COVID-19 Update

Uttar Pradesh and COVID management: A case of misplaced priorities

Print edition : November 06, 2020

A closed cinema hall in Allahabad being readied for the October 15 reopening. Photo: SANJAY KANOJIA/AFP

A rickshaw-puller waiting for passengees at a market in Lucknow on October 14. As the pandemic shows no sign of easing in Uttar Pradesh, there is little visible effort at convincing people to wear masks. Photo: Rajesh Kumar Singh/AP

The management of the COVID pandemic in Uttar Pradesh leaves much scope for improvement and the State may soon find itself in a difficult situation.

Images of the police in Uttar Pradesh humiliating migrant workers trying to walk home during the lockdown are hard to forget. They exemplify the ugly and brutal manner in which the Uttar Pradesh government has been handling the COVID-19 pandemic. Denial and dysfunction plague the Yogi Adityanath administration as the coronavirus rages through the State.

Any outbreak would be a challenge for the populous State, given its development indicators and crumbling public health system. It holds the dubious distinction of reporting India’s second highest maternal mortality rate and the highest infant mortality rate, according to National Family Health Survey 2015-16. It also spends very little on health—Rs.452 per capita, which is 70 per cent less than the average spending by other States, according to India Spend. A series of poor decisions made by the Central government—first on the migrant workers’ issue and then on the agricultural sector—over the course of the pandemic added to its woes.

States that are as densely populated, such as West Bengal, fared better at managing the virus. Until mid October, West Bengal had fewer infections and casualties than Uttar Pradesh. At 6,466, Uttar Pradesh reported the fourth highest death toll in the country. Moreover, its Chief Minister’s obsession with divisive politics and the communal agenda even during an unprecedented crisis set Uttar Pradesh apart from other States.

Also read: COVER STORY | Uttar Pradesh: Hindutva Laboratory 2.0

In the months since the first coronavirus infection was reported in the State, Yogi Adityanath has denounced the Mughals, changed the name of a museum and settled political scores by undoing the previous regime’s project. In August, when India was reporting more than 50,000 cases a day, the Ram temple Bhumi Pujan (ground-breaking ceremony) was held at Ayodhya. The priest who was to perform the ceremony and 16 police personnel manning the site tested positive by July-end. Union Home Minister Amit Shah also tested positive ahead of the ceremony. Several calls made to postpone the event in the light of the pandemic fell on deaf ears. The Ram Janambhoomi Teerth Kshetra Trust and the government stormed ahead with it, with Prime Minister Narendra Modi presiding. One of the five people accompanying Modi and Adityanath was Mahant Nrityagopal Das, who soon after tested positive for COVID. In several photos and videos of the event, he appeared in close proximity to political leaders without a mask.

A hospital in Meerut complained that Muslim patients were misbehaving with staff and refusing to wear masks. It issued an advertisement asking Muslims, prospective patients and persons attending to them, to get a COVID test done if they wanted admission in the hospital. It triggered public outrage and the Chief Medical Officer of Meerut sent a notice to the hospital administration. In a second ad, Valentis Cancer Hospital apologised and said it was not its intention to hurt any sentiments.

After the Tablighi Jamaat (it held a conference in Delhi on March 10-13, and one in Malaysia in February, when travel restrictions were not yet in place in India) was identified as a super spreader, sections of the media and the government used the opportunity to demonise Muslims and brand them as “Corona Jehadis”. Even as India’s caseload crossed 70 lakh and diverse sections of society emerged as super spreaders, from wedding parties to security personnel, hospitals in Uttar Pradesh continued to stigmatise Muslims. The State Health Department used to issue bulletins mentioning the total number of Tablighi Jamaat cases. Apparently, the screening form in some hospitals demanded a declaration from Muslim patients that they had not attended any Tablighi event. They said they were only following government directives. This, despite World Health Organisation guidelines warning countries against profiling patients on the basis of religion or other criteria.

Also read: COVER STORY | Rabble-rousing yogi

When the number of coronavirus cases in Uttar Pradesh touched 1,67,510, the Yogi Adityanath government decided to restart its Legislative Assembly session, becoming the first State to do so. A day before the session started, the State recorded the highest single-day spike of 5,156 cases and the highest daily death toll (until then) of 77. As many as 11 Ministers have so far tested positive, including Deputy Chief Minister Keshav Prasad Maurya. Two Ministers, Kamal Rani Varun and Chetan Chauhan, died of COVID-19. From the opposition camp, Samajwadi Party leader Mulayam Singh Yadav also tested positive.

Even so, the government continued to paint a rosy picture of the situation and projected the recoveries as proof that the pandemic was under control. By mid October, 4,42,118 cases were recorded, the hotspots being Lucknow, Kanpur and Prayagraj.

