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In Kerala, a humane lockdown

At a time when several States are already under one form of lockdown or another, it seems facile to debate whether there should be a national lockdown or not. Indians are witness to never-before-seen sights of bodies floating in the Ganges, drought of medical oxygen, collapsing health infrastructure, a faltering vaccination drive, and the pandemic stretching its tentacles rapidly into rural areas.

With a national positivity rate of about 20% and over 4,000 daily deaths, India must do what it needs to do — a national lockdown if unavoidable; if not, regional lockdowns/micro-containment zones. It should, however, ensure that the implementation of any lockdown is humane and protects the interests of those likely to be worst affected. Lockdowns should be imposed only after adequate preparation and planning, involving experts. Moreover, adequate notice should be given to the affected people so that they have enough time to prepare themselves.

The Kerala model

The lockdown in Kerala offers some important lessons. Realising that night curfews and weekend lockdowns were insufficient to halt the rapid rise in infections, a complete lockdown from May 8 to 16 was announced on May 6. This provided the State with about two days to prepare for the event as compared to the national lockdown imposed last year with a four-hour notice.

From the beginning of the pandemic last year, Chief Minister Pinarayi Vijayan took command and was the main face of the government’s response. Through daily press briefings, he provided detailed information on the rate of infections and fatalities; the availability of beds, ICUs, oxygen and vaccines; as well as measures taken to deal with the crisis. This paid handsome dividends in the recently concluded Assembly elections for the Left Democratic Front. The people liked the idea of a strong leader presiding over their interests and acting as a guardian in a time of crisis. Assured now of a second term, Mr. Vijayan has provided a smooth continuum in leadership and decision-making. He has continued his daily press briefings and communicated the gravity of the situation with facts and figures, steps being taken by the government, and the need for the public to cooperate.

The response to the second wave at the national level and in Delhi has been marked by confusion, conflicting authorities, lack of transparency and no clear assumption of responsibility or willingness to answer uncomfortable questions. People have been forced to use personal networks to scrounge for oxygen and beds in hospitals. In refreshing contrast, in Kerala, there is clarity on where the buck stops. Most Chief Ministers value their engagement with the media and are open and accessible. It is, however, not known how many of them engage with the media on the COVID-19 issue as intensely as Mr. Vijayan does and that too on a daily basis. The Prime Minister, Home Minister and Health Minister as well as Chief Ministers of the worst-affected States would be well advised to follow suit and see transparency as an important part of the COVID-19 response toolkit. A direct, open and proactive approach in this regard would go a long way in building popular trust and confidence that the crisis can be overcome.

 

A commendable aspect of the current lockdown in Kerala has been a clear articulation of the principle that no one in the State should suffer from hunger or lack of medical attention. To this end, food kits are being delivered to homes. Community kitchens and Janakeeya hotels (people’s hotels) have been opened. First-level treatment centres and second-level treatment centres have been set up to ensure that patients are screened and treated appropriate to their symptoms. Only the most serious cases reach the district and specialty COVID-19 hospitals. Domiciliary care centres have also been created to provide shelter, food and treatment to those who do not have the space at home to be quarantined. In private hospitals, 50% of the beds have been declared as COVID-19 beds. Focused efforts are underway to assure migrant workers that they need not flee to their hometowns in panic because of the lockdown. Communications in Hindi have been issued, clarifying that they will be provided food as well as vaccination.

Similar to the ‘Mumbai model’, beds are allotted through centralised control rooms in each district. These rooms also monitor requirements of oxygen and ambulances. Orders have been issued pegging the cost of RT-PCR testing and treatment charges in private hospitals at a reasonable level. The Kerala High Court has stepped in to supervise the government’s response. It has dismissed challenges from private labs to the reduction of charges and in response to a PIL, approved a rate card for hospitals prepared by the government. Coming down on private hospitals, the court pointed out how shocked it was at the usurious charges levied by some for the simplest of services.

Having empowered local bodies and devolved finances to them long before the crisis, elected officials at the grassroots level are Kerala’s first line of defence in the fight against COVID-19. Panchayat members and municipal councillors, irrespective of their political affiliations, function as foot soldiers. They look out for fresh infections amongst their constituents, motivate people to get vaccinated, supervise the implementation of the lockdown and ensure the supply of medicines and provisions to those in need. Commendably, the Opposition led by the Congress has called upon everyone to work together. Leaders from both the Opposition and ruling party have been setting up help desks, providing ambulances and organising food packets.

As a new government assumes office on May 20, the crisis will continue to be the most important item on its agenda. While good systems have been set up, there are complaints that the health workers are unable to cope. There are also reports of oxygen shortages in some parts of the State. There is fear that if numbers continue to rise, bed and oxygen shortages will become unavoidable.

Preparing for future waves

Clearly, the war against COVID-19 is going to be long-drawn and even a well organised State like Kerala will be kept on its toes. The second wave will pass but preparations still need to be made for a third and fourth wave. More lockdowns will be inevitable until such time the vaccination programme makes adequate progress and herd immunity is acquired. What is important is to mitigate the impact of these lockdowns on the lives of the poor by guaranteeing food and equitable access to healthcare. The Kerala model deserves attention in this regard. There are also best practices from other States which could be emulated across the country, such as the Tamil Nadu government’s announcement of incentives for healthcare workers.

Twelve Opposition parties have in a joint letter urged the Centre to immediately begin a free universal mass vaccination campaign and ensure uninterrrupted supply of medical oxygen and vaccines. They have also called for the invoking of compulsory licensing to expand domestic vaccine production. The convening of an online meeting of non-BJP Chief Ministers to support and reiterate these demands would be good follow up to the letter. This could serve as a useful exercise in cross-learning amongst States. It could also reinforce the need to protect the people and formulate a just and equitable response to the pandemic.

Venu Rajamony is former Ambassador of India to the Netherlands and former Press Secretary to President Pranab Mukherjee


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Printable version | Jun 24, 2021 12:56:03 PM | https://www.thehindu.com/opinion/op-ed/in-kerala-a-humane-lockdown/article34573978.ece

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