Covid-19: 2nd Wave & Related Issues

📅: 09^th Jan 2021 ⌚ : 20 Minutes

Topics covered from the syllabus:

GS-2: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
- India and its neighborhood-relations.
- Bilateral, regional and global groupings and agreements involving India and/or affecting India’s interests.
GS-3: Disaster and disaster management.

Note

Following is the summary of ‘The Big Picture’ discussion, which was aired on RSTV.
This is a special edition covering multiple episodes of The Big Picture.
Host: Teena Jha
Panellists: Multiple Episodes
Please note that some inputs have been given by our team in order to make the topic more relevant to UPSC.

Context

The second wave of COVID has led to a huge upsurge of cases in the country, nearing almost 4 lakh cases per day. Many states have announced weekend and week-long lockdowns respectively. However, there has been an increasing clamour for a complete nationwide lockdown to break the chain and give time to recoup the health infrastructure.
Similarly, many states have reported a shortage of medical equipment and aids including shortage of oxygen in the country. Media reports have also indicated inadequate number of beds in the hospitals with reference to the increasing case load in the country.

Prelims Focus

Vaccine Maitri Initiative: This is a humanitarian initiative taken by the government of India to supply the COVID-19 vaccine to foreign countries.

This facility also includes the national commitments to supply vaccines to the countries under the COVAX facility – supported by the World Health Organisation and the GAVI vaccine alliance.
More than 90 countries have received almost 6.6 Crore doses of vaccine from India

America is Back: This is the policy of the newly-elected President of America, Joe Biden.

The policy replaces the ‘America First’ policy of outgoing president Donald Trump. America First largely focussed on keeping the American interests supreme wherever required.
America is Back signals a more cooperative attitude towards global alliances and friends, in keeping with the larger leadership role played by America as the sole superpower.

Sustainable Development Goals (SDGs): They are a set of 17 interconnected goals which have been adopted by the countries to move towards a better standard of life and a sustainable future.

They are applicable to all members of the United Nations.
They build upon the Millennium Development Goals (MDGs) which were taken up in 2015.
SDGs were taken up in 2015 and are supposed to be achieved by the year 2030.

Mains Focus

Corona has been termed as the ‘Once in a Century’ crisis by the Economic Survey and the Indian Government. The problem has been exacerbated by the mismanagement and handling of the pandemic in a complacent manner during the second wave. The oxygen crisis and the shortage of medicines and medical aids has led to a tremendous loss of life and lack of confidence in the governance ability of the Administration. The impact of the pandemic is not limited to the vulnerable sections, but has been felt at all levels of the society.

This is not to say that the Government has not taken steps to address the situation. However, to understand the handling of the pandemic, first we need to understand how the second wave is different from the first wave of COVID. After that, we will discuss the impact of COVID on the different sections of the society. This will make it easier for us to analyse the preparation strategy and the steps taken by the Government to mitigate the impact of COVID on the society.

