Lockdown: Epidemiological tool or political weapon?

Satya Ray

Our time stands frozen in the unprecedented lockdown which has hitherto been unknown in the lexicon of epidemiology. The limitation of free movement of healthy individuals to prevent their contact with the affected ones within a defined space and time is known as quarantine. It existed for a pretty long time before “it has become outdated and replaced by active surveillance” [1] over last few decades. “And quarantine is one of the oldest powers in the book. The closing off of towns, land-border restrictions and networks of isolation hospitals have their origins in responses to the Black Death in 14th-century Italy.” says Graham Monney [2], Assoc, prof. of Jhons Hopkins University’s institute of History of Medicine and Epidemiology. However, many governments including ours, has taken cue from the joint China WHO mission report endorsing “perhaps the most ambitious, agile and aggressive disease containment effort(lockdown) in history”. The report refers to the severe form of lockdown that went on for 76 days in the Wuhan city. Our govt embraced the most aggressive part of it and eschewed the most pivotal strategy of extensive testing at community level ensuring early diagnosis and active intervention. Without any concerted effort to reach out to the community in order to diagnose, treat and contain the disease, the lockdown remains a blunt method to control the epidemic and recent experiences show that it can well be a political weapon under coercive and authoritarian rule. This is precisely the reason why prof. Monney goes on to say “quarantine is also one of the most draconian measures that states can wield in the name of public safety.” The duration of quarantine can never be longer than the longest period of incubation which is 2-14 days (24 days is an outlier observation) in case of COVID 19. Currently, we are passing through a lockdown which will presumably end on 40th day. It goes without saying that so called lockdown far exceeds the perils of quarantine so far as the human suffering and economic disruption is concerned.

Now let us examine the politics and ideas that shape the epidemiological approach both in the past and present. In 1848, the upper Silesia of present-day Poland was ravaged by typhus epidemic. Dr. Rudolf Virchow, a German doctor and scientist investigated it and wrote a report which is still regarded as classic and first ever systematic epidemiological research work. He was the
pioneer in the field of social medicine and public health. He argued that the causes of deadly epidemics are mostly rooted in the social
and economic inequality. He said “Medicine is a social science and politics is in larger meaning the medicine of society.” When waves of revolutions rocked the west Europe, Dr. Virchow enriched medical science with a new consciousness consistent with revolution and propounded his theory on epidemiology. Therefore, the history of epidemiology had its origin in a politics which was revolutionary and humanist. Salvador Allende, a Chilean pathologist and socialist, was an ardent follower of Dr Virchow. Later Allende was assassinated in a US backed coup-de -tat, when he was the president of Chile.  Chile under Allende was the first Latin American country that guaranteed health as a fundamental right. Other countries like Bolivia, Venezuela and Cuba followed suit.

Due to the presence of a robust public health infrastructure coupled with rigorous and spirited training in community medicine Cuba has been not only successfully tackling the spread of corona virus, they are reaching out to Italy, Bolivia, Haiti in their hour of crisis. They have mobilized  in massive number of doctors, nurse, health workers, third, fourth and fifth year medical students who are going door to door to record their history, screen the susceptible people by ‘on the spot’ tests and send the confirmed cases to the regional tropical medical care centre. With the cruelest embargo on shipment of oil and other essential goods imposed by US existing for more than six decades, Cuban people have been undergoing terrible hardship, but they refused to back down. Even in the presence of acute power shortage they are ramping up the production of interleukin 2B which is one of the mainstays of

treatment of seriously ill covid patients. Apart from sending doctors and nurses to the worst affected area of Italy, they have sent the message of humanity and international solidarity by allowing a British cruise ship with 6 covid patients on board to dock in their territory. The passengers of the ship were stranded in the water of Caribbean island after having been refused to disembark by many countries including USA.

While Cuba stands apart as a shining example, the rich capitalist countries are grappling with corona crisis leading to dismal performance and disastrous outcomes. They appear  clueless in their shoddy effort to contain the contagion. The top-heavy health system mostly profit driven and providing state-of-the art facilities to those who can afford appear to have been collapsed simply because the situation called for community diagnosis and intervention at community level alongside tertiary care for the acutely ill patients.

Inspite of being a much smaller economy Vietnam has been manufacturing rapid test kits for covid 19 on their own and it’s ratio of test to positive cases is 100:1 while a country like India with more resources and technological know-how are still groping in the darkness so far as the availability and accessibility of rapid test is concerned.

 In our own country, Kerala has set an example of suceesfully tackling not only the present menace of corona, they did the same earlier in case of Nipa virus epidemic. Relatively more coherent, focussed and better equipped public health infrastructure have enabled them to achieve this feat.

