Covid update

Maharashtra government opts for cooperation over coercion in its new COVID control policy

Print edition : May 07, 2021

A new COVID centre at Thakkar Dome in Nashik on April 10. Photo: PTI

The table included in the press release by Prithviraj Chavan, former Chief Minister, alleging the Centre’s “stepmotherly treatment” to Maharashtra with regard to distribution of critical medical equipment for COVID-19. Photo: credit

When Maharashtra wrote to the Centre asking for more vaccines one of the responses was a statement from Union Health Minister Dr Harsh Vardhan. He said that the state had fallen short of its targets of vaccinating the priority populations and by asking for more vaccines so as to be able to inoculate all above the age of 18 , Maharashtra was "trying to divert attention from... poor vaccination efforts by just continuously shifting the goal posts...".

Opting for cooperation over coercion in its new COVID control policy, Maharashtra struggles with a truculent public and politicking by the Centre.

It is all about numbers. According to the website covid19india.org, as of April 15 Maharashtra had 35,58,952 confirmed COVID cases (6,12,070 active cases, 29,39,624 recoveries and 58,804 deaths). The State has administered 1,07,53,947 vaccine doses. The number crunchers tell us that 2.3 crore people have been tested and there are 5,010 active cases per 10 lakh people.

Maharashtra, Chhattisgarh, Uttar Pradesh, Karnataka and Kerala account for 68.85 per cent of the total number of cases in India. Maharashtra leads with 5,66,278 active cases, according to the Union Ministry of Health and Family Welfare’s data of April 15. Mumbai recorded the highest number of COVID-related deaths in the country in March. Nine of the top 15 districts in the country with a heavy COVID caseload are in Maharashtra. Pune and Mumbai have the maximum number of active cases in the country. With figures like these, Maharashtra is the epicentre of the pandemic in India.

The surge in cases began in February. There were a number of reasons (see interviews with Dr Shashank Joshi and Sachin Sawant) for this. Hesitant to resume a lockdown, Chief Minister Uddhav Thackeray’s government tried alternatives. On April 4, the State government announced a few restrictions to control the spread, including night curfews from 8 p.m. to 7 a.m. and a complete lockdown on weekends that began at 8 p.m. on Friday and went on until 7 a.m. on Monday.

Also read: Spiralling irresponsibility behind rising number of new COVID cases in Maharashtra

But after a brief trial period it was deemed that more stringent measures were required. So, on April 13, via a 38-minute address to the State, Uddhav Thackeray announced a slew of restrictions applicable from April 15 to 30. He preferred to call it a period of restrictions and firmly said it was not a lockdown.

Welfare measures

Essential services and public transport were exempted from the restriction. There were also some pleasantly surprising specifics in the new measures. Uddhav Thackeray reached out to daily wage earners by announcing a Rs.5,476-crore relief package to ensure they had the basics. This would benefit six crore people (about half the State’s population). They will get 3 kg wheat and 2 kg rice for the next month. The government also restarted the Shiv Bhojan thali scheme to distribute food to the poor. During last year’s lockdown this scheme mitigated the distress of lakhs of migrants since it was made available all over the State. Initially, a meal was priced at Rs.10 and later brought down to Rs.5, and this time it is being offered free.

Roadside food vendors who suffered terrible losses last year have been permitted to operate between 7 a.m. and 8 p.m. with the condition that they only provide takeaway food. The Chief Minister specifically mentioned that these vendors were essential services because the economically weaker sections depended on them. “Since the restaurants can be open for home delivery then roadside food vendors can also continue their business,” he said.

In essence, the package of restrictions called on the cooperation of citizens to help fight the virus rather than the imposition of coercive terms that would have severely affected the economy.

Appeal to the Centre

There was no hiding of facts in Uddhav Thackeray’s address. Yes, he said, the number of cases in the State was soaring. But he also added that the State needed help and had been repeatedly asking the Centre for it. He said he had appealed to the Centre to postpone the submission of goods and services tax (GST) of March and April by three months to ease the pressure on businesses. “I have asked the Prime Minister to consider the plight of small businesses especially,” he said.

