Prem Shankar Jha

Modi’s Gamble, and How Many Lives It Will Cost

Modi did not want only to prevent a second wave; he wanted all the credit for stopping COVID-19 in its tracks to go to him and him alone.

Modi's Gamble, and How Many Lives It Will Cost
Illustration: Pariplab Chakraborty

In her heart-rending description of her desperate search for oxygen to save her father’s life, the celebrated TV news anchor Barkha Dutt ascribed his death to three features of governance that have defined Modi’s India: complacency, callousness and incompetence. She could have added a fourth – an insatiable, almost suicidal appetite for risk born of a compulsion to keep reinforcing an already swollen image of himself.

Prime Minister Narendra Modi has displayed this penchant half a dozen times in the last seven years: his personal announcement of  demonetisation before the new currency notes had even been printed; his imposition of the Goods and Services Tax with immediate effect, denying India’s 71 million small manufacturers time to set up the required accounting systems; his sudden  confrontation of the Chinese at Doklam in Bhutan without consulting Thimpu, and his equally sudden removal of price and marketing protection from farmers without even a rudimentary examination of how it would affect them.

His appetite for risk surfaced yet again, within days of being told that the first wave of India’s COVID-19 epidemic had peaked in September last year. Of the 50 lakh Indians who had been infected until then, 81% had recovered. Some 10 lakh patients remained under medical care, most of them at home. A little over 84,000 people had died. The mortality rate of 1.68 % was about the lowest in the world and the envy of other nations (notwithstanding fatality undercounting and underreporting).

But everyone involved in the actual fight until then knew that it was too good to last. Scientists always knew of the danger that the ‘original’ virus could mutate into more dangerous forms. Second ‘waves’ of COVID-19 had already developed in the summer and autumn of 2020, spreading through parts of Belgium, Iran, South Korea, Germany, the Czech Republic, Spain and the US.

When researchers in the UK reported the B.1.1.7 variant in December 2020, the country’s government immediately extended its existing lockdown. The variant was found to be more infectious but no more dangerous than the original. Within weeks, scientists reported two more ‘variants of concern’, from Brazil (P.1) and South Africa (B.1.351), in addition to numerous other strains and mutations. P.1 and B.1.351 have been found to be able to partially evade the human immune system, endangering prospects of vaccines being developed at the time.

Therefore, every government took the risk of a second outbreak seriously from the start. By early January 2021, the B.1.1.7 strain had been detected in samples in Denmark, the Netherlands, Australia, Italy, Sweden, France, Spain, Switzerland, Germany, Canada, Japan, Lebanon and Singapore. All of these countries took quick precautions, imposed lockdowns and/or stepped up their vaccination schedules.

There were only three exceptions – all in large democracies with insecure but ruthless leaders in power: Brazil, the US and India.

India’s scientific and medical establishment, and its health minister Harsh Vardhan in particular, were fully aware of the threat that later strains of the virus could pose. Vardhan had overseen the last phase of the polio eradication campaign during Prime minister Atal Behari Vajpayee’s tenure, so he had an experience of disease control that no one else in the government did.

But from the very first days of the pandemic, the Modi government developed two conflicting aims. While the administration wanted to chart a course of action that would minimise the risk of a second wave, the political establishment – headed by Modi himself – was concerned only with extracting every ounce of political advantage from the crisis.

The conflict emerged in the very first week of the March 2020 lockdown. In speech after televised speech, Modi reminded his audiences that just as the Pandava had won the battle of Kurukshetra in 18 days, he would win the battle against COVID-19 in 21 days. He thus turned the lockdown into a personal battle between him and the virus.

As the days passed, and the number of new cases increased instead of declining, Modi began to look for something, or someone, to blame. Conveniently for him, the Tablighi Jamaat conference in New Delhi gave him just the scapegoats he needed – foreign religious clerics belonging to a religion he detested and had targeted to attain power. The strictest possible lockdown was therefore imposed on the entire Nizamuddin area of New Delhi and criminal cases filed against the organisers – despite the fact that the conference had ended two days before the government imposed the first travel restrictions on foreigners, on March 14.

