The large population of India got into the clutches of the deadly Covid-19 virus with a ferocious and highly infectious second wave in March-April 2021.
My whole family was also impacted. Here is a day-by-day account of our experience.
A lot is being written about what governments did or did not, what experts said or did not, what people did or did not. However, what stands exposed is the vulnerability of 17% of human race to a black swan event in public health.
There is no denial that the severity and extent of the spread is largely attributed to the nature of the mutant B.1617 that has ravaged through the sub-tropical terrain of the country, hitting metropolitan centers first, and now making inroads in the hinterland.
The one thing that is clear is the amount of pressure and in some unfortunate cases, the collapse of the various parts of the medical value chain. Starting from the procurement of essential inputs for medicines, vaccinations and even oxygen, to the actual care center where the patient is being attended. There are multiple points of failure, which got amplified with the enormity of the problem. In nut shell, the patients and their families suffered, the care givers and their families suffered, the administrators suffered and all other critical players of the value chain suffered.
The significant number of cases and subsequent misery is really painful. However, as some dust starts to settle, at least in the metro centers, one can find some of the partially overlaying and seemingly unseen factors that have accentuated the pain.
In my amateurish research, I could isolate two factors that need serious review for a future readiness of any such unfortunate event –
- Reaction: Traditional administrative response due to colonial history led to seeking more control of the resources in hand than focusing on problem solving. Some parts were covered by Chief Economist of Vedanta in his article here in a related context.
- Response: Lack of consistent information distribution framework between different parts of the federal structure of the country in the face of the pandemic.
Reaction: Traditional administrative response
It’s a known fact that the countries that have had a significant colonial past, have an inherent administrative method of working, often proudly termed as legacy. The method relies on identifying the entity with maximum control over the available essential and required resources as the most powerful one. This is a typical command and control mechanism. Consequently, an intense tug of war ensues between different sections of the federal structure, all the way from the top to the lowest level in the hierarchy. In the current crisis, this tug of war, has proved counterproductive in many ways, as is clear from news reported from multiple quarters. Due to this never-ending siege to gain control, the core problem is often ignored or forgotten.
To paraphrase from the above-mentioned article, the complimenting complacency is so deep-rooted that one starts believing that they can practically control everything, even the pandemic. Only to be proven grossly wrong as witnessed with the unfortunate episode in India.
However, a problem-solving approach can turn the tables. When one compares India with all leading developing nations, this difference in response mechanism to a similar crisis is visible.
This could be the moment to demonstrate transformational leadership for national executive. If a problem-solving approach is taken from top to bottom, then there could be permanent change in state of affairs in the country. It is imperative that the leadership takes lessons from this crisis, to fully realize all the points of failure in the current medical care value chain and built a robust plan to upgrade it to become world class, or even better.
A key starting point for this is to significantly increase the union budget provisioning for healthcare care. The healthcare allocation was doubled in FY 2021. That was prior to the pandemic outbreak. We should now re-assess the allocation. From a paltry 2.5% at the moment (after the increase), it should be increased multi-fold to upgrade the entire ecosystem, as has been rightly called out by many experts including the Indian Medical Association. Technology upgrades, manpower training and induction including care providers and administrators, investing in R&D and building a denser network of well-equipped health care centers. These are some areas that can be of focus. Of course, experts can provide much more inputs to it.
An initiative like ‘Swasthya Bharat Abhiyan’ in line with ‘Swachch Bharat Abhiyan’ could be the need of the hour.
Response: Lack of CoNSISTENT INFORMATION DISTRIBUTION Framework
An unfortunate but clearly visible aspect of the outbreak management has been a failure of the collaborative communication between multiple entities. Professional compulsions aside, a lack of a comprehensive and reliable communication and information distribution has significantly contributed to this problem.
Take the example of foreign aid distribution, post its arrival in Delhi airport. A simple dashboard with details of inbound shipment and outbound shipment status, along with point of origin, destination, items in shipment, split of shipment, current status (even if updated manually once in a day) would have saved multiple stressful hours of internal and external bickering. The bandwidth thus saved could have been utilized in other places.
At state level too, inconsistency of a consistent information distribution framework for basics like hospital beds, medicine availability, plasma donors, oxygen supply availability etc. took the chaos to the streets. Even in the National Capital of Delhi, at one point there were multiple posts all over social media seeking help for their kith and kin. Multiple posts used to be posted within a minute. It was overwhelming. It still happens but the frequency is lesser.
Its commendable that multiple individuals and private players built different applications to address this to some extent. However, lack of bandwidth to keep the information updated rendered most of these apps useless.
Petty it may sound, but in all the joint CM and PM meetings, or in one-to-one CM meetings or in any meetings within their staffs, one common and consistent framework for information distribution, could have just reduced replication of same last mile pains in multiple parts of the country.
Moments of crisis like these lead to amplified distrust among the professional opponents. A transparent, technology-driven and easily accessible communication toolset could have led to reduction in replication of similar pain points, artificially generated due to the administrative inefficiencies.
There are many lessons to be learned from the current crisis but the topmost priority remains providing as much care as possible to the affected. As quickly as possible and to save as many human lives as possible.
Closing with a big shout out to all the care providers who are relentlessly working to make the world a better place to live.
(All views are personal.)