Of and for the COVID and thereafter...

Smarajit Jana

After going through  all  different kinds of   policies, strategies  followed by the implementation of prevention programs and major  activities which are steered by  more than hundred countries  all  across the world  to address   COVID 19 epidemic, I sat for a while to comprehend the outcome and impact of those  National responses. Finally  I decided to  take my  stand on the side of COVID 19.I may sound like a dumb and idiot but I strongly feel  that COVID  has been unnecessarily  vindicated and has been blamed squarely for all  the ills   which has impacted   life and livelihood of millions of  human beings in the globe. When I look at in terms of loss of human life, morbidity and all different kinds of human sufferings caused due to intervention strategies adopted by the leaders and the technical experts of different countries may apparently be linked with the COVID. But if we dip down   into these issues with an open mind and unfurling underlying factors we may arrive at a different conclusion. COVID 19 has drawn anger from all corners of our society and became the victim of all kinds of jokes, criticism which to my mind is unjustifiable and unethical to the least.

 Let me clarify my stand,

1. People are dying because there are not enough ventilators in these health care facilities. Even in the so called developed countries there is not enough bed, not sufficient numbers of care givers including lack of treatment facilities.

2 COVID 19 has opened up our eyes pointing to  the fact  how fragile the health care system  is and how it operates ?It  has a revealed  insufficiency  of  these health  care facilities which are extremely limited  and are incapable of  expanding it even  in exigencies. These phenomena calls for a systematic and policy level review which can’t be resolved through short term measures or through some gimmick or theatrical performances by the leaders of these countries. Broadly speaking  it has bared open the  skeleton of the existing  health care system which   remind us the era of dark ages We have to accept that  it is the’ design effect’ of our development program and policies. We can’t expect anything better or different with the present health care system which is the by product [even not the product] of our development goals and strategies.

3. Our global view which has been created and recreated by media, academia is centring primarily on growth of capital, GDP and so on so forth. Health is the least important subject and in our country it probably stands  lowest in the hierarchy of human needs .If we compare with the minimum standard laid down by the WHO  for population doctor ration, population bed ratio etc we stand no where else. In developed countries it might be slightly better but a section of population of these countries and not all citizens are entitled to access those services. In all these countries health care providers are immensely stretched and many have lost life while providing services to ailing masses within last few weeks of time. Policy makers in Italy came up with the idea to express gratitude to health care provider through lighting lamps or clapping hand and encouraged people to do so. Which is no doubt a nice gesture but where is the commitment from the leaders to increase numbers of health care providers, increase in bed strength, medical equipments and so on so forth? This is the same populism and gimmick which all these leaders have masterminded when they face challenges. During this epidemic the rate of infection, death rate etc which we observed is based on the Hospital statistics only be it in USA, or in UK or in other countries People who are dying in their houses or in old age homes, in small nursing homes are not part of this official figure and attempts are made to present far less numbers of death than the actual figure. All different kinds of tactics are being used by leaders of both developed and developing countries.

 4. Elderly people are dying in the hospitals  because they are least protected .Our society and policy makers at large consider them as less important’ living creature’ who are disposable .We  in general  put value to  lives of those who are ‘ productive’-the mantra of development .

5. People suffering from other morbidities stands lower in the list of attention. The notion is that they have already consumed pie of the health care services so no more expenditure for them and they could be put to the back burner in all kind of exigencies. COVID intervention strategies would have been different provided we valued life of elderly and persons sufferings from co-morbidities.

6. COVID is criticized because it spreads like wild fire and moves from place to place, countries after countries in no time. As we belong to human species (we consider ourselves as the king of kings among all races) don’t like COVID’s behaviour, even though we love speed in all of our activities be it in work places, in our mode of travel and transitions, and in the process of creation and destruction of anything and everything on earth. Understandably we would hate to be compared with the behaviour of a virus, but is it not true that we have engineered the route of travel of COVID and laid down all the avenues for its rapid and smooth transmission and translocation?

7. Let’s be little clear on this issue. Slums are not created by COVID where half of cities’ population are cramped like in rats’ hole with little or no space for social or physical distancing. More than half of our countries population don’t have access to safe water to drink, forget about washing hands with soap and water which is a basic minimum requirement to maintain health and hygienic practices and to avoid all kinds of infection not just COVID? People are clamouring for not having enough masks and personnel protective devices in these rich countries. Is it not the fact that one should use mask in all the major cities with special focus to Asian countries to get protected from inhaling toxic dusts and fumes. It should have been used long before COVID arrives in the scene. Have we not accepted production of toxic fume and dusts to fulfil our development goal and strategies? We promoted this kind of unhealthy living condition and accepted it as our destiny. All these has been created and systematized by out fertile brain and selfish behaviour. Under these circumstances why to drag COVID?

