DR NAMAN SHAH, M.D., PHD, IS A FAMILY medicine physician and infectious disease epidemiologist at Jan Swasthya Sahyog (JSS), a community-based health system in rural Chhattisgarh. He has worked in the areas of pandemic influenza planning, disease-control research and programme management with health departments, the Indian Council of Medical Research and the World Health Organisation. Speaking to Frontline on the COVID-19 outbreak (SARS-COV-2) in India and the aspects that need to be prioritised, including health preparedness, Dr Shah believes that cases will grow exponentially in India and that there is an acute need to centre-stage institutions such as the National Centre for Disease Control which was set up for research in epidemiology and the control of communicable diseases. Excerpts from his interview:
While the COVID-19 outbreak has been a wake-up call for public health systems all over the world, it has affected the developed world more than the developing countries. Are there any epidemiological lessons in this? Or is the worst yet to come?
The outbreak is indeed a wake-up call. At a time when social and international relations feel increasingly fractured, I’ve found it amazing that colleagues all across the world are preparing for, or responding to, the same disease now. Cases appear higher in developed countries, but that is a function of their higher international connectivity—as imported cases drive the epidemic in the early stage—and their increased testing. Our worst is yet to come; cases are growing exponentially and we now have virus transmission that is community-based rather than related to travel. We’ll be able to make more meaningful comparisons with time.
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How Not To Handle An Epidemic
The lockdowns were meant to buy time to put in place appropriate health measures and contain the coronavirus’ spread, but they have failed to achieve the objective and heaped immense misery on the marginalised sections of society. India is still in the exponential phase of the COVID-19 infection and community transmission is a reality that the government refuses to accept.
Tragedy on foot
As the COVID-19-induced lockdown cuts the ground beneath their feet in Tamil Nadu, thousands of migrant workers are trudging along the highway to the relative safety of their upcountry homes.
Sarpanchs as game changers
Odisha manages to keep COVID-19 well under control because of the strong participation of panchayati raj institutions and the community at the grass-roots level under the leadership of Chief Minister Naveen Patnaik.
Scapegoating China
As the COVID-19 death rate spikes and the economy tanks in the United States, Donald Trump and his advisers target China and the World Health Organisation with an eye to winning the forthcoming presidential election.
New worries
Kerala’s measured approach to the pandemic and lockdown has yielded results. But it still has to grapple with their huge economic impact on its economy, which it feels the Centre’s special financial relief package does little to alleviate.
No love lost for labour
Taking advantage of the lockdown and the inability of workers to organise protests, many State governments introduce sweeping changes to labour laws to the detriment of workers on the pretext of reviving production and boosting the economy.
Capital's Malthusian moment
In a world that needs substantial reorienting of production and distribution, Indian capital is resorting to a militant form of moribund neoliberalism to overcome its current crisis. In this pursuit of profit, it is ready and willing to throw into mortal peril millions whom it adjudicates as not worth their means—an admixture of social Darwinism born of capital’s avarice and brutalism spawned by Hindutva. .
Understanding migration
When governments and their plans are found to be blatantly wanting in addressing reverse migration, exercises such as the Ekta Parishad’s survey of migrant workers throughout India can be useful to work out creative long-lasting solutions.
Waiting for Jabalpur moment
The Supreme Court’s role in ensuring executive accountability during the ongoing lockdown leaves much to be desired. Standing in shining contrast is the record of some High Courts.
An empty package
The Modi regime, which has been unable to control the COVID-19 infection, restore economic activity and provide relief to millions exposed to starvation, trains its sights on Indian democracy, making use of the panic generated by fear and a lockdown that forecloses paths of resistance.
