How India is outsourcing the COVID-19 pandemic to its poor

There is enough evidence in the public domain to show the complete failure of social distancing and the lockdown. Anushree Fadnavis/REUTERS
10 May, 2020

As someone who has faithfully been locked down for several weeks, albeit more comfortably than the millions who have been ambushed into homelessness and hunger, I seek to know what is the policy that underlies this infliction. It is not good enough to say that we have not one but several policies, that we have policies from one week to the next: breaking the chain, flattening the curve, whatever. Multiple policies, or policies that change from one day to the next, are not policies. These are reactions, incoherent responses papered over with rhetoric. Given this incoherence, my intention is rather to consider the practice of the state, and seek to infer the policy from that practice.

Of course, one effect of this incoherence is that it vastly empowers the minions of the state. In the absence of clear rules, the cop with a stick is the law. Indeed, he is everything—he is the rules, he is the policy, he is the law. We recognise this as the everyday reality of our pre-COVID lives. But is this good enough to deal with the pandemic? Banging pots and pans, lighting candles, bursting firecrackers—these gestures and gimmicks cannot be a substitute for a policy. So, I insist, what is the policy?

Ostensibly, this policy is the one being followed in big and powerful “foreign” countries: the lockdown is intended to “flatten the curve,” so that the number of cases do not overwhelm the health facilities, as the white man says in rich white countries. Now, I understand that we would like to play in the big leagues—to be a superpower, or vishwaguru—but mere imitation cannot suffice for a policy. What health facilities do they have in mind? What is the number of Intensive Care Unit beds in the country? State by state, city by city? There are over a hundred districts where there are no ICU beds at all. Forget ventilators, the patients waiting in the filthy hospital corridors will die of other infections anyway—perhaps that is a way of reducing COVID-19 deaths?

If the detailed data on the alleged number of health facilities is not available, or if the data is too shocking to be revealed, the government must stop this brazen mendacity. How “flat” would the curve have to be for the real health facilities not to be overwhelmed? It is widely believed that the health facilities—our jolly euphemism for the squalid and underfunded butcher-shops we call “public hospitals”—are always already-overwhelmed, so stop pretending.

In any case, the lockdown is a disaster—the epic migrant-labour caravans, the congested holding centres, such as schools and “shelter homes” where migrant workers were being housed, and, not to be forgotten, the bleach spray in Bareilly. There is enough evidence in the public domain to show the complete failure of social distancing and the lockdown. The question is—were these ongoing tragedies predictable, even avoidable? Perhaps not: the virus is unarguably vicious. And, after all, we are assured that the lockdown has saved thousands of lives—so perhaps someone could do a morbid tally of the lives saved by the lockdown, as against the lives and livelihoods lost due to the lockdown.

Even so, is it possible that this apparent “failure” of policy wasn’t a failure at all? The consequence of the lockdown ambush is undeniable: isolating those privileged few who could afford social distancing and being locked down, along with an accelerated and intensified exposure to contagion of all the others. But could this have been the real intent of the policy, after all? One can hardly infer any other policy from the practice of the state and its institutions in response to the coronavirus. I am not saying that that is the official policy. I am only asking how the practice of the state would be different if, just if, it were? 

After all, the lockdown is only the half of it. The other effect, apparent if also unintended, are multiple processes where the contagion has in fact accelerated. Thus, there are the congested and unsanitary holding centres—the description of which is uncomfortably close to the famously “non-existent” detention centres that we remember from the days of the Citizenship Amendment Act and National Register of Citizens. The holding centres are apparently distinct from the “quarantine centres” which are, technically, part of the therapeutic apparatus but have been much in the news lately as places which people seek to evade, and escape from—even, in at least one reported case, by suicide. Factor in the crowds gathering at bus stations and railway stations—desperate to escape from existences that were barely viable even before the pandemic—and at places where civil society volunteers distribute food to the hungry and the homeless. The genius who devised this policy in order to facilitate social distance and break the chain of transmission deserves special recognition. 

