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Gearing Up To Fight Coronavirus


Of Bharat bandhs, the days it was a form of potent protest, it used to be claimed in officialdom that they passed off peacefully. Those were the times when the Opposition declared a strike, or labour leaders brought the city to a halt, or the railway lifeline was impacted as motormen and guards decided to teach the government a lesson.

Of the so-called ‘janata’ bandh, it may be said, that the Sunday last passed off quite mindlessly. Many obedient, some coerced, the rest quite unconcerned, our people decided to follow the instructions of the Prime Minister and sat at home as their contribution to fighting the threat of COVID-19. A large number even participated in the beating of the ‘thalis’, turning what is mostly understood as a form of democratic protest into an instrument of compliance. It comes under a polity that has been marked increasingly by demands of sacrifice, compliance and obedience to authority. Remember ‘note-bandi’? Well, as the meme doing the rounds correctly pointed out, this is ‘ghar-bandi’.

To be sure, the Prime Minister used the word “request” four times in his address to the nation on March 19, when he called for the ‘janata’ curfew. But the undertone of the narrative and the way it was executed makes the message very clear. Buckle up for the coming war against COVID-19.  We, as the Prime Minister had said, “will have to further strengthen our resolve to overcome this global crisis, fulfilling all our duties as citizens, and abiding by the directions given by the central and state governments.” This is a call to fight a war and save a nation, and so the nationalistic fervour is here and demanding acceptance of orders and enforcing compliance. There is politics to this narrative that clashes with the approach and the spirit with which doctors and health experts work.

This tone from the leadership brooks no questions, and it is not surprising that we have had very few questions out in the open from virologists, epidemiologists and a host of other experts on what should be our best approach to prepare for what is the likely rise of the pandemic in India. And it is precisely questions that we must ask in these troubling times. For example, the Prime Minister also asked people to “resolve to not get infected ourselves, and prevent others as well from getting infected”. Which begs the question, as simple as it is complex, how does one do so? But not challenging the narrative coming from above, which is what happens when a top-down approach from an overwhelming authority is followed, delivers a high degree of blind compliance. The focus is soon shifted to how we all managed a Bharat bandh and beat up vessels to make a loud sound exactly at 5 pm on March 22, as the Prime Minister had desired. This is buffoonery at its best.

Those humbler in the face of a grave crisis will ask more questions and resist the rush to provide answers and deliver quick fix solutions. Should we not ask what the purpose of closing down railways, taxis, and indeed Uber and Ola services is, and the amount of hardship these could cause to those who must reach somewhere – to attend to an ailing child, parent or to seek medical attention? The poorest with no means of their own transport will be affected the most. What is the price the nation will pay as tens of thousands of daily wage workers thronged the railway stations to get into trains and get back to their home states, with wages here gone and no hope of a quick revival? There should be worries that some of them have carried the disease far away and to remote corners of India, where it will be difficult to fight. There are other concerns on a one-day lockdown and what happens on the next day as people return to the streets and the markets resume trading and other activity though on a subdued scale. Can we really “fool” the virus? We can never say for sure but the chances are that we may more likely fool ourselves.

Across the world, as it has been in India over the years, the public health approach is sought to be understood more from the perspective of the patients. It is well understood that TB cannot be fought when those suffering do not follow instructions or do not take medication as prescribed over a long period of time. So, protocols are formulated to encourage patients to take their dosage and to return for timely follow-ups. Injectable contraceptives were not introduced in the national family welfare programme because (the government introduced these in the public sector only in 2017) of their longer-term effect, the problems with informed consent in India and risks that were not as well understood. This is even though injectables have been sold in markets like the United States and other parts of the developed world for decades.

This narrative, with the interest of the patient at the core, takes a beating with a top-down handling, and runs the risk of becoming the weakest link in the resolve to fight the threat from COVID-19. Whenever patient rights are sacrificed and administrative action sans inputs from the larger collective of health workers takes the lead, disaster follows. A good example is the sterilisation campaign under the influence of Sanjay during the Emergency, which tarred the programme for ever.

From the perspective of patients, the government must gear up to provide more information that can help people take decisions and act in a crisis. This must cover issues like where do people who have symptoms go for testing. Currently, only a limited number of labs test for COVID-19. If the number of cases rises, what are the preparations to house people, keep up communications, set up new protocols and maintain a sense of order? Just like we are being assured of enough supplies of commodities, it will do well to keep the nation posted on number of isolation wards, hospital beds, test centres and availability of medical supplies where required. This means gearing up the entire health infrastructure and the state machinery to serve more, to reach out more, to support from the top and to hold the authorities to account when they fail to do so. This must be the spirit. And alongside, we can have lesser trains, restrictions on crowds and working from home.

That is a very different kind of preparation and focus from what we saw last Sunday with the police enforcing the ‘janata’ curfew, shockingly beating up people venturing outside in many parts of the nation. It is something to reflect on: we have started the fight against a pandemic by beating up our people. Violators of the “order” from above are being punished. Then we have congratulated ourselves. And we really do think we are prepared!

                Billion Press

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