POLITICS: India’s COVID-19 miscalculations

By: Radhika Bhambi

In March 2021, the Minister for Health and Family Welfare of India, Dr. Harsh Vardhan, declared that India was in the “endgame” of the Covid-19 pandemic. From averaging 11,000 cases per day in February 2021 to more than 400,000 cases in May 2021, India learned an important lesson – ignorance is helplessness, ignorance is poverty, and we succumb under ignorance. 

Too many guards let down, too soon

In March 2021, the Election Commission of India announced Lok Sabha elections in 4 states – Assam, West Bengal, Kerala, and Tamil Nadu – and in the Union Territory of Puducherry. The campaigning was in full swing by March-end, during which protocols for social distancing and face masks were scarcely followed.

By mid-March, the Board of Control for Cricket in India allowed more than 130,000 cricket fans, mostly unmasked, to watch international cricket matches at the Narendra Modi stadium in Gujarat. 

Even when India had started recording an average of 200,000 Covid-19 cases per day, the Union Government gave a go-ahead to the Kumbh Mela. In early April, millions of devotees gathered to attend the Kumbh Mela in Uttarakhand without taking any precautions against the pandemic. 

The rise in number of deaths due to poor healthcare infrastructure – and not the virus

The magnitude of pain inflicted on Indians by the pandemic could have been avoided had the state governments learned lessons from the first wave and preemptively invested in improving the healthcare infrastructure. 

The healthcare infrastructure of several states in India has witnessed an abysmal decline over the last few years. In Uttar Pradesh, the number of primary healthcare centers has declined from 3,660 in 2005 to 2,880 in 2020. Whereas in Bihar, despite the growing population, the number of primary healthcare centers increased marginally from 1,648 in 2005 to 1,702 in 2020 – a mere 3% increase.

Furthermore, as per an OECD report, India’s total healthcare spending stands at 3.6% as of 2017 – which is lower than the average OECD countries at 8.8%. 

Mismanaged even the manageable – vaccination shortage in India

India has also suffered from vaccine shortages despite being the second-largest producer of Covishield – by Serum Institute of India (SII) under license from AstraZeneca. 

Starting its vaccine drive in the 3rd week of January 2020 under the name of “Vaccine Maitri” – an initiative by the Government of India to provide Covid-19 vaccines to other countries around the world – India exported more than 60 million vaccines to 93 countries in almost 3 months (an average of 20 million vaccines per month). A number that together could cover an entire adult population of Mumbai and Delhi completely with two doses. Even though India was contractually obligated to send vaccines to poor nations under Global Vaccine Alliance, Gavy, it needed to export 400 million doses only by the end of 2021 (an average of 3.3 million vaccines per month), with no commitment to roll out a certain number of vaccines at one time. 

Underestimated the importance of genome sequencing 

A proper, regular, and adequate genome sequencing by the Government of India could have reduced the magnitude of this calamity. India had set a target to do genome sequencing of at least 5% of new Covid-19 cases every day. However, it has completed less than 1%. In addition, in the first 6 months of the pandemic when small countries such as Denmark, Belgium and other nations were doing an average of 75,000 genome sequencing, India reached a mere target of 100. 

Conclusion

A lesson that has emerged from this pandemic is that no system can prevent the ramifications of a pandemic in isolation. The state governments in India can emulate lessons from their counterparts such as the Kerala Government – which started monitoring the state’s oxygen demand in March 2020, and set up oxygen plants in October 2020 to supply 199 metric tons of medical oxygen when the state was only using 75 metric tons per day. India also needs to stop restricting testing to misrepresent the actual situation, and instead focus on increasing testing and contact tracing. The Union Government must focus on distributing vaccines, oxygen tankers, testing kits, and other critical medical equipment equitably across the states.

While the second wave has put India’s systems under strain, the pandemic is also a wake-up call for the government to augment the healthcare infrastructure. It’s time that the Government of India adopts an Indian National Health Service – a detailed proposal of which was submitted to the government in 1946 by then civil servant Sir Joseph Bhore for a national health service broadly modeled on the British National Health Service, or NHS. 

The pandemic has provided an opportunity for India to reassess its healthcare system and make significant improvements. The Government of India should consider these measures to mitigate the pandemic’s toll, and provide adequate healthcare facilities for all.