At the end of 2020, dozens of articles celebrated India’s success in its fight against the coronavirus. So when recent apocalyptic images of the streets of India surfaced globally, the world was in shock.
Now at the global epicenter of the pandemic, people in India are living through a lucid nightmare. At least one out of three global coronavirus cases is in India. India’s daily case count has already exceeded all previous world records, surpassing 400,000 cases per day. While the known hot spots are in the densely populated Mumbai, New Delhi, Pune and Bengaluru, the unknown ones are equally concerning, with reports that cases are still being grossly underestimated in India. The surge is attributed partly to a double mutant variant, B.1.617, that experts suspect is more contagious than other strains globally and partly to an unprepared Indian medical and political system.
Even still, the figures fail to capture the intense devastation on the ground. Death is quite literally on the streets, with patients dying in rickshaws or on stretchers, unable to find space in the hospitals themselves. India’s holy Ganges River is now also inundated with the bodies of the dead. Even strict “lockdowns” have lost out to the sheer number of deaths, forcing people to drag the bodies of the deceased in search of an available crematorium.
India is now wrestling with what is likely its greatest crisis since Partition. As experts continue to determine the exact nature of the second surge, this post walks through the various factors that led the world’s largest democracy from confidence to chaos.
In February, India’s ruling Bharatiya Janata Party (BJP) passed a resolution on the pandemic. In it, India reintroduced itself to the world “as a proud and victorious nation in the fight against Covid.” Indians had not just created a victorious India but an “Atmanirbhar Bharat”—that is, a self-reliant one.
The triumph echoed throughout the resolution was not entirely unfounded. In February, daily cases had fallen 90 percent from those reported in September 2020 when the first wave threatened to overtake the United States. With a population of more than 1 billion and a fragile health care system, India—and its global allies—were not just hopeful but surprised.
Various theories emerged to explain the dip in cases. Some pointed to India’s mask compliance, albeit an erratic one, and the seemingly strict lockdown issued by the central government. Others highlighted India’s relatively younger population as the reason for low hospitalization rates, or the “hygiene hypothesis,” which suggested that India’s population had some form of preexisting immunity.
The relief spawned eased restrictions, a lethargic government tender for new oxygen plants, crowded Diwali markets and some of the world’s largest civil society protests against new regulations on farming. Although some public health experts warned of the potential for a second wave as new mutant strains grew across the globe, Indians breathed a collective sigh of relief.
India launched its official vaccination campaign on Jan. 16, having approved the Oxford-AstraZeneca vaccine and its homegrown one, Covaxin. The goal was to vaccinate 300 million people by summer, a number still less than a fourth of its total population. Once again, onlookers were hopeful: India was the pharmacy of the world and had already championed the world’s largest immunization program, having annually delivered shots to protect against diseases like tuberculosis and having successfully eradicated polio.
The vaccine rollout was bumpy. Frontline health care workers resisted receiving the vaccine, expressing skepticism given the domestic vaccine’s rushed approval process. By February’s end, only 0.2 percent of India’s population had been fully vaccinated. The Indian government didn’t appear to take its vaccine rollout seriously either. India, competing with China for global influence, engaged in a game of “vaccine diplomacy,” giving away millions of doses to countries like Nepal, Sri Lanka and Brazil. Not too long before the BJP issued its resolution of India’s victory against the pandemic in late February, its health minister, Harsh Vardhan, continued to peddle a charged pseudoscience about COVID-19 cures, appearing at an event that supported an Ayurvedic medication’s efficacy against the coronavirus, a claim that the World Health Organization quickly debunked.
As relief from the pandemic’s first wave engulfed Indians, so too did a coronavirus complacency. Relaxed regulations, large gatherings, a blasé approach to vaccinations, and political agendas came to the fore. The results came quickly—by Feb. 18, Maharashtra saw a spike in patients, with daily cases above 5,000 for the first time in months. Less than 10 days later, BBC commented on a surge in cases across a number of Indian states and asked the question that no one previously had dared to: Was India encountering its second wave?
A Country in Crisis
India’s second wave has brought its health system to its knees. Patients who are lucky enough to get a hospital bed are sharing them with others. Those turned away from hospitals are fashioning makeshift intensive care unit rooms at home or lining up at Sikh temples to receive whatever help they can get. Newspapers continue to warn patients against fake medicine circulating through the state. As hospitals are suffering from critical oxygen shortages and understaffing, patients continue to die. Crematoriums are not just overwhelmed; some are even melting due to their relentless burning. As death continues to consume public consciousness, parks and parking lots are transforming into makeshift graveyards. Although the reported death toll is already approaching 200,000 in India, experts say that the peak of the crisis is still to come.
