Masking the costs, sanitizing safety: The Covid-19 story of India

As the world community gets a handle on dealing with the Covid-19 pandemic, there have been a series of guideline revisions from the World Health Organization (WHO) to Indian Council of Medical Research (ICMR) along with Central and state governments in dealing with this disease.

This has led to multiple testings, unnecessary costs for the common man, pressure on medical services and politics at the cost of saving lives. The economy has taken a hit, which is being buffered with various packages rolled out by the Central government to support the poor and vulnerable groups.

Thus, the question that comes to mind is, are the government agencies not in sync with each other and if not, why?

<strong>Making hay while the sun shines</strong>
According to the ICMR, anyone not showing symptoms or is asymptomatic, does not need to undergo a Covid-19 test. Those who display mild symptoms and not having any existing medical conditions are also being advised to stay home, in a bid to relieve the already stressed out medical services.
Even the Ministry of Health and Family Welfare (MoHFW) has issued circulars in treating patients with and without Covid-19 and ensuring there is no transmission within the medical premises. But further down at the hospital level, there seems to be a nexus in admitting patients for a mere cough and cold, which ends up hurting the pockets of the common citizen.

To top it off, various testing centres have their own methodology in testing potential patients. Many of these testing centres now boast of Covid-19 tests, the results of which can be determined in a matter of a few hours. Normally, even a simple blood test report would take anywhere between 6-10 hours, yet these testing centres hand out results within the hour. Most of these tests come out negative; however, there is no confirmation whether such results are valid, thus causing more harm.

The Indian Government has been proactive in curbing costs and investigating nefarious testing centres. In Noida many unaccredited testing centres were brought to task for their illegal actions. For patients who tested positive, private hospitals would charge anywhere between Rs one-two lakhs for testing and treatment. Taking cognizance of this issue, the government directed hospitals to restrict charges up to Rs 15,000 a day.

<strong>Listen to WHO?</strong>
WHO Director General Tedros Adhanom Ghebreyesus has been under fire for declaring the novel coronavirus as a pandemic much later than usual. The first ‘non-physician’ president of this multilateral health organisation, Tedros’ appointment has been opaque with many criticising his connection with an authoritarian government when he was running for the leadership.

The Trump administration is not alone in its criticism on how Tedros deals with autocratic leaders. In October 2017, Tedros appointed Zimbabwe’s then-president, Robert Mugabe, as a WHO goodwill ambassador, a decision he later reversed following global outcry.

Critics have also questioned whether WHO is independent, especially when Tedros praised China’s handling and response in dealing with the coronavirus pandemic and quoting the Chinese in January 2020 that there was “no clear evidence” of human-to-human transmission of the disease.

Along with this, WHO’s public response has been confusing to say the least. It did not initiate protective measures early in the pandemic, nor did it declare the coronavirus as a public health emergency in time. It was only when countries like the USA, Italy and the UK witnessed a rising number of cases, did they announce the crisis as a pandemic.

More recently, with global scientists collaborating and rushing to find a vaccine to help immunise people against this disease, Tedros said “there is no silver bullet…and there might never be”, leaving the masses feeling more helpless than ever.

<strong>Masks and sanitizers</strong>
According to reports, the hand sanitizer market is expected to grow at an annual compound rate of 22% until 2027, while the global medical face mask industry is expected to reach a staggering volume of over 52 billion units by the end of 2020 due to the eruption of the Covid-19 pandemic.

Moreover, the global disposable face mask market is expected to grow at a compound annual growth rate of 53.0% from 2019 to 2027 to reach $23.8 billion by 2027, mainly driven by demands from India and China.

This has also led to various brands retailing face masks as a fashion accessory. As Sabysachi Mukherjee said at the India Today Corona Conclave, “We are talking about a health crisis and I hope we don't put privilege on things that are essential for health."

However, privileges are being put into use of such basic commodities. In a recent conversation with an Uber driver, he stressed about the pay cuts and additional costs levied by the company. He said: “the company says they are giving these sanitizer sprays for free but it is actually getting a cut from our commission.”

<strong>Mixed messages</strong>
When it comes to implementation of norms to protect oneself, every medical body, be it government agencies or private health experts, harp the same tune. Yet, some states have decided to form their own policies in dealing with this crisis.

Take Bengal for example. Chief Minister, Mamata Banerjee’s approach has been confusing at best. From keeping the <em>misti dokan</em> (sweet shop) open, allowing movement of trucks for flower sellers and using an odd-even formula for street vendors, it seems business as usual. A friend living in the border area near Nepal in Bengal discussed how people are still flocking to the <em>puchka</em> stall having an <em>adda</em> and not even following the simplest rule: wearing a mask and maintaining physical distance.

Bengal is not alone. Maharashtra, Delhi, Karnataka—to name a few, have been struggling to flatten the curve.

The problem arises out of their inherent need to make additional rules that defy common sense. Each state is responsible in curbing the spread of the novel coronavirus, yet, the ones which are most affected are the ones where there is no synergy between the state and the Central government.

Unnecessary travel restrictions are imposed by various state governments from visiting another state. Yet, there is no clear guideline for a traveller who has visited a state blacklisted versus another non-blacklisted state. For instance, if one wishes to visit Delhi from Bengal, there is no restriction, however, there is restriction for visitors from Delhi. The state government fails to tackle those travellers who might stop over at Lucknow before heading to Kolkata.

<strong>India’s clear message</strong>
The official government line from New Delhi has been clear: encourage work from home, allow online retailers to ply their goods, let India Inc establish its own routine, wear masks, use sanitizers, wash hands with soap and maintain physical distancing.

In a recent meeting with chief ministers from Bengal, Uttar Pradesh, Andhra Pradesh and Maharashtra, Prime Minister Narendra Modi stated that if the top ten affected states can beat this virus, India will recover. Notably, with the implementation of test, track and trace methodology, Delhi has witnessed an improved rate of recovery at over 90 per cent.

Along with this, there has been quick action in implementing a national lockdown, curbing profiteering by health operators, action against illegal testing centres and constant dissemination of updates about Covid-19. In all of this, India’s total recovered cases are more than active cases, with the fatality rate lowest since the first lockdown at 2.10% compared to the global average.

Travel restrictions have eased, with the final call kept with airlines, while the Directorate General of Civil Aviation has capped ticket prices accordingly.

India is not out of the woods yet, however, by joining the coalition of the willing in finding a vaccine, the country has stepped up its game in tackling the deadly virus. The country of a billion plus cannot be assessed in binary terms and the same is true of the government’s response in tackling the crisis. What India still needs is willing states and rival political parties working in unison with the Centre in flattening the curve..