But new cases continued to mount long after the event’s conclusion, so Modi sought help from the occult. To invoke the gods to come to his aid, he asked  people to turn off their lights and beat thalis at preordained times and used the Air Force to shower flowers over Delhi.

While he was monopolising TV time, his administration was setting up 11 empowered groups under the National Disaster Management Act, to deal with the material aspects of the forthcoming challenge. One of them, within days of being set up, warned the government in unambiguous terms that a second wave was likely and provided detailed recommendations on how to prepare for it, should it happen.

Among its most important recommendations was that India immediately import 60,000 tonnes of oxygen and upgrade 150 district hospitals – mainly by supplying them with 162 pressure swing adsorption plants to isolate oxygen.

The 162 plants were expected to cost Rs 200 crore. At the time the empowered group made these recommendations, the PM Cares fund, which Modi had set up to fight the pandemic, had already received Rs 3,076 crore, mostly from public sector companies. So Modi had the money he needed, in abundance.


A COVID-19 patient on oxygen support waits to be admitted at Patna Medical College and Hospital, during the second wave of coronavirus in Patna, Friday, May 14, 2021. Photo: PTI

But Modi did not want only to prevent a second wave; he wanted all the credit for stopping COVID-19 in its tracks to go to him and him alone. So when the  first wave peaked in September 2020, his propagandists immediately  proclaimed that Modi’s harsh lockdown had defeated the outbreak and saved India. From then on, it was business as usual for Modi, and business as usual had  only one goal: to wrest West Bengal from Mamata Bannerjee and the Trinamool Congress, no matter the cost.

In Modi’s highly centralised, PMO-centred decision-making process, this shift of attention sowed the seeds of today’s disaster. The government’s first act was to wind up five of the 11 empowered groups and discontinued the meetings of the group tracking the virus’s spread. The programme to upgrade district hospitals went into limbo – as did the plan to create an oxygen reserve by  importing 50,000 tonnes of oxygen.

Genome sequencing, which is essential to determine which mutations are spreading in which population, took the back seat. It was not till December 25, 2020, after B.1.1.7 had already arrived in India, that the health ministry created the Indian SARS-CoV-2 Consortium on Genomics (INSACOG) – a chain of 10 laboratories to sequence and analyse virus samples.

By March 24 INSACOG had tested 10,787 samples and found 771 instances involving three of the eight ‘variants of concern’ the US Centres of Disease Control had identified. Of them, 94% were of B.1.1.7.

This should have set the alarm bells ringing in every office in the PMO – but four state elections were imminent and Modi could think of nothing else but the stentorian speeches he was preparing to give in the 23 election rallies he intended to address in West Bengal and Assam.

In fact, the absence of any sense of urgency in the government after September was so complete that it took eight months, until November 2020, just to invite tenders for the oxygen plants. As a result, on April 18, 2021, only 11 of the 162 oxygen plants had been installed.

Also, none of these had been funded by the PM Cares fund. In fact, it was not till April 15 that the PMO coughed up a measly Rs 100 crores from its corpus to complete the construction of 59 more plants and bring the number up to 80 by the end of May.

There was a similar departure from responsibility  in the vaccination programme. From January 16, the government concentrated on vaccinating frontline and healthcare workers. Vaccination for those above 50 years began on March 1, but with that private interests and preferences came roaring back into play.

Pfizer was refused permission to sell their vaccines in India. The Centre also failed to strike advance purchase agreements with vaccine-makers and grossly underestimated Indian manufacturers to satisfy the domestic demand for doses.

The government also forced Covaxin, an ‘indigenously developed’ vaccine, on government hospitals before the latter had completed its crucial phase 3 trials. As a result, vast numbers of eligible persons refused to take the vaccine, slowing immunisation still further.