Differences between the First and Second wave
S. No.	Issue	First Wave	Second Wave
1.	Increase in Cases	The increase in the number of cases in the first wave has been more gradual. While the first wave of COVID-19 touched approx. one lakh cases in India, it was a more gradual increase, than the second one.	In comparison, the rise has been sharper in the Second wave. In the Mid-February, India was recording approx. 10,000 cases per day. However, by the end first week of May, the daily tally had touched an average of 4 lakh cases.
2.	Response to the Pandemic	The focus in the first wave, was majorly on arresting the import of virus, by monitoring the inflow of passengers from the affected countries. The arrival of an unfamiliar virus with its rising death toll led to an increase in fear in the country, leading to the announcement of lockdown. This gave time to revamp and scale-up the health infrastructure to match the rising spread of the pandemic.	The second wave has been characterised by a false sense of normalcy. The elections in multiple states, including assembly as well as Panchayat elections have led to large gatherings. Also, Public places were opened and there were large religious gatherings leading to crowded places and spread of virus. Apart from that, the focus has now shifted from stopping the import of the disease to stopping the community transmission between the already infected and the rest of the population.
3.	Medical Treatment	While, to this date, the confusion prevails over the treatment of COVID, the first wave was relatively more confusing for the medical professionals. Also, there was a complete absence of vaccines at that time, leading to a sense of helplessness.	The social media has been replete with cries of help from the people, asking for hospital beds or oxygen cylinders for their loved ones. This shows a gross state of unpreparedness in the health infrastructure. The creation of new facilities is not proportionate to the rising number of infections.
4.	Cooperative Federalism	The first wave led to a complete lockdown, including the transport system in the world. The borders of the states were also clamped shut, in the hope of containing the spread. The states were unanimous in imposing the lockdown as they followed Centre’s lead. This was an important factor in breaking the chain and containing the spread of the virus in the first wave of COVID.	While some states like Tamil Nadu have reported themselves to be an oxygen-surplus state, others have had an acute shortage of oxygen. This points to inequalities in resource distribution.
5.	Data Compilation	It has been reported by media that the data reporting was more accurate in the first wave of pandemic because of the widespread use of ‘Aarogya Setu’ app and better administrative response.	The official data is not able to record the number of deaths outside the formal health system. Therefore, the patients who could not receive hospital beds have been unaccounted for. Similarly, people dying rural areas could not be included the official estimate. The under-reporting is clearly visible in the difference between the reported deaths and the bodies lined up in crematoria in the country.
6.	New Mutant Strains	Unlike the second wave, the first wave was characterised by a better reliability of both the Antigen as well as RT-PCR tests. This led to better accuracy of treatment, despite the lack of unified guidelines on treatment of the disease.	The second wave of COVID has been complicated by the arrival of various mutants like South Africa, Brazil, UK mutant which have been labelled as ‘Variables of Concern’ by the World Health Organisation. Similarly, the Indian variant has also been marked as a contagious variant, with potential for causing huge health implications.
7.	Impact on tier-2 and tier-3 areas	The rural areas were comparatively safer from the pandemic in the first wave. Apart from that, the first wave lead to increase in global agricultural commodity prices. This led to better returns for the farmers as is visible from the high demand of FMCG goods and tractors.	The second wave has been rather punishing for the rural areas. Rural areas face the twin challenge of lesser testing infrastructure as well as lesser access to the hospitals. Apart from that, the agricultural commodity prices remain high and a bumper harvest is predicted riding on above normal South West Monsoonal rains. However, the rural demand may get affected due to the areas getting affected by the pandemic. It is imperative that the second wave subsides in time to ensure rural recovery before the Kharif season to reap the benefits of a bumper crop.

Economic Impact of Covid

Difference between the first and second phase: Unlike the first phase, the government has not favoured complete nation-wide lockdown in the second phase. The focus has been on saving lives as well as livelihoods. Therefore, the states have been advised to enforce partial lockdowns as per the prevailing situation in their respective territory. This has kept the economic machinery moving and partial economic recovery from the contraction experienced last year.
Risk to Economic Recovery: The pace at which the second wave of COVID is rising is enormous, coupled with the discovery of multiple mutants appearing at the scene. This has substantially impacted the economy and a general fall in consumption (except food and basic necessities). The fall in consumption levels, which contributes to almost 65% of the economy, is not good news for the country, as it disincentivizes production and stifles further investment.
Decrease in Lending: At the same time, banks have become cautious in lending, leading to slower credit growth. The banking sector is experiencing risk aversion due to already prevailing bad loans or the NPA crisis, as well as the inability of the consumers to honour the lending commitments due to the COVID-induced lockdown. This does not bode well for the economy as lesser lending points to lower investment levels and arrested growth in the future.
Rise in Unemployment: The falling demand has meant production is slowing down, forcing many industries to close down or temporarily halt production. This has impacted the availability of employment in the country. The informal sector has experienced shortage of workers due to reverse migration in the first wave. The formal sector has also experienced pay cuts due to closure and in the anticipation of worse times in the future.
Falling Confidence levels: Many rating agencies have cast aspersions on the ability of the Indian economy to recover from the slowdown caused by COVID-19. These reports have not been taken well by the industry. Also, the artificial inflation being experienced in the stock market points to a bubble, which may burst anytime and cause further crisis. Thus, confidence in the economy is sinking as indicated by the increased prevalence of cash, in preparation for the tough times ahead.
Disproportionate impact on the Contact Industry: While many sectors have shifted to online sales in the face of social distancing and lockdown, it is the contact-based industry which has suffered the most due to COVID-19. This includes the hospitality sector, travel and tourism sector including airlines and mass transit systems, as well as cab aggregators to an extent, like Uber and Ola. There is also a fall in rental levels, impacting the real estate and construction sector.
Steps required for the economic recovery:
- Fiscal Stimulus: The onus has fallen back on the government to announce a fiscal stimulus with an aim to foster economic recovery. This is difficult considering the falling consumption and subdued tax collection. However, tough times call for tougher decisions, which have to be taken without wasting precious time. The fiscal package may include restructuring of indirect taxes, increased Direct Benefit Transfers and disincentivizing savings to boost consumption.
- Enhanced Vaccination Coverage: One important step to improve the confidence levels is to widen the vaccination coverage. As people start moving out and physical isolation softens, the recovery of contact industries will hasten, leading to a multiplier effect in the economy. Also, a return to normalcy would also unleash the animal spirits in the economy.
- Support lending and investment: It is imperative to boost lending as it holds the key to increasing investment and a rise in employment levels in the economy. RBI has announced measures to support the MSME sector, which is a welcome step. More such steps are required to raise the availability of capital in the country.
- Specific interventions: India is a predominantly agricultural country. Therefore, measures to support agriculture will boost rural demand, leading to a general recovery in the economy. Also, the tenets of Keynesian economics dictate investment in infrastructure as a way to enhance the circulation of liquidity in the economy.

