Research ArticleOpinion Based Blog

THE SECOND WAVE: HAS THE GOVERNMENT MACHINERY FAILED AGAIN?

2nd wave message and virus which is textured with world map sitting over red background, Horizontal composition. COVID-19 second wave concept.

Author: Anushree Sudan, LL.B. I year at National Law University, Delhi


ABSTRACT

Looking back at the working of economies, the ‘ideal’ statistics of stock exchanges and even movies with people standing in crowds seem unnatural in the ‘new normal’ which the COVID-19 pandemic has brought about. The last year and a half has brought phases of various unexpected events all over the world but the ‘second wave of COVID spread in India’ has been the most shocking for the country.

“The sudden spike in cases has brought the nation’s healthcare system to its knees. There are no hospital beds, no oxygen, no medicines. And then there are the variants.”[1] The 7-day average of 3.8 lakhs of new cases[2] excluding the multiple false negatives has been the highest in the world. The healthcare system of the country has been a hollow maze leading people nowhere. People have to line up in front of government dispensaries and wait for hours to be sent home in disappointment as the kits are not enough. The only way out is resorting to private testing which drains pockets. Critically ill patients are struggling to get access to basic medicines like remedisivir and oxygen supplies have been incompetent. The number of deaths is going up every day. Seeing funerals with no attendance and bodies of loved ones being dragged down in sacks to be cremated is a heart-breaking site many families have had to face. The above mentioned atrocities are not just affecting big cities like Delhi and Mumbai, smaller cities and towns are in turmoil too. The numbers are just not going down.

The following research article tries to answer three questions: What is this ‘second wave’ of COVID spread in India and why is it concerning? What leading factors possibly led to this country wide state of apocalypse? What actions by the authorities could have avoided this situation?

The possible conclusions to the questions this article tries to answer are: The sudden spike in cases which was feared and avoided whilst initial lockdown, affecting the country now is what is being referred to as the ‘second wave of COVID’. The leading factors which might have led to these circumstances are a new mutation of the virus which affects a bigger demographic and spreads faster, citizens’ ignorance towards COVID appropriate behaviours and religious/political events which led to mass crowdings. Finally, investment in health infrastructure by the state over differential treatment given by the government to religious congregations and mass election rallies could have avoided this situation.

INTRODUCTION

The SARS-CoV-2 or COVID 19 spread was officially declared a pandemic by the World Health Organisation on 11th of March, 2020[3]. Ever since, the graph of the number of cases in India remained relatively flat until a steep rise was witnessed in the July to September (2020) period.[4] Hitting a peak of almost a lakh cases in a day scared the country and its media. This was considered the ‘first wave of COVID spread in India’. The government had been responsive and reasons ascertained to cause this spread were ignorance by citizens and social gatherings, especially the Tableeghi Jamaat.[5]

Social distancing and other COVID appropriate behaviours like masks and sanitization were mandated all over the country alongside a gradual shift to a ‘new normal’. Offices, restaurants and schools were gradually opened until there was another peak in cases in some states.[6] Delhi saw 8000 and Maharashtra saw around 5000 case rises in 24 hours in November, 2020.[7] This spike in cases was traced back to reduced travel restrictions. The new variant of the virus originated in the UK which was more infectious, was found in these travel hubs and other Northern states like Punjab and Chandigarh. This spread between November and early January was considered the ‘second wave of spread’ in these states. With the onset of public vaccination, February saw a steep fall in the number of cases country wide.

The final stage of the spread started in March. A new ‘double mutation’ of the virus: B.1.617 was detected in India. Mid- March saw a steep rise in India’s daily number of new cases. The increase was rapid and broke records one feared. As of May 2021, the daily increase in cases has touched over 4 lakhs with an outrageous increase of 104 percent in the number of deaths.[8]Total cases have crossed 21 million and the total number of deaths has crossed the 2 lakh mark. April 2021 saw the highest increase in the number of reported cases. This rapid rise in the graph which does not seem to reach its maxima is being referred to as the ‘second wave of COVID spread in India’. The infection has severely affected all stratas of the geographical and social compass in the country. It is also being called the ‘third wave’ in states like Delhi and Maharashtra.