Despite this rampant irresponsibility,  Modi’s luck held for five months after September. Through these winter months, the number of active cases continued to ebb. When it reached a minimum in the week of February 11, 2021, there were fewer than 138,000 patients under treatment and a hundred or so deaths a day. The country heaved a sigh of relief. Markets, restaurants and malls began to function again and life was returning to a semblance of normal. But by then, the seeds of the second wave that is now ravaging the country had been sown.

The second wave

The first warning came, almost unnoticed, in late-February when the number of new cases daily began once again to exceed  recoveries, causing the number of active cases to start rising.  This was slow at the beginning: the first doubling of active cases, from 137,000 on February 14 to 273,000 cases on March 18, took   32 days. But after that, and within six days of INSACOG’s warning, the speed tripled and each doubling took only 11 days or so.

The number of active cases breached the 1 million mark on April 10 and the 2 million mark on April 21. Not until then did it register on Modi that there was something more important happening in the country than the West Bengal and Assam elections. But by then he had already addressed 10 million persons in  23 rallies, where neither he nor anyone in his audiences wore a mask.

Modi’s utter disregard for the consequences of his actions emboldened lesser leaders in his party to follow his lead. The chief minister of Uttarakhand not only refused to cancel the Kumbh Mela but put out advertisements to draw more devotees from around India.

When a special leave petition to the Supreme Court pointed out on April 16 that “there is no protocol in place to ensure that devotees who get infected do not go on to spread the virus when they return”, he retorted that “nobody will be stopped (from attending the mela). We are sure that faith in God will overcome fear of the virus”. As a result, an estimated 28 lakh persons attended the mela, took holy dips in the Ganga, jostled with each other in the crowded, polluted waters of the river, and then dispersed to all parts of India to spread the virus.


Devotees gather to offer prayers during the third Shahi Snan of the Kumbh Mela 2021, at Har ki Pauri Ghat in Haridwar, Wednesday, April 14, 2021. Photo: PTI

Therefore, to Modi’s surprise – and perhaps only his – there were three and a half million active cases on May 4. Hospitals were full to bursting, doctors couldn’t even reply to anxious calls from infected patients, helplines were overloaded and distress calls received no answer. An acute shortage of oxygen killed patients by the scores every hour.

Although the data has not been released, and may never be, I speculate from personal experience that more people have probably died because of the lack of oxygen than from any other single cause. In fact, the shortage of oxygen is therefore the one issue on which the world needs to hold the Modi government, and Modi in particular, criminally responsible. For there is not a shadow of an excuse for the shortage that has developed.

In a report a report submitted to the Lok Sabha in 2020, a committee headed by MP Ram Gopal Yadav pointed out that the country’s oxygen production capacity was 6,900 tonnes a day; that at the peak of the first wave the demand for medical oxygen had reached 3,000 tonnes a day, but as the wave subsided it had fallen to 1,000 tonnes a day. This allowed the remainder to be diverted for industrial use.

So in March, when INSACOG identified the B.1.1.7 strain as the main threat to the country’s population at the time, the government could have diverted at least 2,000 tonnes a day of oxygen back from industrial centres with a single stroke of the pen. But at the end of March, Modi’s fixation on winning the West Bengal and Assam elections was so complete that he ‘forgot’ to make that stroke of the pen. And by the time he ‘remembered’, it was April 19, and  people were dying in their cars and as their relatives took them desperately to one hospital after the next in search of oxygen.

So in March, when INSACOG identified the B.1.1.7 strain as the main threat to the country’s population at the time, the government could have diverted at least 2,000 tonnes a day of oxygen back from industrial centres with a single stroke of the pen. But at the end of March, Modi’s fixation on winning the West Bengal and Assam elections was so complete that he ‘forgot’ to make that stroke of the pen. And by the time he ‘remembered’, it was April 19, and  people were dying in their cars and as their relatives took them desperately to one hospital after the next in search of oxygen.

 

 

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