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Institutional preparedness for a Pandemic

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pandemic

By Prof Amita Singh

On 11th March World Health Organization (WHO) declared Covid-19 as a pandemic. Would a pandemic of Covid-19 qualify for a disaster? If yes then the National Disaster Management Authority (NDMA) has many responsibilities as per the national commitment to Hyogo Declaration and the Sendai Framework. If it’s a health crisis then the Directorate General of Health Services (DGHS) ought to give an informed leadership to health infrastructural requirements to affected people. But if it’s a biological disaster, NDMA should have coordinated not just with DGHS but with research institutions studying the pathogenesis of the virus, epidemiologists, state, and local governance institutions. Institutional preparedness is a key requirement to prevent Covid-19  transmission.

A meticulous document of NDMA, ‘2008 Guidelines for the Management of Biological Disasters’   is available as a lighthouse to a disaster manager. In the opening message, the Vice-Chairman NDMA writes, ‘The specter of pandemics engulfing our subcontinent and beyond poses new challenges to the skill and capacities of the government and society’. The document also foresaw that the fear of biological disasters is obvious and close but more dangerous is  the possibility of  a deliberate introduction of plant or animal pathogen with the intent of undermining socio-economic stability.’ The Guidelines contain bulleted points on infrastructural requirements, Equipping medical first responders (MFR), the Quick Reaction Medical Teams (QRMT), up-gradation of hospitals, socio-psychological-mental health care, and tele-health.

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Many questions perplexed the government before it announced a countrywide lockdown on 24th March.  So, during the crisis period, one finds that many players nevertheless remained ill-coordinated, frantic, and knee-jerking despite Cabinet Secretary emerging soon with advisories and notices to save the sinking ship of implementation. However, Covid-19 provided a great opportunity to revitalize both NDMA and also the DGHS.  NDMA Guidelines 2008 presented an important need for preparedness strategic planning and bringing together pieces of scattered information of virus pathogenesis and drug prophylaxis to supply a potent method to prevent a biological disaster. Notwithstanding the pandemic, Covid-19 is a siren call to the world as it steps into an era of biological disasters. However, when such a disaster comes both the institutional information and the legal frameworks become less important.

Most governments across the world were in denial and did not wish to declare a complete lockdown even though the news from Wuhan in China was loud and clear on the lethal coronavirus by January. On 30th Jan the first case of Covid-19  was diagnosed in India and the speed grew with every coming day. The National Disaster Management Authority headed by the Prime Minister and the Directorate General of Health Services let the anxious February pass by. The Indian Council of Medical Research (ICMR) had information from the WHO that this coronavirus was deadlier and more unpredictable than the Severe Acute Respiratory Syndrome of 2003 (SARS-CoV) or the Middle East Respiratory Syndrome of 2012 (MERS-CoV) but the only effort which could be seen was at the airports where thermal screening had started for passengers from China, Thailand, Singapore, Nepal, Hong Kong, Malaysia, and Indonesia since late January. Why no action was taken outside the airports for almost two months and then the lockdown was announced shutting 1.3 b people inside. Even though on 4th March the government had announced a ‘cluster approach to be adopted for sensitizing and checking the spread of the virus  within 3 Km radius. The pro-active role of NDMA was expected but did not take place. A High-level Group of Ministers reviewed current status, actions for the prevention and management of COVID-19 (16th Mar)under the leadership of the Health Minister during which a comprehensive advisory on Social Distancing was also issued.

It is often argued that the lockdown came at a time when the infection rate was a mere 1.7% as compared to most other western countries and the case-fatality ratio was even lower than the SARS of 2003. If this was true then the nationwide lockdown should have brought very good containment results but the cases continued to spike irrespective of the lockdown. It was then that the ICMR pushed more testing to bring out more cases for treatment. Gradually the need for PPEs, Coveralls, availability of medical kits, foods, Public distribution System(PDS), masks, and other essentials was also overcome but there was no discussion on education, children, migrant labor and alternative options in rural areas.

Corona - Kapil 1

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On 29th March an Order from the Ministry of Home Affairs restricted the movement of migrants and imposed strict enforcement of lockdown measures. As a result of information blockages around an estimated 23 million migrant labor fled the big cities towards their villages. They were so scared to witness how this strange pandemic was being talked about on news channels and the social media that for them staying back in cities appeared an imminent death. However, by obstructing their movement at every state, not providing them transportation support and on top of it spraying disinfectants over them only suggested a deep disregard for human life and dignity. This was an avoidable crisis as given to the country’s best trained National Disaster Response Force, the management of this situation would have been much simpler. The planned evacuation of 5,80,000 Indians stranded abroad through Vande Bharat and Samudra Setu missions suggests that better ways are available with planning.

Covid-19 also allowed the government to go beyond the Disaster Management Act 2005. The Cabinet Secretary invoked Section 2(d) of the Disaster Management Act 2005 but the government went further to also invoke Section 2A of the Epidemic Disease Act (EDA) of 1897. This 123-year-old draconian Epidemic Disease Act (EDA) which was first invoked to prevent the spread of bubonic plague in 1897 was revived after a century. The Central Government found itself safer and stronger with this archaic law to prevent disease transmission as it empowers the government under section (3) where disobedience to any regulation or order made under the EDA shall be deemed to have committed an offence punishable under section 188 of the Indian Penal Code (45 of 1860) which could be both an imprisonment or a cash penalty. So, every order promulgated by a public servant be obeyed as any act to the contrary would be treated as harm and a cause of a riot. A more stringent measure comes under Section (4) which protects persons acting under the Act. No suit or legal proceedings shall lie against any person for anything done in good faith intended to be done under the Act. The strong and violent community reactions to medico-policing in many parts of the country reflected a lack of dialogue that NDMA should have taken up with State and District agencies much in advance.

Institutional preparedness is key to preventing any disaster but institutional seriousness towards assigned responsibilities is much reduced. This is an outcome of an administrative ethos that a government generates for an administrator to initiate measures rather than his incompetence. An ambitious coordinator, a passionate implementer, and an innovative decision-maker in administrative services are rather not trusted. Ironically preparedness is an architecture that is built by a visionary administrator who has a holistic and all-encompassing plan to design advance defences. The government should identify, encourage, and mainstream such experienced administrators who would look at a disaster not just as an environmental and administrative challenge alone. While a disaster is a multifaceted blow to the economy, employment, and social ethos of a nation it nevertheless is an opportunity to assess one’s capacity, capability, and resilience. It’s the best time to bring health sector reforms and to revisit the role and responsibilities of NDMA.


amitaAmita Singh is Professor of Administrative Reforms and Emergency Governance at JNU. She is a specialist in Political Theory and Public Administration. Prof Amita has advanced her research into environmental policy and administrative reforms. The views expressed are her own

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Read More: https://taazakhabarnews.com/prof-amita-singh/

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