8. To reduce the speed of COVID's movement and ostensibly to buy some times to expand health care facilities policy maker in many countries including ours  introduced a draconian strategy called as 'lock down' so that inevitability comes later but not now. The strategy is to spread the disease occurrences over a longer period of time so that the health care system  could be expanded to deal with rising demands for beds, ventilators, care givers etc. Apparently it sound logical but then what was the responses observed in those countries. Let’s talk about USA who could not manage to procure ventilator on time. Spain and Italy is little fortunate to get extra hands from Cuba and equipments, testing facilities etc from China. The very structural barrier in these countries made them incapable of making any significant expansion be it terms of health care facilities and human resources. So far we have seen some of these  countries has come up with Trillions and billions of Dollars or Euros as monetary package to support sagging economy.But so far we have not seen any country came up with packages or vouched for a long term investment in health sector.Surprisingly  leaders of these countries are  yet to accept their incapability to handle any epidemic.If they  continues to ignore this aspect they are bound to fail in dealing with any future  epidemic as it is   rooted in the system. It calls for a paradigm shift in our philosophy and in thinking.  

9 .It is not true that implementation of  Lock down is same or similar in  all other countries.It is much less stringent in developed countries where places of congregation [e.g. Bar, Restaurants, academic institutions etc] are closed but public transport remained open. Primarily individuals are encouraged to stay voluntarily at home .However the very approach and strategy of lock down implemented in our country put life and livelihood of millions of migrant workers and poorer sections of our society into jeopardy. They were not given time and opportunity to return home which created a huge mess and in the process social distancing, quarantine etc became a useless exercise which are part of the objective of lock down. This is the ingenuity of Indian culture or more specifically the behaviour of the privileged sections of our society who just forget that there are more than six crores of interstate migrant workers in our country. But in no way all these developments could be linked with COVID's behaviour, it’s neither communal nor biased towards any specific class, culture, occupation, religion or geography.

9. We are yet to find out any effective mechanism to combat an epidemic other than adopting four hundred years' old strategies namely quarantine, isolation and its more generalized version as the lock down approach. So what has been done since last four hundred years and where we stand at this juncture in terms of discovery and development of public health sciences? Hardly there has been any significant research work in the Public health as no one showed any interest and so no resources tagged with it. We have discovered Rader which can identify any flying object miles higher in the sky but we don’t have a system to identify a microbe when it get mutated and jumped into a new host and to project it well in advance. Our cruise missile can hit the target even circumventing obstacles on its way, but we have no basic knowledge and tools to target a virus. We spend billions of dollar to create floating home in the space but we couldn’t invest money to position human being in the complex ecosystem with an objective to make our life better and healthier. No rich country spend money on any fundamental research of public health be it to understand the natural history of disease and epidemic and we are not bothered at all. Public health science would likely to get its significance in future provide a biological warfare took place in the world.

10. The less we talk about the existence and quality of public health services [the development of which is still in the medieval age] the better.Truely speaking there is no respectability of public health science and the department of public health hardly operates as an independent entity in most of the countries and in the COVID era it is the ministry of home and its cadres are de-facto running the public health interventions. Thanks to COVID, at least it tried to open up our eyes. However our eyes can’t see these things as our minds are not open to see it. We can’t even fathom the miserable states of public health scenario globally. My take is that finding a hapless COVID in place our great politicians would be able to divert us from the bigger picture.

11. We love to swung with all kinds of  jargons and slogans of war and from culture of militaristic approaches which has been mindlessly copied in public health program's vocabulary e.g. war or fight against xyz, disease elimination, eradication etc. We in the process tend to ignore rules and policies, [not even inclined to learn laws of nature] which govern the ecosystem. It is our epitaph of arrogance [which is primarily based on our ignorance] which prompts us to develop public health policies and program in the mindset of war and destruction. Secondly it does create a war like situation which helps policymakers to bring new laws or invoke age old punitive laws, policies in the name of public health intervention. Based on these laws and policies people could be thrashed, forcefully incarcerated, including imprisonment for the  slightest violation of the ‘daktat’ legislated and implemented from the top and all kinds of human sufferings ,beating ,killing etc thus could be justified on ground of epidemic control.

12. How COVID could be made responsible for the lockdown strategy and for all the lateral damages brought out through this imposition? Putting a huge lock on the front door and keeping all the windows and holes opens in a dilapidated building hardly could bring the desired outcome of lock down. Perhaps this was not unknown to the policy makers before. They knew that this would help them to come out with ample excuses for the failure. Later people would be blamed squarely for their bad behaviour and the policymakers would be transformed into a Great War hero.

So long we are reluctant to free our conscience from the lock up condition, any kinds of stricter lock down and for any duration of time are unlikely to bring respite to human sufferings. But for God’s sake Pl don’t blame COVID.Enough if enough.

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Frontier
Apr 27, 2020