Impact of COVID on Vulnerable Sections of Society

Women

Bedrock of Healthy Society: Women constitute almost half of India’s total population. Aspiring for faster economic growth and social development without having half of the population on board is a difficult proposition. Therefore, recently the Vice President Mr. Venkaiah Naidu has called women the ‘bedrock of healthy society’. They not only form the chief care-givers in the economy but also form a substantial chunk of the Agricultural labour force.
Current Issues being faced by the Women: The country is suffering from a skewed gender ratio, perpetuated by sex-selective abortions, due to the prevalence of male preference in society. Also, the weak health caused by the high prevalence of Anaemia, mostly connected to child bearing at a younger age and gender-based violence point to a deeper malaise in the society. Apart from that, women are often under-appreciated for the care work, which is also usually unpaid. There are also reproductive and maternal healthcare issues involved like under-reporting of maternal deaths, gender bias in education, genital mutilation and lack of awareness regarding menstrual hygiene.
Effect of COVID: Due to the high congestion being experienced in the healthcare sector, the reproductive and maternal health has taken a back seat, leading to aggravation of health crisis for the women. The impressive gains achieved by India in maternal health are at the risk of being foregone, if the situation is not brought under control in a timely manner. Also, it might risk falling short of the commitments under the Sustainable Development Goals (SDGs – see inset).
Increased household responsibility: The social distancing norms necessitating a shift to Work from Home has actually increased the workload of women. Closure of the schools has meant increased child care at home, exacerbated by the absence of domestic help due to social distancing norms.
Frontline workers: Also, women comprise a major section of frontline workers including the nurses, teachers, sanitation workers and security establishment. This has increased risk due to the close proximity to the patients, many a times without access to protective equipment like the PPE kits. This increases the vulnerability of women towards the risk of contracting the virus.
Gender Bias: The pandemic has also reversed the gains achieved in the education sector by increasing the dropout rates of female children. The infrastructure required for digital education creates restriction on the availability. For e.g. presence of a single mobile or laptop in the family often means the girl child has to suffer exclusion in favour of education for the male child. Similarly, it has been reported that for the same disease, the mean number of days a patient is admitted in the hospital is lesser for women than men, as they are expected to return to their daily routine sooner than men.
Steps required:
- Regular check-ups: The health system needs to be strengthened to conduct regular check-ups of widely prevalent diseases like cancer, anaemia etc. This would help in timely access to required healthcare and recovery.
- Investment in the health infrastructure: It has been found in the studies that access to healthcare increases if it is available at a lesser distance. This is the chief reason behind the government’s step to create a network of Health and Wellness Centres (H&WCs) under the ‘Ayushman Bharat initiative’. This has already started to show results as 53.7% of visits in such H&WCs are of women.
- Awareness and Behavioural change: It is important to understand that no amount of investment can make us achieve the desired result without actually improving the status of women at the societal level. This requires a concerted effort from the society.