In fact, there is a rather elementary point about quarantine centres that appears to have been overlooked, apart from the small matters of sanitation, and food. If people are being quarantined on the suspicion of being infected—as a way of protecting the larger society—then the conditions under quarantine should be such that the people, some of whom may well be uninfected, since they are untested, should be quarantined from each other within the quarantine centre. Otherwise, with infected and uninfected persons being lumped together, improperly managed quarantine centres will function as hothouses for intensifying the rate of infection—one infected person will infect all the others. It is important to understand the logic of quarantine: uninfected myself, I am infectable, and so I am in danger from others; once infected, I become a danger to others. In the absence of comprehensive and reliable testing, every person is both a victim and a danger. Given this fateful ambiguity, a quarantine centre must be part of the therapeutic apparatus of a careful, caring state, rather than the punitive apparatus of a malicious one. 

We owe a moral duty to each other precisely because we are, each one of us, in this reciprocal relationship of vulnerability and danger, with all others. With COVID-19, one cannot apparently get out of this loop of reciprocal danger and vulnerability even after dying, so that even those who die of it must be treated with proper care and due caution. This is not the nicest way to learn the fundamental lesson of our common humanity, but it is a difficult lesson to ignore. The moral desirability of becoming a society informed by this realisation, rather than a society that is predicated on division and hate, is evident—even when that “social solidarity” must be expressed, paradoxically, through the careful observance of social distance.

But there is more: a large percentage of all the people who are infected, and so are infectious, are asymptomatic. For instance, data from the Karnataka government showed that as of 22 April, over 60 percent of COVID-19 patients in the state were asymptomatic. Now map that onto the other fact—that our testing capacity is, and will remain, hopelessly inadequate. There is no way in which we can hope to test everyone, à la South Korea—certainly not in this decade. This is the realistic reason why testing has been officially restricted to people who are clearly symptomatic. So, it is very likely that there are, or will be, large numbers of people who are out there, infectious and unidentified, and unidentifiable. (Unless, of course, one identifies them in the way that the fifteen year-old Junaid was identified, before he was beaten to death, while returning from the Eid mela— a contemporary variation on Munshi Premchand’s much-loved story, ‘Eidgah’. I know it is bad taste to bring that up, but we have no right to forget.) We can only be safe when, and only to the extent that, all people act honourably, and that we promote a society in which people are encouraged and enabled to act honourably. In such a society, an infectious-but-asymptomatic person who can ill-afford social distancing and social isolation would be empowered to act honourably, not only by his conscience, but also by social support systems. Such conduct cannot be produced by laws and ordinances, nor by lynch-mobs and hate speech, but rather by culture and education. These are the long-term, slow-acting strategies that human societies have evolved over time—but meanwhile, we need to rein in the hatemongers, and introspect a little as to how and why we have become a society in which even to suggest this is to invite abuse, perhaps even to be accused of sedition. 

Further, when someone becomes infected, by whatever route of transmission, they become patients, not criminals. A patient is a patient—but by a clever, and also suicidal, sleight of hand, being infected with COVID-19 has been criminalised. Not only is the victim—the infected person, the patient—deemed guilty and shunned and treated like a criminal but, by extension, so are the people who are professionally concerned with them: the doctors and the nurses, the health workers. One can understand the initial temptation that led to this development. The unfortunate and irresponsible Tablighi Jamaat event at Nizamuddin offered a heaven-sent opportunity to adapt the virus epidemic into a familiar form of sectarian, communal politics—the old “Hindu-Muslim” trick. Suddenly, being infected with the virus was not a misfortune, but a deliberate, terrorist act. Once infected, one became infectious—and so potentially harmful to others, practically a terrorist. The fact that the infected person was also a patient, was conveniently elided—and soon we were in the arms of the corona-jihad. The theme was dutifully amplified in the troll factories, and predictably, we soon had a member of the legislative assembly from the Bharatiya Janata Party asking his constituents not to buy vegetables from Muslim vendors. This is sick and sad—but it is part of an all-too-familiar pattern.