HOW IS THE SECOND WAVE CAUSING HAVOC?

The second wave of infection in India has been in the news all over the world. The staggering statistics covering headlines of every leading daily draw attention to the rampant spread of the virus but are too objective to reflect the social reality of the country. The virus has swept through the class divisions and even the privileged upper classes are in the realm of tragedy.

Increased infectivity and a ‘testing crisis’

The ‘double mutation’ L452R found in the variant B1.671, first detected in India, has been associated with increased infectivity.[9] The atrocities brought about with this rampant spread are multi dimensional. First being the higher rate of positivity which is infecting masses of people within smaller spaces. Since this variant affects the younger age strata too, the demographic of the infected population has widened to all age groups. Children as young as 3 months old are on ventilators and people in their 20s are at the risk of passing away. Rates are going as high as 55 percent in cities like Bengaluru[10]. Even minor contact with an infected person is leading to a concentrated spread to new areas. The question of isolation of the infected has also dwelled into ambiguity. The recognition of symptoms has been difficult. The new COVID strain has brought with it a set of new symptoms including fatigue, shortness of breath and chest aches.[11] These being general symptoms to other ordinary viral infections, often leave people in confusion. Studying the circumstances prevailing in the capital city of Delhi, the status of RT-PCR testing has been outrageously incompetent. Government testing is free of cost but the queues outside these dispensaries start at 8 in the morning. Individuals with clear symptoms standing in proximity with many people makes these testing centres potentially harmful. Moreover, the shortage of kits leaves many people disappointed and makes their symptoms worse before they get the assurance of infection. Private testing witnesses a similar state of affairs but with long waiting lists and prices which drain the layperson’s pockets.

The testing crisis faces various other issues, including increasing numbers of false negative reports. Many symptomatic and asymptomatic patients are testing negative in the RT-PCR and the rapid testing process. This does not only prevent genuinely infectious people from home isolation but denies severely ill patients from receiving COVID treatment in hospitals. The Delhi state government had to officially mandate the city’s hospitals to provide treatment regardless of the covid positivity test results. Scientists have given various explanations as to why false RT-PCR results are on a rise. The most plausible cause seems to be the new viral mutation, improper sample collection by inexperienced professionals and human error in the overcrowded labs.[12] Various labs have the demand for testing on an unprecedented high. Due to the negative supply-demand slope, the pricing of these tests has also gone as high as 1300 rupees per test. This sudden increase in profitability in the health sector has led to widespread black marketing, which leads us to the second dimension of these atrocities.

Shortage of resources and overpricing

Many people desperately looking for a testing facility have resorted to the black market where prices are set so high that even upper middle classes are running out of resources to keep up. These testing facilities cannot be held accountable. With entire families down with COVID, many people have lost thousands of rupees on fraudsters handing them false negative reports. These tumolous circumstances are not just limited to testing. The increase in cases due to a new variant of the virus, new symptoms like lowering of blood oxygen levels and weakness have become very common among all age groups. “In the second wave, critical data has emerged from hospitals being tracked by the government — that 54.5% of admissions during the second wave required supplemental oxygen during treatment. This marked a 13.4-percentage-point increase from the peak during September and November last year, according to data from 40 centres across the country.”[13] This high demand of oxygen and other medicinal supplies has also received an incompetent supply by the government and private hospitals. People are resorting to individually purchasing liquified industrial oxygen. The sight of people carrying cylinders on motorcycles has become a common sight in Delhi. Private suppliers are also not missing the opportunity to exploit the situation for profit. Vials of remedisvir, an essential steroid for critical patients were being sold at as high as 45,000 rupees per bottle until the government passed an order ceiling its prices.[14] Oxygen and ambulance facilities are also difficult to avail without at least making 50 calls and draining one’s savings.

