Government Dangerously Close to Going Wrong on Containment of COVID-19
The Indian and state governments appear to have rolled up their sleeves to ‘contain’ the COVID-19 virus, with lock-downs, quarantines and other administrative measures. But knee-jerk reactions and slipshod implementation have only added to confusion and distress of the most vulnerable sections, while the threat of pandemic continues to grow exponentially. 
 
The Supreme Court on Monday sought a report from the government on the steps taken to prevent large-scale inter-state movement of workers during the 21-day national lock-down on account of the COVID-19 outbreak. The government told the apex court that around 0.5 million to 0.6 million migrants walked back to their villages from cities during the lock-down. "There was no necessity for migrants to rush to their villages as their needs were taken care of by the government's financial package," it contended.
 
 
A 123-year old law, namely, the Epidemic Diseases Act of 1897, is being invoked to ‘contain’ the COVID-19 pandemic.  The law confers special powers on the government to enforce the implementation of containment measures to control the spread of the disease and has been used in the past to contain various diseases in India such as swine flu, cholera, malaria and dengue.
 
The origin of the Epidemic Act 1897 was maritime containment. It was preceded by various European laws aimed at containment of plagues carried across by ships. These laws were implemented by defining geographical areas, and not political borders, for enforcing containment measures. Political borders, in any case in those times, had not yet been frozen as 'India' extended from Aden to Singapore and other political borders world-wide were flexible, at best, and non-existent, in many cases.
 
But this is not the case today. Delhi, for example, is an ambiguous political unit. Does it just mean Delhi, or the three municipalities plus the cantonment board plus New Delhi Municipal Corp (NDMC), or is it part of the national capital region (NCR) or does it also include Gurgaon + NOIDA + Ghaziabad + Faridabad + Sonipat and Rohtak? 
 
State borders (political) cannot be the basis for lock-down/quarantine/containment.
 
Where does Delhi stop, if we wish to quarantine Delhi? 
 
The point is, there are no easy answers—either we are doing too much or too little. But, either way, the threat of applying Section 188 under the Indian Penal Code by the State governments without seeing the geographical realities, is not going to help contain the pandemic. 
 
There are, for example, hundreds of entries and exits in and out of Delhi to Uttar Pradesh and Haryana, some of them lying within parts of Delhi 'territory'. How do you icontain' this, if it is going to be a turf battle between states?
 
Similarly, the borders between Andhra Pradesh and Telangana, and those between Chhattisgarh and Madhya Pradesh, between Bihar and Jharkhand, between Uttar Pradesh and Uttarakhand are artificial constructs, which have nothing to do with the spread of a disease. 
 
Containment of hotspots has to be done on the basis of pure medical analysis/results.
 
Looking at the history of containment of diseases, back in 1897, the first point of containment used to be the ship. It was left to anchor outside in what was and still is called a quarantine anchorage which is a no-go area for all other vessels. Food and water, for example, would be floated towards the ship on rafts. In this day and age, they are doing something similar, by helicopter. Or by towing a dinghy behind a motorboat and tying it up to the ship, nobody reaches the dinghy from the ship till the motorboat has moved a good distance away.
 
Seeking to prevent the spread of formerly incurable diseases, in centuries past, a sea port would bar a vessel until it promised that it carried no communicable sickness, to the satisfaction of the port.
 
Free Pratique, as it is known, is still practised today, though it is now often granted in advance. But a reference to living history is apt here—the associated idea of quarantine comes from a historical minimum of 40 days for which vessels had to wait, after being  captured by the Italian approximation quarantena (ironically, given the very public example on Italy's doorstep), and while with modern medicine the maritime world is now very different. This is from an era when rats carried bubonic plague across oceans. Immunity of local rats was disrupted when foreign rats landed ashore.
 
The present threat of Section 188 IPC is not strong enough to enforce adherence.
 