Children

- Children have been relatively safe during the pandemic, mostly because of the absence of co-morbidities in Children. However, children have suffered disproportionately from the socio-economic impact of COVID:

- Learning Disruption: There has been a discontinuity in studies due to the closure of schools. While learning has shifted online, this has been an added burden for poorer families, especially with multiple children. They have been unable to provide the necessary infrastructure for online learning, leading to the sacrifice of studies of one child in favour of another. Mostly, this has led to exacerbation of the gender gap in children.
- School Dropouts: School dropouts have meant creep-in of a skill gap, which may manifest into a lesser skilled workforce in the future. Similarly, it also has led to an increased prevalence of child marriage, especially in girls. This will lead to weaker mothers and the prevalence of anaemia in society, resulting in a domino effect on the health of infants.
- Loss of health facilities: Lesser immunisation and lack of ante-natal care have the potential to wipe out years of work which has gone into healthier and disease-free children, as well as healthier pregnant and lactating mothers.
- Loss of Employment: Due to the loss of employment, many children have been pushed into child labour to support their families. Also, frustration resulting from a lack of income may result in child abuse, violence and exploitation in many poor families.
- Malnutrition: As the incomes get restricted, a shift towards a cereal-based diet is expected from a protein and fibre-rich diet. This is problematic as it would not be adequate as per the requirements of the children and exacerbate malnutrition in society. This would impact the immunity of the children and put a strain on the health infrastructure in the future.

Old Age Group

The older people have been significantly impacted by the advent of COVID-19. They constitute a major portion of morbidities in society. Their co-morbidities make them more susceptible to the virus. Apart from that, the digital divide and absence of facilities due to Covid-induced lockdown have made them more vulnerable. The facilities and services have shifted online, which is difficult to access for the elderly due to the prevalent digital illiteracy. They are facing an increased threat of illness, yet a lack of social support. Also, physical and social isolation takes a toll on their mental and psychological health, manifest in increasing cases of anxiety and depression.

Transgenders

Transgenders are one of the most affected groups during the COVID pandemic as they constitute one of the most vulnerable sections of society. Lack of health literacy means they are unaware of many precautions and guidelines, which are necessary for the prevention of the pandemic. Also, the prevalence of poverty means many persons live together in common rooms, leading to an inability to observe social distancing. Transgenders also face greater discrimination and social stigma, making it harder for them to access healthcare. Apart from that, like other vulnerable sections, transgenders also face the issue of food insecurity due to loss of employment.

Tribals

The tribals have had a lower case-load because of their relative isolation from the mainland population. For instance, since the onset of COVID, authorities have restricted movement into the Andaman and Nicobar islands, thereby, protecting the tribes present in the region. Also, even if the cases have reached a tribal society, contact tracing is easier as the sample size is small. However, it is important to setup Covid care centres and other required health infrastructure in case the spread starts even in such remote areas.

Scheduled Castes

While it is true that the pandemic inherently is caste-blind, it does impact the lowest strata disproportionately. The major reason behind this is the lesser prevalence of education and lower-income levels in the lower castes. Despite the efforts of positive discrimination by the State, lower castes are unable to access better educational institutions as well as the healthcare infrastructure. Loss of employment has exacerbated the crisis for the vulnerable sections, leading to exhaustion of the meagre savings and a decline in the standard of living.

Preparation Strategy for further Spread of the Pandemic

Availability of Oxygen: The country is grappling with a shortage of medical oxygen. However, as per the reports, the issue is more of movement and logistics, especially after the grants and aids supply by different countries, to help India tide over the crisis. Apart from that, the accessories required to use oxygen, like regulators, cylinders etc. are also in short supply. Therefore, there is a constant requirement of monitoring of the logistical difficulties being encountered in the movement of medical aids.
Cooperative Federalism: Health, being a state subject, the major responsibility of handling the pandemic lies on the states. Therefore, in the second wave, the states have been given the responsibility to identify and enforce partial or complete lockdown as per the requirements of a particular region. However, as mentioned above, the inter-state movement of medical aids like Oxygen need active support of Centre, so as to ensure adequate availability.
Stop Hoarding and Black marketing: The social media is replete with stories of people frantically searching for oxygen, Remdesivir injections and so on. The real issue here is not limited availability of the medicines, but hoarding, which has created an artificial shortage of medicines and medical aids. Such opportunism needs to be prevented at the times of crisis to ensure accessibility of such aids for the people.
Bringing Transparency: The technology can be used to spread information about the available resources, as well as to stop the black marketing. For e.g., a portal depicting the number of available beds, Remdesivir injections, oxygen cylinders can be started, where the citizens can login and check the availability in real-time. Already, the GST applicable on the medical aids can be used to track the movement of such aids.
Augmenting the resources: COVID, being a once-in-a-century crisis, needs extreme measures to ensure proper care for the people. To tide over the shortage of healthcare personnel, the retired healthcare providers can be recalled to duty, along with support staff like nurses, ambulance drivers, ward boys etc. Apart from that, in transport and logistics, even the help of private companies like Ola, Uber can be sought, to tide over any shortage of vehicles.
Further Research on vaccines: The currently approved vaccines are either based on inactivated virus (Covaxin) or viral vector (covishield and sputnik), which are limited in availability due to the bottleneck of base extraction. Instead, there is a need to focus upon other platforms like mRNA based vaccines, which can be easily scaled up as per the requirement.
Identification of booster doses: There is a need for further research on the second booster dose as it has been shown to improve efficacy substantially. For example, the advantage with Sputnik is that both the doses are administered on different variants of adenovirus, thereby prolonging immunity and improving the coverage of vaccine against different mutants. Similar approaches can be used to increase the efficacy of existing vaccines.