He also said the pandemic should be notified as a natural calamity and funds from the State Disaster Relief Fund be allowed to be used for relief work. The plan was to pay Rs.100 per adult and Rs.60 per child daily to identified categories thereby benefiting about seven crore people.

Basic medical supplies were at the top of the list of requirements from the Centre. In fact, the Maharashtra Vikas Aghadi (MVA) government has been petitioning the Centre throughout the past one year for this. Former Chief Minister Prithviraj Chavan of the Congress said there was “lopsided and politically biased distribution of critical medical equipment such as PPE [personal protective equipment] kits, N95 masks and ventilators” (see table 1).

Also read: Worrying increase in Maharashtra COVID cases

Uddhav Thackeray appealed to the Centre to provide desperately needed oxygen. He said he had written to the Prime Minister about the desperate need for Liquid Medical Oxygen (LMO). The State’s manufacturing capacity is 1,200 tonnes, while the requirement is projected to be 2,000 tonnes by the end of April.

In what has become a trademark style, he made a few subtly sarcastic remarks aimed at the Centre during his speech. One such was when he recounted how the Centre had responded to his letter asking for oxygen by offering it to be sent by road from West Bengal and other distant States. As he said this, he held up a map to emphasise the distance between the States. He has asked for the National Disaster Management Authority to step in and airlift oxygen.

Ever since 2019 when Uddhav Thackeray took the decision to break away from the Bharatiya Janata Party (BJP), there has been a continued and often unscrupulous attack on the MVA. The target is, of course, Thackeray and his party, the Shiv Sena. The government says the sudden shortage of vaccines in the State in March is yet another example of the BJP’s hostility and of its misuse of power at the Centre.

Centre’s response

The BJP, however, maintains that the MVA is inept. On April 7, Union Health Minister Dr Harsh Vardhan issued a rather vindictive statement in which he made an observation of “the misgovernance and casual approach of Maharashtra government in battling the virus. The lackadaisical attitude of the State government has singularly bogged down the entire country’s efforts to fight the virus.” Much more was said by the severely misinformed Minister, including an attack on Maharashtra’s contact tracing, which, he said, “leaves a lot to be desired”. This, when Dharavi’s contact tracing was applauded worldwide.

As in his earlier speeches, Uddhav Thackeray chose to reiterate that “this is not the time for party divisions”.

Public health infrastructure

What the pandemic has exposed is the pathetic state of public health infrastructure, but Maharashtra cannot be singled out here. In fact, what is important is the response of States to the shortage. From just two laboratories that could test for COVID-19 at the start of the pandemic, Maharashtra now has 500. From conducting 50,000 tests daily just a few months ago the State now does 1.82 lakh tests and plans to raise this to 2.5 lakh daily. Seventy per cent will be the gold standard RT-PCR (reverse transcription-polymerase chain reaction) tests. Beds have increased from fewer than 10,000 last April to 3.75 lakh beds at present. And Uddhav Thackeray has repeatedly assured the public saying, “We will never compromise on the quality of tests and we will not hide any numbers.”

Also read: Second wave of COVID-19 in India

Dr Shashank Joshi, member of the Maharashtra COVID Task Force, spoke to Frontline of the ongoing efforts: “We are continuously ramping up our healthcare infrastructure. In Mumbai we are building four more jumbos and adding 2,000 more beds because we know that we have to counter this for the large tsunami-like numbers and we have to keep doing this.” Private hospitals are once again being roped in to take in COVID patients. And hotels have been requisitioned as step-down centres for recovering patients.

There is a high hospital occupancy even though the authorities are trying to persuade people that everyone who tests positive does not have to be in hospital. “There are certain red flags like low oxygen levels which doctors tell you about. Only if these medical circumstances arise do you need hospital care,” explained Joshi. Otherwise self-quarantining at home with plenty of rest, hydration and a good diet should see most patients through, he said. The shortage of vaccines that had destabilised the State’s programme is back on track, according to Joshi, but there is still a shortfall in the supply of oxygen.

