Living with the virus (Indian states have to learn to build systems to move on)

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 Living with the virus (Indian states have to learn to build systems to move on)

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• What govt. thinks: The authorities reminded India that "we have to learn to live with the virus". This could well be a big turning point in this pandemic, for India.
• Why exactly: A centralised strategy for containment and elimination is not going to work from here on, at all, for a large nation like India. The states have to take over, with their own mechanisms.
• Legal basis: The harsh lockdowns were imposed by the Union, and accepted by the citizens, as necessary to eliminate the virus. The laws used were

1. The Epidemic Diseases Act, 1897
2. a strange interpretation of the National Disaster Management Act, 2005

• What happened: This 2005 Act needs actual plans at national, state and district levels, but nothing exists. It was simply used to issue instructions to states (by Centre) and concentrate more power in few bureaucratic hands (and central scientific agencies).
• "Containment and Elimination" not for India: These are good ideas for smaller, better-governed nations, who have the money and systems for it. And that too in initial phases of the infection.

1. India cannot provide basic needs to many of its people, and containment is impossible.
2. That explains the pain of migrant labourers across India. They were contained forcefully first, and then they are neither being tested nor being helped to move on.

• Where else containment fails: The poor urban neighbourhoods in India's cities cannot "contain". Density is high, homes are irregularly built and social distancing is not possible. Since savings are few, people have to move out. Many are daily wagers. Many did not even report symptoms due to guilt and stigma attached to it.
• A better tomorrow: India has to now focus on the village level, and ward level work.

1. Agencies have to find regional parameters of the disease, and community prevalence. Then come the treatment protocols. As on date, there's no such data.
2. Once people start seeing such data, their participation will be more forthcoming.
3. Village-level guidelines on returning migrants, quarantines, using common resources (toilets and water) will then be formed properly.

• Urban bias: All policies so far have originated from the urban salaried upper classes, who work from home, and do not run shops or farms. Morbidities in rural regions may be entirely different!
• Not needed: Hospitalisation of all cases is not feasible. So sound data is needed first.

1. Logistics : Medical resources like hospital beds, ambulance services, public transport, provision of basic amenities, welfare services have to be better designed
2. Central focus : The central network of elite scientific institutions has not seen the problem from the rural angle at all, and have remained ensconced in their safe bubble.

• Phase II arrives: Indian states must talk to each other and build the systems needed to deliver medical services properly. Our institutions have to rise to help our common people understand the need for certain actions. It is now firmly proven that Global Science and Economy have not ensured welfare or equality at all. It is time to rectify things. 
• Summary : The central, elite bias of pandemic policymaking has created ineffective ground-level action in rural and non-urban areas, and that needs to change in Phase II of the pandemic.

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