Local Containment Strategy

Identification of vulnerable regions: Ministry of Home Affairs has issued an order to identify the districts where either the positivity rate is more than 10% of the bed occupancy rate is more than 60%. Districts fulfilling any of these measures need to take intensive control measures as per the orders. It also asks the people to keep following other norms like wearing masks and maintain social distancing. The order has been issued under the Disaster Management Act.
Heterogeneity: The problem with India is its huge population. Therefore, managing the pandemic becomes difficult, especially in a federal government with multiple levels of governance. Apart from that, there is a huge diversity in India, with different levels of testing, different levels of the spread and so on. Therefore, the regular metrics and assumptions are not applicable to India. For example, the European countries usually see the rise and peak for approx. four months, when the pandemic starts to die down. However, the same is not applicable to India, in which many European countries can be accommodated without much impact on the already existing population.
Immediate Steps: Due to the unexpected surge in the second wave, the priority of the government has shifted to reducing the mortality rates and breaking the chain to arrest the spread of the pandemic. The oxygen supply is being monitored at the highest level by the government, as onset of hypoxia brings criticality to the patient.
Ramping up of Health Infrastructure: Authorities have stepped up the efforts to make isolation beds available for the COVID patients. It was seen that the scaling up of infrastructure took place in the first phase of COVID. However, as the cases dwindled the beds were being utilised for non-COVID patients. Now, these beds are again being allocated to the COVID patients.
Home based Support: The advantage society has during the second wave is the better knowledge availability, if compared to the first wave. Therefore, many patients experiencing mild symptoms are being treated at home itself, rather than being admitted to the isolation wards or the hospitals. The home treatment requires better community support than being in the hospitals. Similarly, there is a need to arrest the tendency to panic and increase in anxiety levels, which can be considered to be the chief reason for hypoxia.
Need for a Rational Approach: The major concern which Indian government is facing now is to fight the rumours and myths going on in the social media. For example, vaccine hesitancy has been encouraged largely due to false data and the prevalent myths about the different vaccines in the population. The pandemic can be tamed by vaccinating a large majority of people and promoting herd immunity. Similarly, there is a need to adhere to COVID-appropriate behaviour in social settings to mitigate the spread of the virus.
Requirement for further Research: The limitation of the current vaccines is their inability to prevent the spread of the virus from a patient or a non-symptomatic person to the rest of the population. The vaccines are meant to boost immunity in the beneficiary, rather than actually arresting the spread of the virus. Therefore, there is a further requirement for research in producing medicines and therapies for treatment of the infected patients.

Comparison of Vaccines approved for usage in India
S. No.	Data Point	Covishield	Covaxin	Sputnik V
1.	Manufacturer	Serum Institute of India	Bharat Biotech (in association with National Institute of Virology and Indian Council of Medical Research)	Gamaleya National Research Institute of Epidemiology and Microbiology, Moscow
2.	Origin	Oxford - Astra Zeneca	Indigenous	Russia
3.	Technology	Viral Vector-based (The vaccine works by modifying the Chimpanzee adeno virus, which carries the spike protein of COVID virus, and inserting it into the person to boost the immunity against the specific protein)	Whole virion Inactivated vero cell derived technology (The vaccine contains inactivated virus, which though is unable to infect the person, is still able to generate an immunity response in the person	Viral vector – based (Carries two different weakened adeno viruses (which cause common cold in humans). Just like covishield, it also carries spike protein of corona virus)

