I hardly know a family that has not had Covid-19. There is hardly an extended family that has not witnessed death or suffered from its after-effects or due to the unavailability of critical medical care. It is the severity and reach of the disease that makes it a pandemic.
But there is another side to this which is positive and not being reported because death is big news and recovery is not. More than 85 percent of people recover without hospitalization and it is only the 5 percent or so which needs critical hospital care. While I have heard news of the deaths of friends and associates, I have also heard news about entire families recovering very fast.
But the larger debate in the country is not about recovery or death: it is about who should be blamed for the pandemic. Very few are talking about China and the possibility that the virus has been unleashed to weaken India. A pertinent question to ask would be why countries similarly or worse placed such as Pakistan and Bangladesh have not reported the same severity. Have people there become very disciplined or has the health infrastructure there become better than India? This is something inexplicable.
When we are too emotional, particularly when we are deep in sorrow, our critical faculty refuses to work. We try to apportion the blame for death. Was it our inability to get a hospital bed or oxygen cylinder that led to death? Who is responsible for this? Surely the chief ministers, who are caretakers of health infrastructure in their respective states, can’t be responsible. They have done a splendid job by crying and trying to do politics and express their helplessness. A chief minister even said that he can’t reach every person and it was the responsibility of the residents of the state to save the state. No one found it objectionable.
People cried for oxygen and the chief ministers cried too, trying to blame the Union Government. There surely must be one person who is not allowing them to work for the welfare of people. To them it is the failure of the Central Government to provide oxygen to the states. However, when asked to explain why different states have performed differently, they have no answer.
So, the blame must lie with Prime Minister Narendra Modi. Why is he not crying in a country where talking is taken as acting, where bravado is seen as a sign of leadership? His critics are attacking with vengeance and creating optics that the pandemic has happened due to him and due to his inability to tackle the situation. Why did he address election rallies? Why did he allow the Kumbh Mela? Why did he not impose a nationwide lockdown like last time? Most attacks hover around these issues. Let us try to understand what the Prime Minister has been doing when the chief ministers were crying and doing politics.
Here is a prime minister who tries to work silently when a crisis comes and does not react to political statements since this is not the time to take the bull by the horns. He focuses on channelising his energy into finding solutions and works with double speed. If he also becomes a crybaby like the others, who will come up with a solution? I would not have defended him since the person who is the best speaker in the country does not need a minion like me to defend him. But I am angry. Angry that we seem to be losing our critical faculty. Facts and logic work no more.
Modi’s critics have been trying to systematically destroy him by painting a negative image. But he has come out with flying colours every time. This is because he believes in the philosophy of nishkaam karm (selfless work) and stithpragya (to stay steadfast in every situation)—the two ideals suggested by Lord Krishna in The Bhagwad Gita for a karmyogi. But we must ponder, are we doing the right thing by targeting a man without even a shade of civility? Society should not become so ungrateful. We should not crucify our saviour every time. We should learn from mistakes.
This pandemic has exposed the failure of our health infrastructure to give it an adequate response. First, nobody in the world had expected that the second wave would be so pervasive. Everyone thought this would be less severe. Can we blame Modi for this? The Supreme Court while asking the government to pull up its socks on fixing the oxygen supply also gave a tongue-in-cheek statement that should not be missed. The observation came on 30 April 2021. The Court held, “… the healthcare infrastructure inherited over the past 70 years was not sufficient and the situation was grim.” Can we blame the Prime Minister for this? In fact, he has brought the best healthcare facilities within the reach of the poor by enabling them to get best treatment under the Ayushmaan Bharat scheme. Till the time we have super-speciality hospitals in every district, let people not suffer.
We should not forget that till Atal Bihari Vajpayee became the Prime Minister, there was only one AIIMS that had been set up in 1952. It was Vajpayee who decided to open six AIIMS, one each in the states that did not have good medical facilities such as Madhya Pradesh (in Bhopal), Odisha (Bhubaneshwar), Rajasthan (Jodhpur), Bihar (Patna), Chhattisgarh (Raipur) and Uttarakhand (Rishikesh). Learning from Vajpayee, Dr Manomohan Singh as Prime Minister opened one AIIMS in Uttar Pradesh at Rae Bareli in 2013. When Narendra Modi came to power he decided to open 14 AIIMS to cover the entire country. Every state should have a centre of medical excellence so that they don’t have to rush to Delhi. His vision has been that the problems of a country of India’s size needs addressal on a big scale and a piecemeal approach would not work.
