Preparing for the waves

There's more to come

Just over a hundred years ago, the Spanish Flu pandemic devastated many parts of the world. An estimated 100 million people died; India accounted for 15-18 million of them. It was the second wave that was deadly. So far, the official death toll in India due to Covid-19 is over 330,000, and one can reasonably assume that the figure is undercounted. But it is, for sure, still a long way from the Spanish Flu figures.

With Covid-19, we don’t know for certain how many waves and types there will be. But looking at the devastation already wrought, we must prepare for more waves even as we deal with this one. We should have been doing far better than we have with the second wave. The State must identify and initiate the requisite measures to meet the disaster as a national emergency. Most importantly, this national disaster demands that crisis managers be not overly rule-bound and needlessly procedural. It is most essential that they give up their clerical mindsets.

India has been battling Covid-19 for more than a year. The virus never went away. The second wave has brought into full view the incompetence of the governing class that includes politicians, bureaucracy and even some constitutional institutions at many levels. But it seems to be worst at the top.

The major attitudinal change required is to deal with the situation as a grave national disaster and along with that the acceptance that the crisis cannot be managed by rules and procedures shaped for a normal situation. The emergency demands that rules and procedures do not stand in the way of saving lives. The ultimate question for decision-making on any policy or action should be: Will the measure save lives?

In normal times, rules and procedures focus mostly on misuse and is mostly wrapped in protective procedures. How can those rules and procedures work now when the containment of the pandemic and provision of adequate support facilities to patients have to be our primary aim?

The overriding of rules and procedures should be done by the political class and they must take full responsibility for maintaining integrity. Importantly, it also means that as much as feasible and necessary, power and freedom of action must percolate to as low a level as possible within the national and state administrative structures and also synergise with India’s commendable NGO and private sector capacity. Fundamentally, it requires the empowering of India’s federal system.

As a principle, the states and Union Territories must be the organisational frontline, with the Centre playing the provider’s role. Covid-19 must immediately be declared a national disaster and the NDMA, which is headed by the PM, must take overall charge and coordinate central and state inter-agency activities through the state Disaster Management Agencies, which are headed by the chief ministers. States must be allowed maximum space to device their own strategies and deploy resources. The problem is currently that they have been denied the desired level of freedom of action by the Centre. The states and everyone below seem to be looking back over their heads and waiting for instructions from the top. Admittedly, the balance has already shifted towards the states in the second wave, but has it translated into jettisoning of belief systems by people who have to do the execution?

Execution of the vaccination drive and provision of medical resources like oxygen is a major task of the governing class. By all accounts, the most important part of the vaccination drive – procuring vaccines -- has been badly bungled. There is no choice but to try again, and this time pull out all stops to procure vaccines centrally and for the states to speedily vaccinate the population. Speed requires loosened checks and balances. Vaccination should be made as easy as any citizen walking up to a vaccination centre, producing an identity card and getting the jab. No rules and procedures must come in-between. Dr Devi Shetty’s suggestions and the quick approval for them by the PM to use under-training medical personnel for staffing the Indian medical infrastructure should work. The PM has bent the rules as a policy move and it is hoped that the governing class below will not invent procedures that will make it difficult and slow to implement the idea.

There are still the untapped resources of nearly 50,000 doctors who have qualified in foreign medical institutions but are not allowed to practice in India till they qualify in an Indian exam. A temporary waiver will mobilise this resource. The need is critical; it is hoped that the political class will push the governing class to act with speed because it is about saving lives.

If any state requires, the Indian armed forces must be immediately deployed to rural areas and though they may not be able to provide medical facilities required, they can make it up to a limited extent through their organisational capabilities and the human touch. The medically trained veterans of the armed forces can also be invited to volunteer and utilised to support the medical infrastructure, especially at the district level. Retired medical personnel of all other organisations, government and private, can also be requested to volunteer. A call from the prime minister and chief ministers should suffice.

Public Communication

The pervasive impact of social media in the information age has been recognised as a technological boon if it is utilised well. No doubt this medium is not fully under the control of the government. The main area of improvement required is that the government’s efforts have to be transparent and sincere. It should be specifically sensitive to prevention of panic. This domain demands a major policy shift.

This crisis will pass, like many others before it. The responsibility for leadership in a democracy will be called out through the electoral process. But in an emergency, all elements restricting the efforts toward dealing with the disaster have to be cast aside. Only if the political leadership realises this fundamental truth can India’s efforts be effective. The stakes for India are high.

(The writer is Director, Strategic Studies Programme, Takshashila Institution, Bengaluru, and former Military Adviser, National Security Council Secretariat)