Pain and agony of lockdown stretching over umpteen number of days do not end in its myopic planning and clumsy execution. It derails the economy and hurts the democratic functioning of the society at a deeper level. The politics and idea behind such a crude method of halting the pandemic is appalling. The real intent of enforcing a sweeping measure under the cover of covid 19 can be understood by taking a closer look at the following events taking place in different corners of the world.

Almost all the strong men at the helm of their countries have used the metaphor of war while invoking lockdown and restrictive laws pertaining to it. The pliant media acted as indefatigueable cheer-leaders.

Hostility and disdain for scientific temper, humanity and welfarist slant of state of leaders like Donald Trump of USA, Andre Manuel Lopez Obrador of Mexico, Netanyahu of Israel and Jair Bolsonaro of Brazil are well-known.

 Up till the middle of March of this year, their official and embedded media have downplayed the threat of corona. Fox news has squarely blamed the democrats for raising much ado about nothing. In Serbia and Turkey the pro-govt. media claimed that their community is endowed with genetic make-up giving them innate immunity against corona infection. But as the pandora’s box opened up, the strongmen invoked sweeping power purportedly to fight corona. But it has transpired that they were more keen to further consolidate their authoritarian rule.

In Hungary, the govt. led by Victor Orban, under the pretext of protecting from Corona, has suspended all the existing laws and started to rule by decree. Curbing all the parliamentary functions he introduced new draconian law empowering his regime to impose hefty fine or even five years imprisonment for spreading fake news. Curiously, the rulers world over whose official and lapdog media  have mastered the craft of disseminating most vicious fake news are prone to invoke most stringent laws (purportedly to stamp out fake news) to target the dissident citizens and independent media.

In Israel, the prime minister Benjamin Netanyahu has again assumed the power through the revolving door. Under the pretext of fighting an emergency in the time of corona virus, he roped in Mr Gantz to join his govt.pre empting the formation of a coalition govt. Citing national emergency , he suspended the parliament, postponed his corruption trial and gave extra ordinary power to the intelligence agency to carry out most intrusive domestic surveillance.

In Serbia the national election was postponed and freedom of assembly was severely restricted. In Poland the ruling Law and justice party is bent on holding the coming national election in the presence of severe restriction on political activities. French president Macron gave clarion call “We are at war.” It gave him an unexpected opportunity to immobilise the die-hard street protestors under blanket restriction of movement.

In USA, the justice department directed the Congress to promulgate new law giving the authority sweeping power to detain the asylum seekers without trial and strip them of any kind of legal safeguard. However, they had to back out in the face of stiff opposition from democrats. Britain is known for its strong democratic institutions. The Corona virus bill was rammed through the parliament. This piece of legislation is so much repressive in nature that the critics have called it Henry VIII power. It gave the authority unbridled power to detain and isolate people indefinitely, ban public assembly and shutdown ports.

If we turn our eyes to the Latin American countries, the lockdown on people’s movement, public gathering and protest appears even more repressive. In the months preceding the emergence of corona scourge, the streets of Santiago witnessed the army tanks rolling
out to put down the protestors. Now Chilean govt has declared a state of catastrophy and brought the streets permanently under the control of army.  The new found weapon called lockdown has become handy in suppressing the dissidents and political oppositions in other latin American countries like Bolivia, Brazil. The Asian authoritarian rulers of Philipines, Thailand and the dictators of middle east are no exception in using the new found weapon called lockdown.

In our own country, we have seen how the dissident writer, academic, the activists and organisers of anti CAA and anti NRC movement were targeted and put behind bars under the cover of lockdown. Regressive labour laws are being introduced to increase the working hours to12 hours with the wages remaining the same.   During the period of lockdown the people who are daily wage earners had to bear the maximum brunt. Many of them are left with no job, no money, no shelter let alone the protective shield from coronavirus. The health infrastructure barring a few oasis of ultra modern hospitals within the confines of big cities, which has already been in tatters, is now mindlessly focused on a single point agenda. A good number of people seeking treatment of maladies other than corona, both in govt. and private set-up are being denied treatment due to a toxic mix of lockdown, unreasonable fear and lop-sided health strategy. If the present multi dimensional crisis compounded by painfully prolonged lockdown remains unabated, economically and socially disadvantaged sections of the masses will face an existential crisis not due to a killer virus but due to a most bitter and lethal pill called lockdown. We do not know whether the word lockdown will get a mention in the parlance of future preventive and social medicine, but we have enough reason to believe that it will remain a chosen word in the playbook of authoritarian rulers.  

References:
1. Text Book of Preventive Medicine, K Park, 15 th Ed, pg 98
2. Graham Monney, the author of Intrusive Interventions: Public Health, Domestic Space and Infectious Disease Surveillance in England 1840-1914.

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Frontier
Apr 29, 2020