The Modi government has decided to open 157 medical colleges across the country, something that was never thought of. And the government is not withdrawing from the health sector. The number of government medical colleges would be more than those in the private sector. There were 215 private medical colleges and 189 government colleges in 2014-15. In 2019 there were 279 government colleges and 260 private colleges. The vision is to have at least one super-speciality hospital in every district.
Have we ever thought that there is a huge shortage of MBBS graduates and specialists in this country? There were only 50,000 medical seats in the country till 2014. In the last six years, 30,000 additional seats have been added, besides 24,000 postgraduate seats to promote specialization and excellence. A question needs to be asked here: why was this not thought of earlier?
The doctor-population ratio in India is 1:1456 against the WHO recommendation of 1:1000. This is just a statistical average. The situation is abysmal in some states. Bihar has one doctor for 28,392 people, followed by Uttar Pradesh (19,962), Jharkhand (18,518) and others. Even the national capital has one doctor for 2203 people, which is almost double the number in the WHO norms. According to a study by the Medical Council of India, Jharkhand would take 87 years at the present rate to reach the WHO norm.
People would say it is not a big deal. That is the reason he was brought as the Prime Minister. One can’t disagree with this. Now let us look at the short-term measures taken for or immediate response given to the pandemic. During the first wave of Covid-19, the Prime Minister imposed a nationwide lockdown since he knew that the country was not prepared to face the crisis. His strategy paid off even as our economy slid to an unimaginable point. But the time was used to ramp up medical infrastructure and the pandemic was contained. His decision was criticised by many states that said it was unconstitutional and the states should have been given the liberty to devise their own strategies, that the Centre should limit itself to sending advisories or sharing knowledge, and that since the pandemic had differing extents and severity in different states, they should have had strategy that suited them.
So, when the country had enough PPE kits, sanitizers, gloves, masks and inoculated medical and paramedical staff, the states could be trusted with taking care of the crisis. Many leaders had opined that a national lockdown was not the right solution when most states had opted to go for their own versions of lockdowns.
On four occasions, the Union Government sent missives to the states saying that the second wave was coming and they needed to follow Covid protocol strictly. The Centre had written a letter to four states—Maharashtra, Kerala, Chhattisgarh and West Bengal—in January 2021, asking them to take precautions and warning them about impending danger. On 21 February, the Centre wrote again, asking them to increase the number of Rapid Antigen tests and RT-PCR tests and impose strict and comprehensive surveillance. At that time, more than 74 percent cases were from Kerala and Maharashtra, and Madhya Pradesh and Chhattisgarh had also witnessed a spike. On 25 February, the Cabinet Secretary had a review meeting with seven states that had witnessed a spike—Maharashtra, Kerala, Punjab, Madhya Pradesh, Tamil Nadu, Gujarat and Chhattisgarh. On 27 February, the Cabinet Secretary had a review meeting with Telangana, Maharashtra, Chhattisgarh, Madhya Pradesh, Gujarat, Punjab, Jammu and Kashmir, and West Bengal. These states were advised not to lower their guards, enforce Covid-appropriate behaviour and also deal firmly with violations. Many such meetings took place, showing that the Centre was aware and that it kept asking states to prepare themselves. The Prime Minister held 28 meetings in April-May on how to deal with Covid-19.
The Central Government also told the Supreme Court on 30 April that it had been urging states to prepare for a second wave of Covid-19. The states, however, had not updated their data even after constant persuasion. It stated in an affidavit that it had asked states to prepare a district-wise estimate of beds and capacities in Covid care facilities, based on the trends of infection growth. Had the states followed the projection tool created by the Central Government and ramped up medical infrastructure, the situation would have been different, the Centre said.
On the supply of medical oxygen, the Centre said that of the total requirement of 8462 MT, 22 high-burdened states were already allocated 8410 MT. Also, the Centre was augmenting oxygen on a war footing such as it had already floated a short-term global tender on 16 April for the import of 50,000 MT of medical oxygen. Besides these, 551 PSA oxygen plans are being set up at district hospitals. This is apart from the 500 PSA plants being set up by the DRDO to augment oxygen availability. The signal-free Railway Oxygen Express is also running to ensure the supply of oxygen to needy states. The PM CARES fund has also been used to purchase 1 lakh portable oxygen concentrators and set up Covid hospitals in states, besides spurring the vaccination drive. The Prime Minister has reviewed the progress of converting nitrogen plants to oxygen plants and the process is underway in 14 industries. Further, 37 nitrogen plants have been also identified for conversion this way.