Which brings me to the last part of my article—containment was, and is, done by identified or suspected clusters. Not by political borders. And clusters would be across political borders, for example, the complete riverine belt near my house, on the Jamuna, generally known as 'Molar Bandh' which spans Delhi, UP and Haryana. 
 
There are many such clusters all over India which defy the concept of political borders between States simply because they have become so huge over the decades and political borders have cut across them. 
 
The present silos in the government appear not to have taken such issues into account, largely also because the forgotten poor citizens, lately being sadly referred to as "migrant labour" reside in mostly lawless territories. As the son of a migrant refugee myself, I know that as a citizen of India I would react very strongly to being called a 'migrant' in my own country, but then that is not the subject of this article.
 
The history and laws of virus / epidemic / pandemic control, past and present, provide us with guidelines that are valid even today
 
The subject of this article is drawn from the report on the Supreme Court and COVID-19, and the word "containing" the virus pandemic in the report.
 
a) The core word here is containment. At its smallest unit it could be a room, a house, a ship, a bungalow, an apartment complex and now, as this goes to press, a Formula One Stadium too. Every which way, with summer coming, hermetically sealed or re-cycled air for air-conditioning should preferably not happen in such locations. 
 
I have not seen a single guideline here, while China had fleets of negative air-pressure ambulances, and scores of articles on the subject of the air quality needed. https://www.youtube.com/watch?v=5NsX1ipoLbI
 
To my knowledge, we do not have even one negative air-pressure ambulance, which is simple enough to develop, while there are fleets of Bharat Stage-4 (BS-4) vehicles about to go for scrap.
 
b) Containment by clusters. Tri-junctions and bi-junctions of states are especially important here, but so are areas demarcated by natural or man-made boundaries such as sea, mountain, river, habitat, ghetto, slum, posh colony, and so on.  Not just a state border.
 
Lock-down, quarantine and containment are the three progressive steps that need to be systematically taken. The pandemic has to be contained. To carry forward the progress brought about by lock-downs, quarantines or containments need to be enforced by clusters un-connected to political borders. That is the core point. 
 
In short, we need even stricter action but the threat of IPC 188 and closing state borders is perilously wide off the mark.
Comments
jprab569
5 years ago
I am a totally layman and don't claim any expertise over the subject. But I see several anomalies. Firstly about lack of timely creation of awareness. On the contrary, the seriousness of the threat was diluted by the words and deeds of the leaders in spite of the feeble warning by the concerned doctors and the enlightened. So common people whether literate or not, didn't understand it right and were caught by surprise. Just few days before the announced lock down, the AP CM was protesting against the postponement of the AP local bodies election and blamed the opposition leader. Around the same time the concerned govts and party were busy and spent all their energies to pull down a legally formed govt in MP, while transporting some MLA s across to Jaipur and Bangalore back and forth implying Corona was not that urgent threat. Shaheenbagh protesters in Delhi were urged to vacate for reasons other than Corona. Corona threat was not mentioned once while combating the riots in Shahdara. Lakhs of people were organised to crowd in Ahmedabad to welcome President Trump. Telangana CM assured in the assembly that paracetamol is sufficient. Annual religious event with lakhs of pilgrims was organised in Warangal district. Mega jamat congregation allowed. The list goes on. Suddenly, people who don't stay indoors are criminal.
Initially we were asked to stay home. OK, but for some days, hotels were vacated forcibly after closing down caterers, guests couldn't go home because transportation was also stopped. Later hotels were to reopen allowed without food. For regular residents, markets were closed in the evenings perhaps that is the time when Corona virus is more active. People are beaten up by the police on streets. Inmates of hostels for students and working people wetre given NOC by the host state administration to return to their neighboring home state, but were held up and blocked from entering at the state borders by home state Police, but later were given option to to accept quarantine in their native state or return to the state of residence irrespective of whether they have any symptoms of Corona. Till 'migrant' workers started walking hundreds of km, their existence was not realised.
Disclaimer: I am not here to blame the administration that is still learning by trial and error how to cope up with this unheard of situation. I just urge them to treat people as partners in this gigantic program, leave the unidirectional top down bureaucratic style of thinking., consult with all stake holders at all levels and above all stop treating this as a law and order emergency to be dealt with by the police.
veereshmalik
Replied to jprab569 comment 5 years ago
I live between two big hotspots in Delhi (Nizamuddin and Moti Bagh) and a possible 3rd one emerging nearby. What happened has happened and if containment has to happen, it will, and so be it. You can not imagine the stress that people inside a containment zone go through. Blaming the past only makes it worse.
vswaminathan
5 years ago
@ https://www.facebook.com/swaminathanv3/posts/2832340826842185