Increased death rates

Although the recovery rate goes as high as 81.95 percent, the figure is not impressive. The number of active cases crosses 3.6 million and the most tragic of all the statistics is the increasing death rate, the third dimension of this wave of infection. The country’s overall death rate has reached 1.09 percent, which might seem low objectively but considering the total number of cases is 21 million+, the number of reported deaths has crossed the 2 lakh mark[15]. The death rate does not seem to go down either. The last 14 days have seen the death rate go up by a staggering 104 percent and the past week has seen a daily average of over 3600 deaths. [16] Children are left orphans with both parents passing away at young ages and funerals have no attendance. Many families are missing out on the last glance of their loved ones, frontline health workers are traumatised calling families informing demise multiple times a day and bodies being dragged by the floor in sacks to be cremated without being paid last respects to.

WHAT LED TO THIS RAMPANT SPREAD?

Various factors have led to this apocalyptic state of affairs in the country. This section will try to encompass the factors which led to the spread of the virus as well as the response by the authorities which deemed inefficient in controlling it.

Public gatherings

As already mentioned, the new COVID variant detected in India potentially spreads across a bigger demographic faster than before. After being detected in early March, the number of new infections in the country grew at a fast pace. The period in February when the country’s situation was in control, the process of ‘unlocking’ the economy to function in the new normal opened public spaces and made movement comparatively lenient. One of the leading reasons as to why the COVID spread saw a rise in all states unanimously after this period was the general ignorance towards pandemic appropriate behaviours. The nightclub culture in big cities like Delhi and Mumbai led to unattended crowds of upto 200 people neither maintaining social distance nor wearing masks. Thus resulting in high spread among the younger demographic.[17] Other factors which led to this spread all over the country was resuming activities like going to restaurants and gyms, where masks were inevitably removed. Crowds were not just gathering for recreational purposes. Public and private offices and schools had also started opening their gates in a controlled manner therefore making professional arenas prone to infection too.

Except the general everyday behaviors, there were certain events held in the country which are said to have acted as ‘super spreaders events’[18] and made the slope of the graph more steep. These events in the Indian context had religious and political significance. The first one being the Kumbh mela 2021 at Haridwar. The event started on the 11th of March and went on till the 27th of April. A person who takes a ritual bath under such a cosmic arrangement during the event is said to attain Moksha.[19] Not a mandatory custom but a celebrated one, the Kumbh Mela hosted over 3.5 million people. [20] Looking at the graph of the country’s COVID cases in the 11 March-27 April timeline, the slope becomes flatter on the y axis and does not hit a point of maxima. The number of new cases in 24 hours went as high as 3.6 lakhs on the last day of Kumbh.[21] The event having gathered multiple people at one place along with the activity of dipping in a river, covid protocol even if followed, led to compromise of the preventive measures of wearing masks and social distancing. The event did not just lead to a country wide spread but also made devotees belonging to older age groups more susceptible to the infection. People coming from all states attended the event and contributed to the spread in all states. Thus the Mela led to a pan India rise in cases in people of older age groups along with their entire families and communities they went back to.

Not just religious congregations, political activity also led to a steep growth of cases in many states. Kerala, Tamil Nadu and West Bengal held Legislative Assembly elections within the March-April period.[22] Many constituencies also held bye-elections in this period. The entire process of an election does not only require monetary investment but mass human interaction too. Campaigns and rallies in these states, especially in Bengal took a form of unhealthy political competition. Mass rallies in the state with 10 lakh attendance targets[23], street processions with no covid protocol and door to door campaigning were the various practices most political parties used whilst a pandemic. It could be observed that the campaigning was done by associating a sense of pride in political affiliations, which mobilized people to step out in competition rather than prioritising containing the covid crisis in the country.[24] The parties’ grassroot workers and their supporters thus came out in large crowds in response to these campaigns.

