New Delhi: Medical infrastructure in states is not the only thing that’s reeling under the deluge of Covid-19 cases. This so-called ‘second wave’ of the pandemic has also put a strain on the Narendra Modi government’s much-touted mantra of ‘cooperative federalism’, with the Centre and states blaming each other for mismanagement.
Not only were the authorities not prepared to handle the overwhelming number of cases, but about a dozen senior government officials in the central and state governments told ThePrint that there was laxity on the part of the Modi government in responding to red flags raised by states and also to issues highlighted in internal meetings at the central level.
The government is responding now, taking a series of measures like allowing direct open market vaccine sales to states at a pre-declared price and allowing vaccination of all above 18 years of age from 1 May.
ThePrint reached the central government’s official spokesperson Jaideep Bhatnagar through phone call and email for a comment, but there was no response till the time of publishing this report.
‘Tsunami was staring us in the face’
A senior central government official involved in Covid management told ThePrint on the condition of anonymity: “The tsunami was staring us in the face. By February, data from the Centre’s National Centre for Disease Control started showing the trend that the number of persons getting affected by the mutant strain (of the SARS-CoV-2) were increasing. States had also started flagging issues like shortages of bed and medical oxygen. But we did not respond like we should have.”
The official clarified that it was not that the Centre was not reviewing the situation or interacting with states, “but we did not map what the data said with the action that’s required on the ground”.
A second central government official said although meetings were happening, the issues of shortage of beds, supply of medical oxygen etc. were not discussed adequately.
“States should have been alerted to be prepared as the mutant strain is more virulent. Instead, the Centre’s whole communication thrust continued to revolve around how we have started the largest vaccination drive in the world and on Covid-appropriate behaviour,” the official, who also did not want to be named, added.
The second official said that irrespective of whatever communication strategy the Centre adopted publicly, it should have taken health measures that were required in view of the data that showed more people were getting infected with the mutant strain.
“The Centre had the technical know-how. Why couldn’t they see what was coming? One can understand that maybe they did not want to create panic among the public. But what prevented them from readying their infrastructure and alerting states,” the official added.
Mechanisms put in place last year
Soon after Covid cases started rising in March last year, the Modi government announced a nationwide lockdown, and put in place a multi-layer coordination mechanism.
It constituted 11 empowered groups of secretaries — each dealing with a specific aspect of pandemic planning like beds, medical equipment, logistics for essential services, public transport, etc. — to take decisions on a real-time basis. The groups met daily, while both PM Modi and Cabinet Secretary Rajiv Gauba held regular review meetings with CMs and chief secretaries.
The government also formed Groups of Ministers (GoMs), including one on health. Individual cabinet ministers were asked to coordinate with high-burden states to address grievances.
However, once the number of Covid cases started dipping, the 11 groups of secretaries were replaced by six larger groups last September. “The existing groups were not meeting often,” said a senior official of a social sector ministry, who is part of one of the groups.
An official of the Union health ministry said the GoM on health has started functioning again, after not holding a single meeting between January and March.
“Besides, the PM, health minister, cabinet secretary and health secretary are also interacting regularly with states. In the last two days alone, PM had held over half-a-dozen meetings with various stakeholders,” said the health ministry official.
States’ distress calls to Centre
The blame-game between the Centre and states began when cases started spiking about two weeks ago. On 7 April, Maharashtra CM Uddhav Thackeray told industry representatives that he had tried to contact PM Modi to request for medical oxygen supply as the state was running out, but was told the latter was not available.
CM Thackeray and state Health Minister Rajesh Tope also appealed to the Centre to allot more vaccine doses to Maharashtra, but the Union government kept pointing at statistics to show that the state had a few lakh doses stocked. The Centre eventually promised 17 lakh more doses to Maharashtra within three days, but Tope said this was not enough to meet the requirement. The state’s daily vaccination numbers have now dropped to under four lakh.