To repeat (and reiterate) :

sub. ROAD reality (experience) :

“The Police earlier said that it would be providing curfew passes to people who are a part of the essential services.”

On the ROAD , reality – what that is, as of date- any update?

In the interim, for related woeful thoughts shared >
https://www.facebook.com/swaminathanv3/posts/2831733523569582

BACK drop:
https://www.facebook.com/swaminathanv3/posts/2832265453516389

Advisory on Social Distancing – Press Information Bureau
pib.gov.in › Press Relese Detail

https://pib.gov.in/PressReleseDetail.aspx?PRID=1606637
vswaminathan
5 years ago
To share ( a seemingly contra but better pragmatic approach ) - within > https://www.youtube.com/watch?v=fq_mYjfkFNk

MESSAGE: Not to forget that ‘you’, as a miniscule part of the wide world outside (this planet) - is in the midst of ‘peak of evolution’ – worth hearing the clues of mystic wisdom for salvation !
https://www.youtube.com/watch?v=7-9zXLO5JoU

Many more - to search for and find ‘messages of ‘ optimism of the ‘will ‘- pessimism of own helpless human trait of ‘diffidence’( X confidence- to face gracefully the ‘unprecedented crisis ) ?!
https://www.facebook.com/swaminathanv3/posts/2830181307058137
riteshcalcutta
5 years ago
Good to see your article after a long time. I just could make out your writing style. Stay safe, Stay Home.
ganeshjohnson
5 years ago
The lock-down needs to be re-evaluated and cooler heads must prevail. Certain factors unique to our genes, climate, microbe flora/fauna, and others need to be considered. By now it is a foregone observation that India (and South East Asia) has not borne the brunt to the extent the colder hemispheres have. Our immunity is less innocent than theirs. A coronavirus attack on an American cell that has never been exposed to multiple microbes and pathogens earlier elicits violent reaction, causing further damage. A new theory postulated states our mandatory BCG vaccination to all helped (whereas Europeans and Americans abandoned this a long time ago thanks their stupid opposition to vaccination theory.) And coming to economic decimation, there is a limit to which Indians can financially endure (many have reached that limit.) Given all these factors, its time to take an educated risk, and start withdrawing the lockdown.
yerramr
5 years ago
Social distancing can happen either voluntarily or by a dictate. Several villages have themselves put barricades to prevent unknown persons encroaching and causing the spread of virus unknowingly even. This is not by force of law. But locking the borders even if thin, makes lot of sense in the situation we are in. We are not a small State like South Korea or a city State like Singapore. Our Hospitals and other health systems are ordinarily incapable of tackling such a massive attack as the one that we are facing since March 2020 because of the low budgets of both the Union and States for decades. Yet, we have the Allopathic, Ayurvedic, Unani and Homeo medical systems functioning within their own limitations and all of them have capacities to put their mite to help the affected to come out of the attack if identified early. It is time to join the efforts of the governments in whatever position we are placed and wherever.
Still, the lockdown did help spread slow initially. It was a religious meet in Delhi of all places, that has enabled spread lately at exponential dimension. Governments are all exercised in identifying those who participated in such congregation and the people they came in contact and it is a massive exercise. The police and health workers deserve a broad shoulder from all. Let us do it.
veereshmalik
Replied to yerramr comment 5 years ago
Thank you for your views, which resonate, and I agree with them. Especially the part about supporting those on the frontlines - police, conservancy/sanitation workers, medical persons, and others. Matters are going to improve, but yes, will take a lot of effort.
DeepakSB
5 years ago
All passengers of any country while entering India goes thru immigration checks with passport details.Why people are requested to declare travel history? Immigration authorities have details of people ,indian citizens and foreigners entering country and exiting .

