities and civic sense stood cruelly exposed. In the second half of March 2020, when Covid-19 was making its entry in India, our leaders convinced themselves that a lockdown for a few weeks would eliminate the virus.

The Prime Minister said so, and a member of the Niti Aayog declared that India would be Coronavirus free by 15 May 2020. There was little scientific evidence behind such assertions, which were based only on a personal understanding of the pathology of the virus. Once a lockdown was imposed, migrant workers, who had no means of sustenance left in their adopted cities, headed to their native places on foot, on bicycles, inside dumper trucks, in the blazing sun, in the most inhumanely distressing ways possible.

The political leadership ignored their plight; even the Supreme Court convinced itself that there was little movement of migrant labour, and the few who were on the roads were being taken care of. Once the first wave of Covid-19 infections abated, our love of religiosity and politics came to the fore. Not a single person objected when elections for assemblies in five States, various municipalities and zilla parishads were announced. Political leaders went mask-less at the head of large crowds during elections. Large religious congregations were held with State support.

When the second wave struck, the Government promptly went in denial mode, playing down the scourge of the pandemic by comparing Covid statistics of India to that of other countries. Obviously, the ratio of the number of infected persons in India to its large population was quite small, which enabled apologists to claim that Covid was almost non-existent in India. The Government constituted a number of Empowered Groups, mostly headed by bureaucrats, as apex bodies under the National Disaster Management Authority, to handle the Covid-19 pandemic. Despite having all resources at their command, the Empowered Groups did little to ramp up medical infrastructure between the first and second waves of the Covid19 pandemic.

Our administration prides itself for being rule-based, but rules of procedure are such that at the time when the pandemic was advancing, and a vaccine shortage was staring us in the face, on 21 April 2021, an advance of Rs.4,500 crore could be sanctioned to vaccine makers only after a public hue and cry, apparently because the General Financial Rules did not allow such advances. Notably, other countries had advanced humongous amounts to their vaccine makers, much earlier, even before the first dose had rolled out; Serum Institute of India itself had received substantial grants, not from the Government of India, but from Gates Foundation and GAVI, for development of the Astra-Zeneca vaccine. Also, the Government continued to charge GST on vaccines and deduct TDS on payments to vaccine makers, and essential supplies for the pandemic continued to attract Customs Duty and oth er Central taxes ~ pushing up the cost of vaccines and me dicines. The shortage of funds allocated to healthcare was cruelly exposed during the pandemic.

According to the Institute for Health Metrics and Evaluation of the Washington University, as on 13 May 2021, India needed more than 22.90 lakh hospital beds and 4.67 lakh ICU beds to treat Co vid patients; but with an availability of around 2,60,000 hospital beds and 20,000 ICU beds, resources were woefully short of requirements. So, unsurprisingly, the pandemic exacted a hu mon gous human toll. Looking forward, we need to create a ro b ust health infrastructure that would not be overwhelmed by any kind of calamity; such an asset would ensure the well-being of our countrymen in normal times. We can begin by creating wellequipped Government health centres at the taluka and district level, so that good quality healthcare is available all over the country. The Covid-19 death rate in India was 3.33 per cent, roughly half of that of the Western countries, which would indicate that advanced healthcare was of no use once the virus took root. It can be safely said that if we had a sufficient supply of ordinary health equipment like PPE kits, masks etc. then the number of infected people also would have been lower, resulting in correspondingly fewer deaths.

It would appear that the correct way to handle future pandemics in India would be to augment basic health services and spread information about healthy practices, which the entire population should observe. The next priority could be decongestion of our over-populated cities. Poor administration and concentration of population in a small number of cities has stretched their civic facilities to breaking point and has created a host of social problems. During the Covid-19 pandemic, overcrowding and the deficient infrastructure of metropolises helped the virus multiply unhindered, endangering the lives of millions. Population pressure on metropolises can be relieved only by providing proper civic amenities in smaller cities, so that people from the hinterland do not unnecessarily migrate to metropolises. Along with Coronavirus, SARS, H1N1 (Swine Flu), Bird Flu, MERS, Ebola, Zika and Nipah ~ all recent pandemics ~ are of animal origin.

Known as zoonotic diseases, which literally means “disease from animals,” these diseases are caused by pathogens which have the ability to infect both humans and animals. Zoonotic diseases are much more common than what we realize; approximately 58 per cent of all human diseases are zoonotic diseases. By destroying the natural habitat of animals, man has come into contact with wild animals and has been infected by their diseases. Therefore, future epidemics of zoonotic origin can be prevented by preserving nature and natural habitats. The physicist Stephen Hawking summed it very succinctly: “One can see from space how the human race has changed the Earth.

Nearly all of the available land has been cleared of forest and is now used for agriculture or urban development. The polar icecaps are shrinking and the desert areas are increasing. At night, the Earth is no longer dark, but large areas are lit up. All of this is evidence that human exploitation of the planet is reaching a critical limit. But human demands and expectations are ever-increasing. We cannot continue to pollute the atmosphere, poison the ocean and exhaust the land. There isn’t any more available.”

(The writer is a retired Principal Chief Commissioner of Income-Tax)