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.
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.