Generally, the government’s power to regulate pandemics originates in the Indian Constitution. The Seventh Schedule of the Indian Constitution delineates the powers of the central government and those of the states, explicitly empowering both to generate legislation related to public health. While the central government’s unique powers are to regulate port quarantines, maritime health and interstate quarantines (Art. 246, List I, 28 and 81), the states have control over public health and sanitation, hospitals, and dispensaries (Art. 246, List II, 6). This clear division starts to erode, however, because the Seventh Schedule gives concurrent jurisdiction to prevent infectious diseases crossing interstate lines (Art. 246, List III, 29).
An archaic, British colonial-era law, the Epidemic Diseases Act of 1897 (EDA) similarly authorizes the central and state powers to regulate infectious diseases. The central government and states have previously invoked the act to contain the swine flu, dengue fever and cholera, and they did the same in the spring of 2020 in their fight against the coronavirus. Section 2 and 2A of the act empowers the states and the central government to implement special regulations to curb an epidemic—states are able to impose “temporary regulations” including inspections of travelers and segregation of the infected, and the central government can likewise inspect and detain ships and vessels coming in and out of ports. The EDA has been criticized for its inability to account for modern viruses, neither defining what constitutes a “dangerous epidemic disease” nor discussing vaccinations.
While the delineation of constitutional power may lean in the direction of making states responsible for issues of at least internal public health, the practical realities are that the central government’s fiscal and institutional capacities have made them key players in defining health policies in India. Even in the recent declaration of the EDA, it was the central government that advised states to invoke Section 2 in their jurisdictions.
Who exactly has the authority to implement national lockdowns during the pandemic is unclear. Some point to the vague language of the EDA, although the EDA seems to limit the powers of the central government to regulating port authority. Others have pointed to the Disaster Management Act, 2005 (DMA), which was also invoked last spring. The DMA gives more power to the central government, with the National Disaster Management Authority (NDMA) headed by the prime minister as the primary node of authority through a crisis. In March 2020, the NDMA issued an order directing the central and state governments to take measures “ensuring social distancing,” and it was soon after this order that the prime minister imposed the national lockdown under Section 10(2)(l) of the DMA. Moreover, invoking the DMA gives the central government several broad provisions to take advantage of, like the authority to “give direction to media” (Chapter XI, 67).
Prime Minister Narendra Modi has been largely quiet on the matter of the pandemic, having waited until April 20 to address the nation on the issue for the first time. Resisting calls for another nationwide lockdown, the central government has now focused its efforts on acquiring and distributing necessary resources to the states. For one, the central government ordered for the diversion of industrial oxygen for medical use via the Indian Railways system, creating an “Oxygen Express” service to carry these tankers. The government has also utilized the strength of the military, recalling medical officers for deployment and having armed forces set up temporary hospitals in places of need.
Despite a de facto policy of self-reliance in times of disaster, India has also begun accepting foreign aid to ameliorate its extreme dearth of oxygen, drugs and medical equipment such as ventilators. This global campaign to assist India has included the likes of Germany, the European Union, the United States and even China. India has also recently approved the Russian vaccine, Sputnik V, the first batch of which arrived at the beginning of May, in an attempt to accelerate its inoculation efforts.
Beyond scrambling for resources, the central government’s response to the second wave has largely been to shift more discretion, and therefore accountability, to state governments. This has entailed leaving states to manage vaccine rollout for those 18 to 44 years of age, which accounts for approximately 44 percent of India’s population. The central government has also given states full authority to decide lockdown policies.
But this lack of cooperative federalism has led to political sparring. For example, states are now striking back at the central government for not regulating vaccine prices, particularly given that states will have to pay nearly three times as much for the medicine as the central government. The skewed pricing scheme risks jeopardizing states’ ability to provide free vaccines for their constituents, thus ultimately impacting the poor and rural classes the most. As of the end of April, only 18 out of India’s 36 states and territories had guaranteed free vaccines for their residents, and only 1.97 percent of the population was fully vaccinated. At the current rate of vaccinations, experts estimate that it will take eight years for India to reach herd immunity.
The limited resources have also forced states to compete with one another. Haryana’s chief minister even claimed he ordered police to protect shipments of oxygen from being stolen by other states. States are also now asking how the central government is distributing what resources, when and to whom. For example, the leaders of the nation’s capital, New Delhi, alleged that their hospitals are not receiving the oxygen quantity allocated to it by the central government.
Filling in the Gaps
As the government falters, civil society has developed a striking system of mutual aid, albeit one rooted in desperation. SOS messages have saturated all forms of social media, requesting leads on plasma, oxygen tanks and bed availability in nearby hospitals. And in many cases, friends, strangers and Twitter search engines have delivered at least some form of relief, whether it be affirmations or actual resources. From the low-caste Dalits who continue to risk their lives cremating infected bodies, to the Good Samaritans cooking meals for patients near and far—a new class of civilian heroes has emerged in the midst of the crisis.
