How To Prevent Another Devastating Wave In The Land Of A Million Mutinies

The worst of the second wave of Covid-19 in India seems to be over. The number of daily positive cases peaked on 6 May.

The curve of active cases is finally flat after peaking on 9 May and is now moving downwards thanks to more recoveries than positives in the past one week.

Demand for life-saving medical oxygen has stabilised and is declining in some major hotspots like the national capital.

While we need to stay vigilant, all indicators are pointing towards things returning to normalcy after a month of serious battering.

Going forward, one expects three things. First, vaccine hesitancy will be much less even in rural areas which have been hit the hardest this time.

Second, people will not underestimate the virus anymore and lower their guard as they did after witnessing low caseload and deaths in the first wave.

Third, and this is more of a hope, the governments will ensure that there is mask compliance and social distancing measures are not violated with impunity in addition to ramping up medical infrastructure to prepare for even a bigger third wave.

While these factors should help us prepare better for the future, these may not be enough to protect us fully from new virus strains. Significant mutations may pose a challenge even in societies where the majority of the population is fully vaccinated.

Going further, the governments are likely to overreact to any sudden spikes in cases even if they may not be as destructive as the past waves for the simple reason that politicians can’t afford to appear carefree.

This is especially true in democratic societies and more so in India where elections are always around the corner.

So, what’s the ideal way forward which Indians should follow for the foreseeable future, until we are absolutely sure that the pandemic is over for good?

We need to think about fundamentally remaking public life with an assumption that virus outbreaks of different kinds (natural or weaponised) leading to pandemics may be the new normal.

The suggestions are thus naturally given keeping both the long-term and short-term in mind.

First, there should be a complete ban on superspreaders — events or people. We know the virus infections are fat-tailed i.e. overwhelming majority of the infections are caused by very few events or people.

First, the events. There should be tough restrictions on large congregations — protests, rallies, crowds in cricket matches, religious festivals, public transport (with caveats because we can’t really survive without it thanks to policies that have led to overreliance on this) etc.

Campaigns can be digital-only with fake crowds clapping and making noises to neta’s speeches in the background (like the IPL match telecast). People can take to technology (like Apple/Jio glass/VR headsets) to enjoy almost real-life experience of being at rallies or in a cricket stadium or even attending classes.

Protests can also go digital. The country can surely do without nuisances such as road blockage, rioting, etc. India can’t fight the virus mutants while allowing various groups to instigate a million mutinies on the side.

Second, the people. All infected people aren’t the same. Some are more infectious than others. The State must focus heavily on quarantining the super-spreaders.

Second, the State must be strong and have capacity at the right places — a recommendation that has been made so many times by so many people that it’s now a cliche. For the first suggestion to succeed, the State must be strong enough. More importantly, it must be consistent because a strong state also requires legitimacy to take harsh measures and deliver punishment which can be gained only by consistency.

If you allow politicians to conduct political rallies while you beat hawkers for selling vegetables in the street, then don’t expect people to follow the rules.

For the second suggestion to succeed, the State needs to have capacity at the right places. Ideally, we should’ve completely banned international travel when the first case was detected in India.

We kept waiting until it was too late. We repeated the same mistake with the UK variant. Within a few days, we removed travel restrictions without understanding enough about that variant.

If the restrictions aren’t sustainable, the least we can do is invest in enough resources to test and quarantine all the infected. Surely, it has to be much easier than letting a humanitarian disaster take place and struggle to produce, import oxygen, medical equipment, etc and see tens of thousands of people die.

Third, the virus is an invisible enemy which can be ‘seen’ only by the power of testing. That’s the most important thing in the fight against it. Still, it’s a mystery why individuals can’t buy test kits for testing at home or the businesses can’t do that to test their employees and have to remain shut for months.

Surely, the investment in testing by businesses will be a fraction of what they are losing out on by constant closures.

Testing also helps us track super-spreaders and quarantine them early before they infect others in their family. The State needs to understand that it needn’t do all the heavy lifting. Individuals or local communities can be trusted as well. Personal responsibility towards family and friends will be enough of a barrier for most to test themselves frequently and isolate in case they are positive.

This is the biggest weapon also because it allows us to come out of lockdowns and return to leading normal lives. The investment needed by the government on this front is not even a fraction of what the country is paying in terms of lockdowns, curfews, etc.

The technology is already there. Scaling will ensure that it's cheap enough to be afforded by individuals and businesses.

Fourth, diversification is absolutely important. We need to diversify risks by expanding out from a handful of cities with huge populations to more and more cities in different parts of the country.

Of course, one is aware that this is largely a generic process which will happen on its own with eastern States getting richer and improving the business environment but the Centre must think hard on how to fasten the process.

Rather than trusting the Chief Ministers, maybe it’s time to go at an even lower level and change the governance structures of the cities where directly elected mayors can be empowered to take executive decisions in their jurisdictions to improve ease of business and attract companies.

Another diversification that’s needed apart from the cities is in the transportation system. There is nothing worse than mass public transport in a pandemic.

Over reliance on it has crippled a vast majority of the country's population and economy. Thanks to its super-spreading nature, the governments can’t start buses, trains, flights or metros for these cramped, closed, overcrowded spots are ideal for transmitting the virus to tens of thousands of people in no time.

And people don’t have personal means of transportation that will allow them to commute and resume normal activity. India needs to seriously think about cutting down overreliance on mass public transport and invest in infrastructure and devise policies (like lowering tax) that incentivise more people to afford their own vehicles.

With the future looking increasingly electric, the pollution argument doesn’t stand. And diversifying from 4-5 metros to more cities will also bust the ‘traffic’ argument.

These two are obviously long-term suggestions and require focused attention for the next two decades to make society and the country more robust against shocks.

Fifth, the country needs to heavily invest in those resources which are most useful and most vulnerable at the same time in a public health emergency. These are healthcare workers and the frontline workers. They are the warriors at the frontlines fighting for every life. They are also the most vulnerable due to most exposure to the virus. The Centre needs to tweak policies to incentivise setting up of more medical institutes and hospitals to ensure that there is enough supply of trained individuals at any time.

All the governments need to ensure that no posts are lying vacant in police departments.

Additionally, they need to be trained well and provided with enough resources. It’s not without reason that the government decided to give priority in vaccination to healthcare and frontline workers. Thanks to that, we didn’t see stories of these groups falling sick in large numbers unlike the first wave which was much smaller in comparison.

If these were not vaccinated, India would’ve been facing a much graver problem of shortage of these most essential human resources. Oxygen production can be ramped up in a short period of time, equipment can be imported but you can’t multiply the supply of doctors, nurses and police forces overnight.

It’s important that the governments keep the focus on these groups even after the pandemic is over.

Sixth, the mountain with sanjeevni booti must come to Laxman. Most of the State’s services, especially the essential ones, must move from large centres to people’s homes. If the welfare can be directly deposited in the accounts of the beneficiaries, other government services should also follow suit.

If the schools, banks, etc have come home via smartphones, surely the sarkar can too. I already talked about taking testing at homes. Vaccination should also follow. During a pandemic when there is community spread, it’s unwise to have large vaccination centres, for they themselves would become hotspots.

Ditto for any other centres which dole out essential services.

India must always keep preparing for the worst so that it may never have to face it.