On 13 July 2021, the Uttar Pradesh government released a list of election workers who died from COVID-19 and whose families were eligible for compensation. According to the government, the people on the list had contracted COVID-19 while on duty for local body elections in April and May, and had died within 30 days of their assigned election tasks. Uttama Maurya, a 19-year-old resident of Bhadohi district, told me that she was distressed to find that her father Chhabinath Maurya was not on the list. Chhabinath had died due to COVID-19 on 20 May—35 days after he was on election duty. Uttama had collected all her father’s medical documents and reports but could not claim compensation because of the government’s 30 day cut-off.
The UP government has offered a compensation of Rs 30 lakh ex-gratia—a payment the government makes voluntarily apart from a regular remuneration. The government’s list includes 2,020 beneficiaries. The Caravan spoke to many families whose deceased relatives should have been eligible and had applied for compensation but were not on the list. The state government’s arbitrary 30-day rule and the requirement that families show documentation of COVID-19 positive tests has prevented many families from getting the compensation due to them.
In mid-May, Ajay Singh Bisht, the chief minister of Uttar Pradesh blamed the election commission for its strict criteria for COVID-19 deaths. According to the commission, a person is considered to have died while on duty only if the death occurs at the place of work, on the way to work or on the way home. Bisht appealed for a more liberalised approach to allow for more families to be compensated. While the state has extended the consideration for death while on duty to 30 days, it has still fallen short.
In June this year, The Caravan reported on how the UP government had risked the lives of teachers who acted as poll officers to carry out simultaneous three-tier local body elections in the middle of the second wave of COVID-19. About 3,000 primary and secondary teachers and school staff may have died due to exposure to the virus, according to estimate on estimate by of the state legislative council. These teachers had worked at polling booths and in counting centres. The Caravan had documented the details of the deaths of nine teachers, including Chhabinath and Daksh, at the time.
Moreover, Uttama told me that the state government has not been consistent in sticking to the 30-day cut off. Atul Bhardwaj was an assistant teacher in Etah district, and died 32 days after he went for poll duty. OP Sharma, Bhardwaj’s father, uploaded his son’s counting-duty schedule as part of the claims process. The government seemed to have considered the last day of counting to which Bhardwaj was assigned as the start of the 30-day period. However, Bhardwaj did not work on that counting day since he was already ill. His last actual day of work was two days earlier. “We were afraid that the two-day gap [between his polling booth shift and counting duty] would be a problem but fortunately the government approved him as eligible,” Sharma said.
Uttama said that the difference between Bhardwaj and her father was that the latter was simply not assigned counting duty. “I will be writing and requesting the government to consider our case and give us ex-gratia,” she said. “Our family’s financial condition is not good and he was the only breadwinner. This ex-gratia could save us.” She has actively tweeted to authorities, including the UP chief minister’s handle and the prime minister’s handle. “I had been trying to convince the basic education department, the state government and also the central government through my tweets and letters to consider the case genuine and make him eligible for ex-gratia,” she said. Her tweets had also asked for the 30-day rule to be relaxed. “Unfortunately, I have not received any response.”
Dhawal Gupta also did not find his brother Daksh Kumar on the list. Like Bharadwaj, Daksh had worked on election day at a polling booth, then fell sick and had to miss counting duty. Daksh died 38 days after his first day of work as a polling official. Gupta also said that the 30-day cut-off was unreasonable. “Looking at the complexity and possibilities in such deaths according to medical science, they must consider relaxing the rule on period of death so that cases like ours can get justice,” he said.
Current research does not show whether deaths due to COVID-19 occur within a specific period of time since the disease often leads to other medical complications and the full impact of long COVID is still being revealed. “Fixing a particular period of 30 days for death due to COVID-19 infection is not a good idea,” Arun Gupta, the president of the Delhi Medical Council, told me. “Medically it cannot be fixed because no one knows what and when any complex condition would occur in body which could be fatal.” Kuldeep Kumar, assistant professor in the department of medicine at the University College of Medical Sciences and Guru Teg Bahadur Hospital in Delhi, said that the UP government should not have such a deadline. “There is a chance that a patient could die after six months or even more than that period since infection.”
The state government’s released guidelines on the criteria and process for claiming compensation on 1 June. It directed that one person from each of the state’s18 administrative divisions should be deputed to examine ex-gratia applications. These applications had to be submitted between 15 June and 22 June. The district administrations had to verify the facts and approve the applications. The officer in charge of verification had to check documents that showed the death was due to COVID-19 with the families of the deceased. The officer was also responsible for making sure that no possible claimant missed the deadline to fill the online form.
Shivendu Shekhar Ojha, whose mother Priyambda Ojha died of COVID-19 during election duty in Ballia district, missed the deadline. He was not aware of the ex-gratia programme till after the last date to apply. “It was the duty of the department to make all such families of deceased aware to fill the form online,” he said. “When I knew about it the last date was over. I tried to meet the district magistrate but could not succeed.” He added, “Finally I wrote letters to the chief minister, the district magistrate and the basic education department to consider my case and give me a chance to apply.”
Ojha told me that when his mother went to the district hospital after falling ill, she was not tested for COVID-19, and sent back home. “The doctors said that it was COVID and that she needed oxygen because her oxygen level has fallen to 68,” he recalled. “I was surprised that they sent me home and did not do a COVID test.” Ojha arranged an oxygen cylinder for his mother at home but she did not survive. The result was that he did not have any document to show that she had died of COVID-19. “Whom should I blame for not having the test result?” he asked. “It was the responsibility of hospital to do the test.”