Major Issues

WTO waiver: see inset
Vaccine Policy: The availability of vaccines is finite, especially in the initial times, when the whole world is rushing to get inoculated. The major reason for this is the time taken to ramp up the production infrastructure. If a decision is taken to create a vaccine manufacturing plant, it would only be after approx. 3-4 months that the facility would materialize. Therefore, there is a need to prioritize the different sections of the population, for better management of the available resources.
- For example, the drive was initially geared up towards vaccinating elderly citizens above 60 years of age. This was required because they were highly vulnerable due to the presence of co-morbidities.
- Later on, the population within the age group of 45-60 years was also asked to get the vaccine doses. As the coverage increases, the vaccination has now been opened up to all citizens above 18 years of age.
- In fact, despite its global commitments under the COVAX initiative, the government has now prioritized the citizens of the country and decreased the exports to the other countries.
- However, there is a need to rationalise the doses in such a way that the first priority is always the booster second dose for the people who have already received their first dosage, otherwise the gains of vaccination will be wiped out.
Complete Lockdown: The focus of the government in the second wave is saving lives as well as livelihoods. Therefore, instead of going for a nation-wide lockdown, the government has shifted to calibrated partial lockdown in the states as per the case load.
- Similarly, the focus is now on regulating the movement of the infected persons, rather than the whole population. Therefore, movement of the patients is being clamped down by barricading the individual houses and flats. Thus, a delicate balance is being maintained between the revival of the economy and managing the health crisis.

WTO waiver vs Compulsory Licensing

WTO waiver: India and South Africa have piloted a proposal in the World Trade Organisation to temporarily waive the sections 1, 4, 5 and 7 regarding patent, viz. patents, copyrights, trade secrets and non-disclosure of secrets and industrial designs, so that the developing countries with required infrastructure are able to produce vaccines for mass usage.

However, many experts have pointed out that instead of asking for a temporary waiver, the developing countries can make use of the already existing provisions of TRIPS agreement to tide over the shortage of vaccines, such as Compulsory Licensing.

Compulsory Licensing: It is a provision under the section 84 of the Indian Patents Act, 1970. It is a TRIPS-compliant provision. Under this, the government can grant license to produce a particular drug to any pharma company, without the consent of the original manufacturer company, even if it is a foreign company.

CL requires the payment of royalty to the original manufacturer, which is an ‘adequate remuneration’ as per the ‘economic value’ of the drug.

Need for a WTO waiver: Though the TRIPS-compliant Compulsory Licensing provision exists in the national laws, it is not adequate in the present scenario because:

Complexity of Procedure: Compulsory Licensing is a legal system, which requires hammering out terms and conditions, before the license is granted to a firm. It also has the provision of appeal for the original manufacturer. All this means that Compulsory Licensing consumes a lot of time, a luxury which cannot be afforded for the vaccine production, due to the rapid surge in the number of cases. For example, it took four year to hammer out an agreement, before the license for the HIV-drug was grated in Rwanda.
Predefined Quantities: Under the Compulsory Licensing provision, if a license is granted, it is granted for production of a fixed quantity of drugs with pre-defined usage. However, the COVID vaccine requires large-scale production for mass inoculations, which will be difficult under the Compulsory Licensing provisions, especially if the vaccine is also exported to the under-privileged countries of Africa.
Research and Development Costs: The reason for granting patents and other copyrights is the huge investment required in the Research and Development of such drugs and vaccines. However, COVID related vaccines represent a unique scenario where most countries have produced the drugs either through government funding or crowd-funding. In such a scenario, recovery of costs becomes irrelevant and focus must shift to mass-production for increased availability of the vaccine.
Lack of Clarity: The royalty under the Compulsory Licensing provisions is provided under the TRIPS agreement, which requires provision of ‘adequate remuneration’ as per the ‘economic value’ of the drug. However, what is ‘adequate’ and the determination of ‘value’ is not clearly explained. Therefore, it becomes a cause of dispute among the parties concerned. WTO waiver would avoid any such legal tangles.
Lack of availability: The COVID vaccine has been termed ‘once in a century’ crisis in the economic survey 2019-20. Mitigating its impact required the mass production an large-scale availability of vaccines globally. However, the reports point out to the cornering of vaccines by the rich countries. For e.g. Canada has ordered vaccine equivalent to ten times its population. Similarly, Oxfam suggests that the richer western countries, despite having just 13% of the global population, have ordered more than half of the future supplies of vaccines. This has made the vaccine unavailable for the poorer countries. This can only be offset by the mass production, granted by WTO waiver.
Retaliation: The government granting compulsory waiver is vulnerable to the retaliation of the original manufacturer and the foreign government where the original manufacturer is based. For e.g. a license granted by Thailand for Abbott made HIV drug, led Abbott to withdraw all its drugs from the Thailand markets. Similarly, US Trade Representative (USTR) maintains a watchlist for IPR violations, which might subject the defaulters to trade violations.