But the leaders did not lead by example and people did not realise the importance of social distancing and wearing masks. The Allahabad High Court issued an order on September 24 that no one should be seen outside their house without a mask covering both the nose and the mouth. Unhygenic quarantine centres

The bench of Justices Siddhartha Varma and Ajit Kumar, who were hearing a public interest litigation petition on inhuman conditions at quarantine centres, said: “Do gaj doori mask pehna zaroori seems to be an empty shibboleth coined by the government. Neither the government is looking interested in implementing the rule that two individuals should remain two yards away and wear masks nor the people of our State are interested in following the above rule…. While the lockdown was imposed, we found that police was really effective. Today, when social distancing and wearing of masks has to be done in letter and spirit, we find that strict enforcement is missing. Quite often, it has been found that even police personnel outside their police stations are not wearing masks…. All police personnel and all government employees should compulsorily wear masks. Unless they themselves wear masks they cannot ask others to do so.”

Also read: COVER STORY | Uttar Pradesh's Muslims bear the brunt of Yogi Adityanath's politics of "badla"

The petition, which sought better treatment for corona positive people, was filed by Gaurav Gaur, a High Court lawyer, after the first COVID death in Prayagraj. The family of Virendra Singh, an engineer who died of COVID on May 6, had alleged that negligence of medical staff was responsible for the death. Gaurav Gaur’s petition brought to the court’s notice the pathetic situation in quarantine centres. After perusing photographs and video of the facilities, the court observed that the conditions in SRN Hospital Prayagraj were not good and asked why hospitals were unclean and were not being sanitised.

In the course of hearing the petition over several months, the court pulled up the State government and asked why state-of-the-art medical facilities were not available in the hospitals and Samudayik Chikitsalayas of Prayagraj. It issued a slew of guidelines on managing the flow of migrants returning from the cities and urged the government to be more organised.

Already wanting in primary and tertiary health care, the State faced a severe shortage of personal protective equipment and oxygen kits. As early as June, Union Cabinet Secretary Rajiv Gauba had warned that Uttar Pradesh, along with four other States, would face a critical shortfall in intensive care unit (ICU) beds and ventilators as COVID infections rose. He stated that the case fatality ratio (CFR) in 11 districts of the State was very high. These districts were among 69 across 13 States where the CFR was rated as very high. Regardless of these early warning signs, the Chief Minister continued to fete himself as a saviour of migrant workers and children. The government squarely blamed the lax attitude of the public for a spike in cases after the lockdown was lifted.

Sharp decline in health-care services

Analysing data from the Health Management Information System (HMIS), the noted economist Jean Dreze and Vipul Kumar Paikra stated that health-care services in Uttar Pradesh had declined by up to 70 per cent during the lockdown. The massive disruption of health services was avoidable and not uniform across States with similar parameters, they said. “The sharp decline of health services activity indicators at the national level is largely driven by comparatively irresponsible States where little effort was made to sustain basic health services through the crisis,” they stated. In the States that fared badly, maternity-related services were neglected and there was a sharp drop in antenatal care registration and institutional deliveries. Despite the pandemic, almost all States barring Uttar Pradesh, Bihar and Jharkhand had managed to keep afloat maternity-related services. “Pregnant women, it seems, do not count for much in this patriarchy-ridden region,” said the researchers. The situation was worse in the backward regions of Uttar Pradesh such as Bundhelkhand and Poorvanchal, where even primary health care is not always available.

Meanwhile, a slew of scams hit the administration. A racket to issue fake COVID-19 reports surfaced in Meerut. A first information report was registered against a private hospital that was copying the seal and stamp of a district hospital to issue these certificates. On September 4, Devmani Dwivedi, the ruling Bharatiya Janata Party’s (BJP) MLA from Sultanpur, wrote a letter to Adityanath, alleging that COVID kits priced at Rs.2,800 each were procured in his district at Rs.9,950.. The kit consists of a thermal scanner, an oximeter and a pulse analyser. In April, these kits were given to health workers for a door-to-door survey across the State. Soon afterwards, local media reported similar scams from several other districts. The opposition claimed that such rackets were operating in 65 districts.

The Congress leader Priyanka Gandhi tweeted: “In the schemes meant for the general public at the time of the disaster, the BJP government which cuts allowances is running a gallop in the scam. The result is that the corona kit scam is being done in almost every district of UP. The UP Congress has demonstrated and warned the government to stop saving scammers.”

Also read: COVER STORY | In Uttar Pradesh, casteism and social apartheid are the norms

Under pressure to act, the government set up a special investigation team. But opposition parties, including the Aam Aadmi Party and the S.P., demanded an inquiry by the Central Bureau of Investigation or a special investigation team (SIT) headed by a retired judge of the High Court. Panchayati Raj officers of Sultanpur and Ghazipur districts were suspended and the district magistrates were transferred.

Early on in the pandemic, 57 minor girls and an employee in a government-run children’s home in Kanpur had tested positive. Five of these girls were pregnant and it was reported that one was HIV-positive and another had hepatitis C. The National Human rights Commission took suo motu cognisance of the matter and sent notices to the authorities concerned.

But in what has now become the typical style of the BJP government, instead of investigating the matter, it went after the messengers and lodged FIRs against unknown sections of the media and social media for circulating “false” information. In its zeal to promote Yogi as an efficient administrator, the government was treating every COVID-related information as “false” and every criticism as dissent. Unless the government changes its ways, Uttar Pradesh may find itself in an alarming situation.

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