Day 415: What’s wrong?

03/05/2021

Day 415: What’s going wrong?

More of watching the pandemic unfolding and governments’ response today.

The trend maintains itself – as a state climbs up the chart of number of infections and deaths there begins a rapid regulatory failure of its key agencies. Drug regulator failed long back when the run on remdesivir began. Hospital admissions in government run facilities have seen a mixed trend but one observation prevails – if one has a contact in the system then beds status and access comes in a clear line of sight.

An almost complete collapse of ethics is not even considered yet.

The thin sheet of public institutions and bureaucracy that ran this country until now lays tattered. An instance triggering this thought today is New Delhi’s Deputy Chief Minister writing to the Ministry of Defence seeking armed forces’ help. The hearing of this case in the Delhi High Court is telling. A senior advocate of the Delhi government explains to the bench

the assistance of armed forces is taken for providing logistical support with regards to the oxygen supply.  He explains that this would also do away with instances of black marketing and would eventually lessen the difficulties faced by doctors and patients in the national capital.’ 

This is a complete collapse of administration and governance as it relates to pandemic response in the city. It is not expected either. Even if this is overlooked and the case for army’s use is accepted, what does the Delhi govt hope to achieve with its deployment?

The Deputy CM details in his letter – 

to set-up, operationalise and run some COVID Health Facilities with about 10,000 oxygenated non-ICU beds and 1,000 ICU beds. 

We also request the Ministry of Defence to make arrangements for supply of medical oxygen for the COVID health facilities to be set up. 

The Ministry of Defence may also kindly provide medical and para medical teams to supplement the medical manpower of Delhi.

In short, everything. 

Perhaps, armed forces can bring in coherent structure, order and clear processes that have been missing in Delhi. 

In Jharkhand, their High Court wants the state’s CID to keep vigil on black marketing of life saving drugs (and not the state drug controller, who even failed to appear for the court hearing).

Another diagnosis of what tripped India’s covid efforts here –

Compounding this is the absence of research. Do micro-containment zones work? How does Kerala manage to keep its death rate so low? Is mass-testing of non-symptomatic people a good idea? And broader questions: Are our railway coaches any safer today? Or our classrooms? These should have been answered over the last one year. We have over 3,000 eminent scientists and professors in our elite institutions, with the best students at their disposal. But they have yet to step out of their campus to work, suo moto, on live problems and provide answers. Unless they do this, they will serve neither science nor society.

Thus, it is unfair to blame our people for their anxieties or solely our politicians for their folly. The real problem all along has been an outdated administrative system, and a knowledge elite who have soaked up prestige, but not delivered the facts. They are the biggest hurdle between us and a material society with a modern accountable state.

A national effort in asking relevant questions and deploying our research capability in seeking the answers should have begun by now. 

Meanwhile, a move to open up intellectual property in vaccines is being led by India and South Africa. The opposition to this is stiff. The explanation is laced with usual assumptions of scientific and industrial capacities outside of the the advanced economies – 

Sir Robin Jacob, chair of intellectual property law at University College London, said there was “no evidence” that other companies would suddenly be able to make the vaccines if the patented intellectual property was released. Vaccines often have far fewer patents than drugs — but they are trickier to manufacture, he said, so it is the availability of expertise that is holding back production. Johnson & Johnson has said it examined 100 potential partners but concluded only 10 were capable of making its shot. “There’s almost nobody you could license to. They couldn’t do it — you need a huge plant, huge skills, patent or not, it doesn’t matter,” Jacob said.

The argument is not to advocate bypassing IP. Instead, it is about making an exception in this extraordinary situation in the world, in the interest of equity as well as safety from an event that envelopes the planet without respecting borders. The shortsightedness of IP holders is staggering.