Mercifully, the government recognised that this criminalisation was leading to the attacks on doctors and health workers. However, instead of trying to address the citizen distrust from which such behaviour springs, the government has, by ordinance, now criminalised such unforgivable, but unfortunately not incomprehensible, behaviour. While the threat of punishment might keep medical personnel safe, it is not going to make the process of dealing with the epidemic any easier. A state whose relation to the citizenry is primarily punitive rather than caring, cannot expect to receive the enlightened cooperation of its constituents. And without that cooperation, the fight against the coronavirus cannot but end in failure. An epidemic in which a person can be infectious without being personally affected can only be contained on an honour-based system, on a social understanding of the protection that one owes to others. If I am infectious, I must sacrifice my freedom of movement so that I may not infect others—even when I am asymptomatic. Is it so difficult to understand why anyone living in today’s amoral and brutalised society is unlikely to have that kind of enlightened social sense unless we make a deliberate, state-driven effort to become a society different from the cruel and divided society that we seem determined to become?

A state that strove to promote the development of that kind of society could reasonably expect its citizens to trust its good intentions—as may be observed, for instance, in Germany, or perhaps even more remarkably, New Zealand and South Korea. However, when one tries to map that ideal onto the realities of the Indian state and its practice—its malevolent hybridisation of neglect and cruelty—both prior to the virus epidemic, and even now, when citizen distrust of the state can only be suicidal, one realises that it is time to start praying for a miracle. After all, what can be the possible purpose of the active pursuit of policies that are bound to deepen the distrust of citizens towards the intentions of the state? No matter how many ordinances are promulgated, such distrust will have the entirely predictable consequence of defeating the stated containment policy for the coronavirus epidemic. It is possible that this might well be an unintended consequence of official incompetence or ideological blindness. But I wish, finally, to examine the possibility that these predictable outcomes might perhaps just be the unstated, but not unintended, consequences of state practice and, I fear, state policy.

So, again, what are some of the elements from which one must try to construct and infer state policy? These are, broadly, a savage and sudden lockdown that has displaced millions of vulnerable people, forcing them to expose themselves, with and without state assistance, to abnormally higher levels of risk; and a more or less happily locked-down middle class, which has adapted to the routines of lockdown with alacrity, and indicated its approval with banging plates. One’s relative comfort with being locked-down has become yet another index of privilege in our deeply unjust, brutal society. Now, when we map these on to the alleged public health facilities—which are being saved from being overwhelmed by the lockdown, remember?—a few facts emerge. Inevitably, the ever-larger numbers of infected people will produce some people who will need, but also be afraid to seek, medical attention. Arguably, this number would have been higher if there was no compulsory lockdown and people would have gone about their normal business. A merely voluntary lockdown would have been restricted to the relatively privileged who could afford to be locked-down and still buy medical attention if they needed it. But for the bulk of the people—who will not seek or receive medical attention irrespective of how flat or not the curve is—what we have by way of a policy is a virus-inflected replication of our socio-economic apartheid.

The COVID-19 epidemic, and what it entails, is particularly well-suited to the primarily Hindu-savarna Indian middle class. Social distancing comes naturally to a Brahminical caste society, as wittily argued by the historian and author Mukul Kesavan. As he noted, there is an instantly recognisable sense in which COVID-19 is an Indian disease, “accidentally invented” in China. But the sinister compatibility between India and COVID-19 runs much deeper than mere distancing, deeper than obsessive self-cleansing. It is completely standard with us to delegate all work to those we refer to as servants—the cooking and the cleaning, the washing and the swabbing. It is hardly news that all the hard and dirty work of our society is farmed out to the poor. That is the unspoken backstory behind the sudden, heart-breaking superfluity of the armies of migrant labour, the hungry children, stumbling along the burning highway. With the lockdown and the coronavirus epidemic, is it possible that this so-called “work” happens to be getting infected, perhaps dying—or better, developing immunity, and perhaps even producing usable plasma for the rest of us? 

It does not need strenuous demonstration to see that the lives of the privileged in India are somewhat reminiscent of the airy Wildean sentiment: “I have devoted my life to Art. As for living, our servants can do that for us.” For art, substitute money, substitute power. But the way in which the supposed policy with regard to the COVID-19 epidemic has panned out, there is a sinister addition: now we have, I believe, farmed out the dying as well. And even as we hunker down, we do so with the guilty hope that all that dying out there will produce the immunity that all of us, cocooned in privilege, are hoping for. After all, “herd immunity” will have to be paid for—in infection and, naturally, in mortality, too.