The only indication that he could apply for ex-gratia was the presence of his mother’s name on a list prepared by the basic education department, along with 26 other teachers who died of the novel coronavirus infections while on election duty. “I have requested the administration to give me a chance, even the chief minister should think over the cases like me across the state because there could be many cases like me in such a big state.”
Several people like Priyambada died without getting tested for COVID-19, both due to a shortage of tests during the second wave and reluctance by the authorities to test. Numerous people also missed getting tested in the rush to get admitted to hospitals that had run out of beds or to find oxygen. According to media reports, several people were insteadtested for typhoid. Typhoid has many symptoms similar to COVID-19 and is a far more familiar disease in many parts of rural India. Media reports also pointed out how many people died at home without being diagnosed at all.
Surender Ram and Shamsuddin Ansari were two more teachers in the Navanagar block of Ballia district, who fell ill with symptoms such as cough, cold and fever, and then died due to severe breathlessness. When I spoke to their families over the phone, they said that the two teachers were never tested for COVID-19. Deepak Kumar, Ram’s son, told me that the doctor said his father had COVID-19 but did not prescribe the test. Ram was only tested for typhoid. Deepak cannot apply for compensatory schemes.
I spoke to Rajnish Kumar, son of Lalita Devi who was an assistant teacher also in Navanagar. She died on 18 April, three days after a training for election duty. She was in her early fifties. Devi may not have been eligible for compensation for poll workers since, according to Rajnish , she had fever before the training and had been sick for a week before she died. “We were giving her the medicine from the pharmacy thinking that this was normal fever,” he said. “She did not want to attend the training on 15 April as she was not fit.”
Rajnish said that the district administration pressured Devi to go for training. So, when her fever abated, he took her to the local community health centre to get vaccinated. They did not know that she was not supposed to take the vaccine while she was ill. She did not disclose her illness because she was worried about losing her job if she did so. Devi continued to have fever. “On 17 April we took her first to our CHC, but no one was present there, so we were told to go to Sadar Hospital in Ballia,” Rajnish recounted. The government hospital did not have oxygen beds, so they went to a private hospital where a chest X-ray showed that Devi had pneumonia. “We are not aware what an X-ray is and what having pneumonia meant,” Rajnish said. “I understood that the doctor suspected COVID but no COVID test was done.” Devi died on 18 April around 2am. In their grief, the family did not think about documentation of her death.
Devi’s case highlights the atmosphere of fear and lack of information around COVID-19 even during the second wave, the compulsions that teachers faced to show up at crowded venues and the lack of safeguards to avoid infections spreading from individuals like her, who might have already had COVID-19.
Kuldeep, the assistant professor, commented on the apparent negligence in Devi’s case. “It is criminal offence on the part of treating doctors,” he said. “Not only are they responsible for the death but they also helped in the spread of COVID-19 in the community as there were no isolation for these patients.” He added, “Relatives were allowed to take care of the patient in the hospital as non-COVID patient.” Arun, of the Delhi Medical Council, concurred. “If any patient with COVID-like symptoms goes to a doctor during a surge of cases, then he or she must be tested for COVID. If they are tested for typhoid and not for COVID, then this is a sheer negligence.” He added, “If it happens in any government or private hospital, it must be taken seriously by the administration with strict action.”
In May, the Uttar Pradesh Prathmik Shikshak Sangh, which is the primary-school teachers association, released a list of 1,621 primary-school teachers who had died of COVID-19. Thirty of these were from Ballia. The Ballia district basic education department listed 27 teachers as having died of COVID-19. Aditi Singh, the district magistrate told me that only 12 of their families have been approved for ex-gratia payment. Singh said that neither the basic education department nor teachers’ association was competent to declare death due to COVID-19. She added that only medical proof and a certificate from the district chief medical officer could establish a COVID-19 death.
Doctors said that the deaths during the second wave in UP, especially when the patient had COVID-19 like symptoms, should be considered as COVID-19 deaths. “We have witnessed in number of cases where rapid antigen test and RT-PCR both were negative, but we did not have alternative diagnosis for moderate to severe cases of suspected COVID,” Kuldeep said. “Moreover these patients had corroborative evidence in chest x-rays and high resolution computer tomography scans. These tests too were not done in many cases. After considering clinical and radiological evidence, the absence of other clinical diagnoses, and the magnitude of ongoing pandemic, we should label them COVID-related deaths.”
Dinesh Chandra Sharma, the president of the Uttar Pradesh Prathmik Shikshak Sangh, told me that the government had been unsupportive of teachers acting as poll officers throughout the elections and the second wave. “At first we wanted that those approved for ex-gratia get their payments and then we will take on the cases of those who have been left out. We will be fighting until each teacher gets justice.” He told me that they had demanded in writing that “anyone on election duty, who died during the surge of COVID cases in UP must be considered a COVID death.”
Meanwhile, the state employees joint council is collecting data of those who died due to COVID-19 but have no test reports to prove that they had contracted the disease. Hari Kishore Tiwari, the president of the council said that his brother-in-law died due to COVID-19 but he was unable to convince the chief medical officer in his district to give him a COVID-19 death certificate. “This is a long fight and we are ready for that,” he said.