Lackadaisical attitude

But Uddhav Thackeray spoke of a wall that the government has come up against. Cautioning against a lackadaisical attitude, he said, “This strain of the virus is highly contagious. We need people to cooperate in this fight. Our doctors are exhausted.” As he neared the end of his speech he said, “I appeal to you with folded hands… let this be a Janata curfew… let it be from your hearts. We have to break the chain.”

The common misconception is that the threat from the virus is over. And this has affected people’s behaviour. Mask and social distancing protocols are flouted more and more, contributing greatly to the current spread of the virus. While critics advise the Maharashtra government to get its act together, a senior doctor in the Brihanmumbai Municipal Corporation (BMC) said, “There should be limits to arguing for the sake of arguing and to bash the government because it is the thing to do. And in the case of the handling of the COVID crisis in the State it’s time for everyone to stop, take a deep breath and look at their own contribution to the crisis.”

He listed the appropriate behaviour for people: “Rule One—wear a mask, an appropriate one that covers the nose and chin and sits tight across the nose. A 3-ply surgical mask or an N95. Not a pretty embroidered cotton one that satisfies your conscience for Indian crafts but does nothing for protection. Rule Two—Sanitise and keep distance between people, don’t gather in crowds. Rule Three—Don’t go out unless you have to, use technology to socialise. These are what will taper off this pandemic. And yet fewer and fewer people are following them. At the same time, we have to listen to nonsense about government failing to control the virus. Truly there are too many Covidiots [someone who disregards health guidelines for COVID] out there.”

Callous about health guidelines

The following is just one story out of hundreds, but it exemplifies the doctor’s outburst. The BMC sealed a posh south Mumbai apartment complex for 14 days because it had five cases. Instead of implementing this, the Society’s committee members opened the back door to let residents come and go as they pleased. The number of cases rose to 12 in the building, including two children. Instances like this are so common all over the city that now sealed buildings have policemen posted on duty.

While people who are callous about health guidelines are a growing species, corrupt officials have found the pandemic to be a time of great profit. A marriage of a lower middle-class family in the north Mumbai suburb of Kandivali had been planned for a Sunday. When the weekend lockdown experiment was announced the families panicked and contacted the BMC. They were apparently told that if they paid Rs.30,000 the authorities would turn a blind eye to the celebrations. Unable to afford that, the families shifted the event to a Monday. After a bit of bargaining the deal was closed at Rs.15,000 and 200 guests when actually only 50 are permitted.

Also read: COVID second wave: Clueless Centre cannot hold

A well-known building complex in the north Mumbai suburb of Goregaon has been paying the BMC upwards of Rs.1 lakh to ensure that it is not sealed. A south Mumbai liquor shop had hordes of mask-less people jostling at its door. When the police came to check, the manager went with a few bottles to the police van and the van drove off.

There are a number of loopholes and ambiguities in the rules. Can domestic help go to work? It is no one day and yes the next. Can liquor shops operate? Yes, but only deliveries. So, customers stand 20 feet away and the shop assistant delivers the liquor to them. Similarly, there are blunders in government communication. Like the one of a government campaign saying ‘I am Responsible’ with the image of a man using a handkerchief in place of a mask.

But on the whole the Maharashtra government is working on the belief that the principles of cooperation will bring long-term results instead of the short-term benefits of coercion. Sachin Sawant of the Congress had said that “the economy will be a big decider in the final decision” and so it was. A full lockdown would have been disastrous for the State’s finances as well as that of individuals.

Humanitarianism was factored into the decision to avoid a lockdown. The haunting images of last year when the poor became destitute seem to have left their mark on at least some in the State government who were determined to avoid a repeat of that scenario.

Weighed in the balance, the package of restrictions presented to the public is a workable one. Lose the chance and the options that stare one in the face are nasty. The virus has mutated into a lethal strain that transmits rapidly. Uddhav Thackeray has said that the number of active cases may cross 11 lakh by the end of April. If the caseload rises there may be no alternative to a complete lockdown. Following the guidelines of the State government’s restrictions for a few weeks or maybe even a month—doctors and scientists are unsure how long—will help break the chain of transmission to a great extent. It is a small price to pay for the return of normalcy.

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