Immigration database can be used to track down people entering india and should be tracked for quarantine and covid 19 tests!!!
veereshmalik
Replied to DeepakSB comment 5 years ago
I'm making a point about internal movements and restrictions thereof - under the Epidemics Act and the Disaster Management Act, State Borders are not really the defining internal borders (unlike International Borders). A containment area may be bigger than a State, smaller than a State and may also stretch across States. That's the point I am trying to articulate.
m.prabhu.shankar
Replied to veereshmalik comment 5 years ago
Sir, Irrelevant. As of now country borders are blocked. So is State and District. Any other area cutting across these boundary lines needs co-ordination between respective administration which I see is already happening both in terms of quarantining as well as support to other state labourers who need financial support as I see Tamilnadu CM and Maharashtra CM are already working very closely. So no issues. What is required is all powers from Centre needs to be transfered to states except Defence and Foreign Affairs. Even Trade and Commerce policies should be in the hands of states. We don't want some one (Irrespective of parties) sitting in Delhi deciding what states should do. Ridiculous.
Irshad
5 years ago
Paraphrasing famous couplet of Mirza Ghalib:

या-रब वो न समझे हैं न समझेंगे तेरी बात,
दे और समझ उन को जो न दे तुझको को ज़बाँ और
veereshmalik
Replied to Irshad comment 5 years ago
Poetry and rhymes and couplets have their own place but right now please do look at what our neighbours are doing with their fundoos.

https://www.geo.tv/latest/280170-quarantine-tableeghi-jamaat-members-wherever-they-are-ig-sindh-tells-police
shadikatyal
5 years ago
Sorry being dummy but I cannot understand how India being a nation could discriminate and treat residence of one state as migrants and thus close their borders. Granted we have all our food, language and dress differently but are we not a citizen of one nation?
Modi has treated this as his own state like Rajahas of the past and thus makes decisions without consultations and account of such bunder. Notebandi destroyed middle-class business and now the poor one.
While harvesting around the corner and such workers left for villages, how much delay and spoilage of crops will have future effects. Did such thoughtless lockdown keep poor safe but starved? The way such a class has been treated is beyond imagination
.
veereshmalik
Replied to shadikatyal comment 5 years ago
I guess everything has to be done in a sequence.
vikram.chin
5 years ago
I agree. Germs and viruses dont care about passports and political borders and policemen going around as if they can see individual viruses in the air to knock them out with their lathis is comical at best and depressing in actuality. The Coronavirus concept is a disease of the intellect rather than the body and one more opportunity for Modi to make his presence felt by punitive action like demonetisation.
veereshmalik
Replied to vikram.chin comment 5 years ago
Right now it appears to me that the authorities are treating the movement and therefore curtailment of the Covid Virus like GST or a Centre-State issue when actually it is not just inter-State but inter-National in spread - as the Tablighi Jamaat episode at Nizamuddin indicates. I live 2.5 kms away from this location, thus.
vikram.chin
Replied to vikram.chin comment 5 years ago
Density of infection is different from distribution with thermodynamics likelybeing a better model for predicting contagion in much the same way that kinetic energy is transferred between vibrating / moving molecules in a closed container.
vittalanand1943
Replied to vikram.chin comment 5 years ago
The greatest and idiotic mistake the government committed is that it rushed to bring back NRI s from corona affected countries and allowed those muslims back , without screening them and isolating them from general public for a period of 28 days and then letting in those who proved negative. Instead the lock in period of 21 days including
those who returned allowing every body ,mingle freely paving way for spreading the disease.
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