Global Support to India’s Call for Assistance

Perils of globalisation: A global pandemic of the level of COVID-19 requires joint coordination at the global level. This is all the more important due to the spread of globalisation and increased interconnectedness in the world, which makes it difficult to limit the spread of the virus within a particular region. For e.g. Three months earlier, it was the United Kingdom which was reeling under the impact of the mutant strain of Corona impacting the country.

Global Cooperation

Global Response to COVID crisis in India: The global community has responded in an overwhelming manner to India’s call for assistance in its fight against COVID. The offers have included traditional friends like Russia, Israel, France, Japan etc., as well as the adversaries like China and Pakistan.
- In fact, even the United Nations offered India its Integrated Chain Supply for COVID related material. However, India refused the offer stating that India has its own indigenous logistical system for movement of the material.
Reciprocation of the Goodwill – While it is gratifying to receive global support in India’s fight against COVID, it actually signifies the goodwill created by India in the global community over the years, including in the first wave of COVID. India had risen up to the occasion by supplying the vaccines and medical equipment (like PPE kits) to multiple countries under the ‘Vaccine Maitri’ initiative (see inset) of India’s medical diplomacy. Therefore, India is only reaping the dividends of the seeds of friendship it has planted all over the world.

Issues with Global Assistance

Reassess Priorities: While a single action is not enough to warrant a shift in foreign policy, it is also true that true friends are tested in adverse times. For e.g. India’s civilizational ties with Russia received a boost with Russia being one of the first countries to respond to India’s call for help. At the same time, despite India’s waiver on a ban on the export of Hydroxychloroquine (HCQ), there was a delay in the response of US, which did not go unnoticed in India as well as in the Indian diaspora in the USA. This calls the ‘global strategic partnership’ of the two countries in question.
India’s claim to regional leadership: India has a stated policy of not accepting conditional foreign aid from the ‘India Shining’ years of the Atal Bihari Vajpayee government. However, COVID has caused a departure from this policy, making the government ask for help to supplement the medical oxygen and other aids. This is a cause of concern in India’s claim towards being a global power. It calls into question India’s claims for independence and might tempt the neighbouring countries to shift further towards China, attracted by its deep pockets and vaccine diplomacy.
Cornering of Vaccines by the West: Another dimension of the pandemic is the attempt of countries to garner vaccines for their own citizens while side-lining the global needs. For instance, a US official in a statement seemed to place the value of US lives over the other people. Although, it is understandable for the countries to be prepared for the worst and calculate home requirements first. However, some countries have been criticised due to their stockpiling of vaccines and medicines at the cost of others. For e.g. while India has supplied 60 million jabs to almost 95 countries, US is sitting on 45 million jabs of AstraZeneca vaccine, without even approving them for use. It has placed orders for 1.2 billion vaccine vials for its population of hardly 300 million. This is against the policy of ‘America is back’ (see inset) of Joe Biden’s administration.

Government Steps to Mitigate the Impact of COVID

PM Garib Kalyan Yojana

Finance Minister had announced a relief package worth approx. Rs 1.7 Lakh Crore to provide support to the citizens, including poor and the under-privileged during the pandemic. Major features of the scheme are:
- PM Garib Kalyan Ann Yojana: Under the scheme, almost two-thirds of the population, comprising about 80 Crore people would be provided with an additional 5 Kg of Rice or wheat and 1 Kg of Pulses.
- Farmers: The first instalment of PM Kisan Samman Nidhi (PM-KISAN) scheme would be given in advance, to the support the farmers in the crisis.
- Support to Women PM Jan Dhan Account Holders: All women PM JDY holders would get Rs. 500 per month for three months.
- Free LPG cylinders: 8 Crore households will be given free LPG cylinders.