The Centre has also airlifted oxygen tankers from Germany, the UAE, Singapore and other countries using the Indian Air Force to meet the demand for cryogenic tankers for the supply of oxygen. As a part of Operation Samudra Setu II, seven Indian Naval ships—Kolkata, Kochi, Talwar, Tabar, Trikand, Jalashwa and Airavat—have been deployed for the shipment of liquid medical oxygen-filled cryogenic containers and associated medical equipment from various countries. The Army has opened its hospitals to civilians and paramilitary forces are running Covid care centres in various states. The Railways have provided 70,000 Covid care beds across the country and opened Railways hospitals for non-Railways patients. Leading industrialists have also diverted their industrial oxygen for medical needs.
The Prime Minister is the one who stressed the need to vaccinate people. Target groups were identified and allocation made for the vaccination drive. But our leaders politicised the vaccine as well, calling it a “BJP vaccine”. It appeared that they were playing at the behest of forces keen to weaken India. Crucial time was lost. A lot of politics was played regarding the price of the vaccines as if the government was making money out of it. The crucial factor is the reach of the vaccine and not the pricing. While the poor need to be given it for free, those who can afford it must pay to lessen the burden on the exchequer. Hopefully, now the states would go for faster vaccination. Those who can afford can take it from private hospitals as well.
Some critics also made a lot of fuss when India was supplying vaccines to the world for their critical needs such as the vaccination of their healthcare workers. This was not being done at the cost of citizens but as per protocol. India’s efforts have been appreciated the world over. Now that India is in need, the entire world is trying to help us. It is not without reason that French President Emmanuel Macron said that India does not need to listen to lectures from people on vaccine availability. India has helped many countries in making vaccines available and thus helped humanity. Prime Minister Modi’s appeal to countries of the European Union that the TRIPS waiver be given for vaccinating the entire globe without thinking of earning profits has been taken positively.
Enhancing vaccine production capabilities and giving vaccines to all in India and also the world has been the country’s priority. The Prime Minister is working for that. The government has already ordered 160 million doses of vaccine that would take care of things till July. The Centre has allowed states to procure vaccines directly from private players too. Since the Centre has decided to give the vaccine free to target groups and people above 45 years, 50 percent of the vaccines would go to the Centre and 50 per cent to states or private players. Subject to import licensing and approval by regulatory authority, private players can import vaccines. These importers can supply vaccines to states or private players. Sputnik V is going to be the first vaccine available in the private market. Dr Reddy’s Laboratory is already raring to go.
Why did the Prime Minister participate in elections? He could have said no. Is this a fair proposition? The Election Commission conducts elections and the Union Government provides the means and resources to conduct elections including paramilitary forces. When the Election Commission was reportedly toying with the idea of postponing elections in Bihar, every party had opposed and wanted immediate elections. That had also taken place when Covid was surging. The same was the norm this time. Nobody had problems with other parties or their leaders campaigning but critics had problems with the Prime Minister. You don’t create a different norm for the PM. And he did cancel his meetings towards the last legs of campaigning in West Bengal. BJP leaders including Modi and Union Home Minister Amit Shah cancelled all their election visits to the poll-bound state of West Bengal.
Why was Kumbh Mela allowed to take place in Haridwar? This could have been cancelled. It was for the state government to decide whether it was feasible to organise such a large mela and yet follow the Covid protocol. The Union Health Secretary had written to the Chief Secretary of Uttarakhand on 21 March expressing concerns on the Kumbh Mela. The Union had warned the state about a surge in cases as people from affected states would also reach the mela. The state was also told that the daily testing numbers reported in Haridwar (i.e., 50,000 Rapid Antigen tests and 5,000 RT-PCR tests) were not enough and they must be increased as per ICMR guidelines. Strict quarantine and treatment were suggested for affected people. The state government had already shortened the Kumbh Mela from a four-month event to just one month (January-April to just April) in view of the adverse situation. But the decision proved to be a bad one. The Prime Minister did appeal to people and seers to make the mela symbolic.
Because of space constraints, I have focused largely on what the Prime Minister has done and how unfair we have been to his efforts. In the next, if needed, I would write how various chief ministers have failed their respective states.