China may be blamed for attempting to conceal news on the extent of the virus' spread in Wuhan but we were well aware of the perils by early January. One wonders why governments did not prepare for the possibility, if not the eventuality, of COVID-19 reaching our shores. India's tests and testing capabilities still remain very low. Unless we get lucky and find that the heat moderates the spread of the virus, we will be hit hard. Yet, why neither the centre nor states made any arrangements for rapid testing kits and respiratory support systems like ventilators escapes reason.
There is no denying the complete failure of policy-makers in assessing the risks of COVID-19. It demonstrates faultlines of a highly centralized health management system with no real initiative for independent action at local level. Devoid of an adequate strategy and given India's population density, a complete lockdown is the only way to suppress the disease, giving time to prepare a medical response for mitigation. However, the economic and social costs of an extended lockdown may fast overtake any such benefit.
With higher inflow of international travelers, Kerala and Maharashtra may be hit the hardest, but are more likely to flatten the curve early with aggressive testing. Those states with low incidence also have low per capita testing, suffering from an 'Ostrich Syndrome'. They need to understand the nature of this disease. The lockdown will slow but not halt the incidence. As the lockdown starts to lift and mobility increases, so will the rate of incidence. It is imperative that identification and testing increases for those who are vulnerable, even for asymptomatic cases.
Faced with an uncertain economic future and the fear of a hostile environment, thousands of migrant labors have attempted to walk home, carrying with them a new wave of possible risks. Stopped at borders and barred from villages, this tide has ebbed temporarily, but is waiting to break through post the lockdown. While governments are now making an effort to feed and secure these migrants, they still remain vulnerable to ostracization, exploitation and the disease. Left to fend for themselves in foreign lands, unless adequate rations and a safe environment is assured, they will venture out. The next wave of scared migrant labor returning home, could raise the incidence in rural India, where the doctor-population ratio is 1:10926, far lower than the WHO-mandated 1:1000. Rural quarantine or isolation and treatment monitoring is virtually impossible given the understaffed rural health system.
Bolangir and other parts of the impoverished KBK region have lakhs of people migrating every year for low l-paying construction jobs. While local labor offices are mandated to register such migration, the reality remains just a fraction of the total. A well-oiled middleman system under patronage means that there are currently millions of unaccounted migrants stranded in various parts of the country. Factory owners and middlemen involved must be held accountable if migrant labor is left abandoned during the lockdown.
My own experience in coordinating relief has been heartening. Using mostly social media, we have managed to get immediate relief for thousands of migrant labourers from Odisha. I have received prompt responses and action from officers of Punjab, Maharashtra, West Bengal, Tamil Nadu, aided by the offices of the Chief Ministers and friends from parliament. Odisha has now set up a body to coordinate such efforts. It's encouraging to see the immediate response from both higher as well as field level officers of various governments. However we need to shift move from an adhoc fire-fighting mode to long-term strategies. It's imperative that we manage an exit policy which accounts for the safe return of these migrants.
Governments need to start focusing on carefully identifying migrant labor if we are to be ready to deal with the next challenge. States such as Tamil Nadu, Karnataka, Maharashtra and Telangana which import a large part of their labor need to ensure their well-being and security. This information should be shared real-time with the states of their origin to plan for their inevitable return. Labor exporting states such as Bihar, Jharkhand, Chattisgarh and Odisha should identify migrant labor through village-level surveillance and district labor offices. NGOs and civil society organizations working in these areas must be included in the call for action. Dedicated trains and buses will need to be organized to ensure the safe return of these migrants, followed by their quarantine and testing.
With the political class mostly absent and the Babus focusing on managing relief, there is a screaming need to bring epidemiology experts and economists into the policy and decision-making framework. A strong political leadership is required to override the brittle egos of the executive and to ensure that sane professional advice forms a part of the long-term strategy. A cohesive strategy must be devised from stronger centre-state relationship to change protocols and remove red tape. Creation of immediate heath capacity by including the private sector must be done on war-footing. Lastly, governments must communicate honestly to gain the trust of their people rather than resorting to empty headline-grabbing and a marketing blitzkrieg.
Without a serious effort to provide adequate social welfare and livelihood, the chances of labor migrating again are real. Unless we ensure a basic level of income, an exodus of migrant labor back to the cities before we have controlled COVID-19 is likely. It's time that the centre and states pooresources to create adequate provisions for livelihood and economic opportunities in rural India. Maybe it is time to seriously think of a Universal Basic Income Scheme. Moving away from political grandstanding to conceive genuine social welfare and direct income transfer to those who are most vulnerable is the call of the day.
Government and political thinking must evolve to meet this challenge.
(Kalikesh Narayan Singh Deo is a second-time sitting Member of Parliament from Bolangir in Odisha and a prominent leader of the Biju Janata Dal.)
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