In some instances, the state courts have also played their part in holding actors accountable. In Gujarat, Modi’s home state, the High Court demanded the state release accurate statistics on the number of coronavirus patients and deaths after seemingly underreported case counts were touted. The Madras High Court chastised the Election Commission as being single-handedly responsible for the second wave by allowing political rallies to continue through the pandemic. Similarly, the Delhi High Court urged the BJP’s opposition party to put “its house in order” and manage the shortage of oxygen and remdesivir, an antiviral drug used to treat COVID-19. Most recently, the Supreme Court of India advised the central government to once again issue a nationwide lockdown to curb the pandemic.
While Indians are living through a nightmarish reality, the central government has continued to build an alternate factual universe powered by its pre-pandemic agenda: building a Hindu Rashtra. The BJP, known for aggressively pushing a Hindu nationalist agenda, continued pandering to its Hindu voter base when it allowed more than 3 million pilgrims to enter the Ganges to celebrate Kumbh Mela in Haridwar, Uttarakhand. The festival, held from March 11 to mid-April, received robust political support from the BJP even as the second wave was in full surge, featuring full-page advertisements showcasing Modi and the assurances that the pilgrimage was “beautiful, clean, [and] safe.” Although drawing COVID-19 causality has been difficult for scientists, thousands of new coronavirus cases emerged in Haridwar following the start of the festival and 1,600 devotees tested positive in the span of a few days in April. It was only in mid-April, approaching the festival’s end, that Modi finally made the delayed about-face and asked devotees to keep their celebrations “symbolic.” The delayed course of action stood in stark contrast to the BJP response to Muslim holy celebrations during the pandemic’s first wave, when top BJP officials were quick to accuse Muslims of propagating the disease through “corona jihad” and “corona terrorism.”
The BJP has also taken this disregard for the pandemic to its political campaigns. With key state elections on the horizon, Modi and his second-in-command home minister, Amit Shah, announced a road show through the poll-bound state of West Bengal in mid-April. Top officials even boasted their commitment to fighting the political fight, noting that for the first time, a prime minister would host three rallies in a single day in West Bengal. Photos from the rallies show a dense crowd of what seems like thousands cheering on the prime minister, without a mask in sight. While Modi would ultimately heed criticism and switch to virtual campaigning starting April 22, his Twitter posts in the days leading up to late April are telling, largely alternating between messages on the elections and the pandemic.
While the pandemic surges on, so does the BJP’s gamesmanship in Kashmir. While the BJP-appointed lieutenant governor of Jammu and Kashmir ordered the closing of schools and canceled designated vacation days for medical staff, he also celebrated the intense rush at Kashmiri tourist destinations. The prime minister even boasted of the opportunity to visit the Kashmiri tulip garden in late March, welcoming tourists and once again attempting to signal normalcy in a region fraught with controversy after BJP’s 2019 abrogation of its special autonomous status. Similarly, the governing board of the annual Amarnath pilgrimage in South Kashmir, a pilgrimage meant for Hindu devotees, has still not canceled the program despite the concerns over the second wave.
The BJP has also used the second wave to advance its political agenda in New Delhi. Although the capital was under the leadership of an opposition party, the Union Home Ministry’s office issued a notification on April 27 announcing that the Delhi government will now have to obtain permission from a centrally appointed lieutenant governor before taking any action. The move effectively defanged a party that had been a key rival to the ruling BJP at a time when the capital was facing one death from the coronavirus every four minutes.
The BJP’s response to the second wave reflects the party’s approach since its election in 2014: political pandering in the name of Hindutva. Just as Modi’s demonetization policy immensely affected the poor, the low-caste, and women, the vaccine rollout policy threatens to, once again, force these classes of people into the category of Indian have-nots. And just as ministers consistently validated the vigilante need to lynch Muslims and the low-caste for their butchering of cows, they validated the narratives of a Muslim-driven virus while also pandering to the Hindu polity’s desires for Hindu festivals. The pandemic has not created the problems India is facing today; rather, it unearthed and amplified what was already lurking beneath the surface.
A specter of illness has swallowed communities across India: 90 percent of Indian districts have now passed the national threshold, 5 percent, for a high positivity rate. Of those districts, India has 150 districts with a positivity rate of more than 15 percent, with some major hubs like Delhi reporting a whopping positivity rate of 40 percent. Thus, for some, the question of contracting the coronavirus has now shifted from if to when. The consequences of catching the disease are darkly intimate for Indians, with many having had a relative, a friend or a neighbor who has fallen prey to the virus.
The current crisis is a reckoning not only for India but also for other countries—India’s second surge is forcing the world to recalibrate both domestic and global attempts to contain the pandemic.
From Confidence to Chaos: India’s Journey to Its Coronavirus Crisis is written by Shaiba Rather for www.lawfareblog.com