Governance

Lockdown: To break the chain and ramp up the health infrastructure, the Government had announced a total lockdown throughout the territory of India during the first wave of COVID. The lockdown helped immensely in flattening the pandemic curve in the country.
- Although the second wave of COVID has not seen a proportionate response from the Centre, the states have been given a free hand to impose complete or partial lockdown as per the requirements in the respective territories.
Awareness programs: The government issued multiple alerts and advisories to make people sensitive about the COVID-appropriate behaviour. For e.g. wearing masks was made mandatory in the public, while advising people to regularly wash their hands and sanitize their belongings before re-use.

Medical Measures

Insurance scheme for Frontline Workers: All health professionals treating COVID patients are eligible for a free cover of Rs. 50 Lakh under the scheme. This includes support staff, viz. ward-boys, nurses, ASHA workers, paramedics, apart from doctors and other health workers.
Vaccines: Three vaccines (see the table for comparison) have been approved for usage till date by the government as a part of mass vaccination drive in the country. The vaccines are being prioritized to the most vulnerable groups, with the objective of reaching to all the sections in the coming times.
Oxygen express: To tide over the shortage of oxygen in the country, railways created green corridor for the trains transporting oxygen tankers from oxygen-surplus states to the deficient ones.
Scaling up testing infrastructure: With an objective of early detection and treatment of the cases, the testing capacity of COVID has been ramped up from 2000 odd tests in the initial days to almost 20 Lakh tests per day. The objective is to increase the number of tests in such a way that the test positivity rate remains below the recommended level of 5%.

Economic Steps

Aatmanirbhar Bharat Abhiyan: During the initial stages of pandemic, over a period of 5 days, Finance Minister had announced a relief package worth Rs 20 Lakh Crore to support the different sectors of economy viz. industry, agriculture, PSUs, MSMEs etc.
PM CARES Fund: A dedicated fund to help in the healthcare emergencies emerging due to COVID has been setup, with PM as its ex-officio chairperson. The fund will consist of voluntary donations by the individuals or organisations.
Employment: PM announced the Garib Kalyan Rozgar Abhiyan to boost the employment and livelihood opportunities for migrant workers, who have returned to their native villages. The Scheme would focus on building durable assets in the rural areas with an approximate cost of Rs. 50,000 Crore in 116 districts. The government has increased the allocation for MGNREGA for the benefit of migrants, apart from increasing the daily wages by Rs. 20.
RBI announcements: RBI had announced moratoria on loan repayment to help the retail investors cope up with the COVID-induced crisis in the country. Recently, RBI again announced augmentation in the capacity of healthcare by allocating additional capital to the sector and relief packages to the MSMEs, which have been rendered vulnerable due to the COVID-induced lockdown.

Technology Related Steps

Arogya setu: The app was designed to identify and track the COVID-infected patients, apart from providing information to the people about the number of cases in their vicinity.
Case tracking: To increase the transparency, the government has started to post the data regarding the infected cases, recovered cases and the pandemic-related deaths on the COVID portal.
CoWin app: Again to increase the accessibility and ease for the public, the vaccine inoculation is being done through an online slot booking app called CoWin. This avoids queues and makes people follow the principle of social distancing to keep them safe during the vaccination drive.

Conclusion

The present crisis signals the decision-makers to reorganise the national policy and rethink the government structure to keep the country prepared for a similar fight in the future. There is a need to improve the health infrastructure, to make it adequately prepared to not wilt under a similar load in the future. The country’s large population cannot be an excuse in any future crisis of similar proportions.

Practice Question

Do you think India’s call for assistance will impact its coveted status as a global powerhouse in the international community? Discuss the impact of the response of USA to India’s distress call.
Discuss the modifications required in the National Disaster Management Act, in the wake of India’s inability to arrest the spread of second wave of COVID in the country.

UPSC Previous Year Questions

'Indian diaspora has a decisive role to play in the politics and economy of America and European Countries'. Comment with examples. (GS2 – 2020)
COVID-19 pandemic has caused unprecedented devastation worldwide. However, technological advancements are being availed readily to win over the crisis. Give an account of how technology was sought to aid management of the pandemic. (GS3 – 2020)
Discuss the recent measures initiated in disaster management by the Government of India departing from the earlier reactive approach. (GS3 – 2020)

nnnn

QUICK LINKS

Public Notice Against Piracy