Centre’s Response

The second wave makes us evaluate the country’s response to the crisis from a social, economic, political and infrastructural point of view. The social side of things makes us question the religious and recreational priorities of the general public and authorities over a genuine health hazard. The first being the response to Kumbh Mela.

Delhi saw a whopping 24,000 new positive cases on 17th of April and the centre issued guidelines mandating testing and quarantine[25] instead of sealing of borders. Not just inter-state but even within the state, containment zones were not strictly sealed.[26] The media coverage by independent online new sources accessible to the ‘digital elite’ did try covering the impact of Kumbh on the pandemic but the government is yet to release statistics and the mainstream news news sources seem to prioritise covering the cultural significance of the event instead of its pragmatic impact on worsening the already alarming situation. Uttarakhand Chief Minister Tirath Singh Rawat said in a statement that there should be no ‘rok-tok’ which means nobody should obstruct, as this ‘Mela’ is open for all.[27] The government’s response to the tumolous developments brought by the event seems dubious considering the response to a plea to allow Namaz in a spacious masjid during Ramadan by the Juma Masjid Trust was rejected[28] while Kumbh just required a negative RT PCR test. [29]

While comparing the government’s response to Kumbh, a major contributor to the spread in the second wave to the it’s response to the 2020 Tableeghi jamaat, a major contributor to the spread in the first wave, the centre seems to be contradicting itself.[30] Media coverage of the Tableeghi Jamaat event criticised the organising community for being ignorant to public health. Multiple FIRs were lodged against the organisers. Even four residents of the Old Delhi area who housed four female Tablighis from abroad in March last year have been slapped with Sections 188 (disobedience to order duly promulgated by public servant), 269 (unlawfully or negligently doing an act likely to spread infection of any disease), 270 (malignant act likely to spread infection of disease dangerous to life) and 120B (criminal conspiracy) of the Indian Penal Code.[31]Multiple accounts of strict quarantine by foreign[32] and domestic attendees showed the government’s paranoia towards the pandemic. The Home Ministry went on to further blacklist 800 preachers from Indonesia. But considering the Jamaat hosted upto 9000 attendees[33], the Centre sanctioning 325 crores to a mela[34] and mandating just an RT-PCR test for an event hosting 3.5 million seems purposely underwhelming.[35] A similar response to the 2020 Rath Yatra at Jagannath, Puri makes one question whether the government’s policies are governed by practicality or communal perspectives.

Similarly, the Prime Minister urging voters in Bengal to come out and vote on a day where the country reported over 2.6 lakh cases[36] even makes one question the political priorities of the Centre. Leaders in power at the Centre including the Home Minister and Prime Minister of the country went on to conduct mass rallies in West Bengal until the Election Commission of India intervened.[37] The State Governments are constantly being questioned over healthcare resources as “health is a matter of state jurisdiction”[38] but considering that testing, vaccination and the allocation of the PM Cares Fund are controlled by the Centre, their authority is just nominal.

The poor and the healthcare system

The second wave made us realise that the condition of the country’s healthcare system is completely broken. The death rate going up everyday is nowhere proportional to the health infrastructure of the country. As discussed above, the healthcare system is incompetent in providing to the sick population. Government facilities are filled to a point where people on ventilators are being bedded on corridor floors.[39] The poor man feels blessed if one gets a bed in a government hospital and the prices charged in private facilities just completely rules out the poor’s access to healthcare. Black marketing and hyperinflation has left the general population, the one who does not have connections and plenty disposable income in misery. Even the upper classes are finding it difficult to avail basic resources.

The ‘oxygen crisis’ of India in particular has left people questioning where the taxpayer’s money is going. With only 1.26 percent of GDP expenditure on healthcare and being ranked 145th in access to healthcare[40], adequate investments in the healthcare sector would have most probably if not avoided it but responded to this catastrophe better. Also, regulating and ceiling of private healthcare facilities would have made availability of basic health essentials required in this pandemic more inclusive to all sections of the populus.


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  38. THE INDIAN CONST. 7TH SCHEDULE.
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