Since then, the ruling Maha Vikas Aghadi coalition and the opposition BJP have been locked in a conflict over oxygen and remdesivir, an antiviral drug repurposed for Covid-19 treatment.
Rajasthan CM Ashok Gehlot also wrote to Modi, requesting him to finalise an integrated standard operating procedure for better coordination among states. In his letter on 7 April, Gehlot had also suggested that the Centre should open vaccination for all above 18, a decision that PM Modi took Monday, 19 April.
By mid-April, other states had also started requesting the Centre for help. Facing an acute shortage of doctors, Jharkhand CM Hemant Soren wrote to PM Modi to allow the state to avail services of doctors and paramedics from Central Armed Police Forces (CAPFs) and military hospitals. On Sunday, Soren tweeted that the state government had approached pharma companies in Bangladesh for importing remdesivir.
Odisha CM Naveen Patnaik also requested PM Modi on 17 April to make Covid-19 vaccines available in the open market, outside the government supply chain.
‘Sense of complacency’
A senior Maharashtra government official involved in Covid management said “a sense of complacency” had crept in after the first wave of infections ebbed.
“Last year when the pandemic hit us, everybody was shooting in the dark. Both Centre and state were holding each other’s hand. But this time, a sense of complacency crept in. Nobody anticipated the numbers would be so overwhelming. Also, Centre-state coordination is not happening like last year as there are not enough resources,” said the Maharashtra official.
Speaking to ThePrint, Jharkhand Finance Minister Rameshwar Oraon said it’s not like the Centre was in the dark about the new, more virulent variant that had started in the USA, UK and France. “Forget these countries, the new variant was also wreaking havoc in Maharashtra. The Centre should have taken a cue and become more alert… By mid-March, states had already started reporting shortages of medicines and doctors,” Oraon said.
Like the Maharashtra official, he also said that Centre-state coordination this time around was found wanting in many aspects.
Vini Mahajan, Punjab’s Chief Secretary, meanwhile, told ThePrint that her state had also articulated to the Centre about the need to ramp up vaccinations more quickly.
“We think the Centre should also allow prioritisation of vaccines on a geographical basis. We should have been able to saturate densely populated areas like Ludhiana, Jalandhar, Patiala by vaccinating everybody, so that these areas don’t become super spreaders. Also those working in certain professions like the judiciary and teachers should have been vaccinated so that their work did not get affected. But perhaps the central policy was due to a shortage of vaccines,” Mahajan said.
Senior government officials said that many of the decisions taken by the PM Monday could have been in response to the suggestions made by various state CMs.
What some states have been doing on their own
Some states, like Punjab and Odisha, have stuck to their own preparations apart from those made by the Centre, which has benefitted them so far, their respective chief secretaries said.
Although Punjab was never among the high-burden states, remaining around 17th in caseload, in the initial stages of the pandemic last year, it had put in place a strong expert group of doctors and health professionals to review and monitor the situation. The group still meets weekly, and more frequently if necessary, to discuss difficult cases, treatment and research into new drugs for treating Covid.
“For instance, based on the recommendation of the expert group, we were quick to place orders for high flow nasal cannula, which they said is more effective than ventilators for treating serious Covid patients. The health department is monitoring the situation across the state and making sure that requirements of hospitals like ventilators or oxygen are met expeditiously,” Punjab Chief Secretary Mahajan said.
Even Odisha has reactivated the mechanism set up last year to review the Covid situation. “Right now, the situation is under control, but we expect the numbers to rise once migrant workers start returning and the West Bengal elections are over. Already, border areas have started reporting a surge in Covid positive cases,” said Odisha Chief Secretary Suresh Chandra Mahapatra.
The top official in the state added that currently, more than eight lakh beds are available for Covid patients.
“We are readying our infrastructure. Private hospitals are being roped for Covid treatment. Those entering our borders are being asked to produce Covid test reports. If found positive, they are being quarantined at facilities that have been put up,” Mahapatra added.
(With inputs from Manasi Phadke)
(Edited by Shreyas Sharma)
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