The old adage “to a man with a hammer, everything looks like a nail” seems to be particularly true for the Manipur government. It appears that the government thinks its job is done once restrictions have been put in place.
TFM Report
More than one lakh people in Manipur have been infected thus far by the novel coronavirus, with the 753 new cases reported on Tuesday taking the cumulative tally to 1,00,625. With this, the tiny state, with a population of about 30 lakh, has become only the second from India’s Northeast – after Assam – with over one lakh confirmed COVID-19 cases. The virus has so far claimed the lives of 1,592 people, which means the case fatality rate in Manipur is 1.8%, against the national average of 1.4%. On Tuesday (August 3), the active caseload stood at 9,490, with a recovery rate of 88.98%. This is once again worse than the national average of 97.38%.
The same goes for the test positivity rate (TPR) as well. While, nationally, it has been on the decline and has stayed below 5% since the first week of June, Manipur has reported more than 10% TPR since June 21. In fact, over the past week, Manipur has had the second highest TPR – 13.94% – in contrast to the national average of 2.43%.
These figures speak volumes about the prevailing COVID-19 situation in the state, despite restrictions being in place for three months and partial or total curfew having been imposed by the state government to arrest the spread of the pathogen.
To understand the factors that have led Manipur to this scenario, The Frontier Manipur spoke to various health experts and officials. While they pointed out various lapses and shortfalls in the state’s COVID-19 response, a common thread in their criticisms is the state government’s “casual approach” in dealing with the second wave.
Dr Y Mohen, the chairman of the Manipur state chapter of the Indian Red Cross Society, said that the Manipur government was always “one step behind”. He lamented the fact that Manipur does not have a health minister to deal with the situation. L. Jayantkumar Singh, who was the health minister in the Biren Singh government, was dropped from the cabinet in September last year. He has not been replaced.
Dr Mohen said that since community transmission is already happening, the authorities need to focus on practical measures like effective management of micro-containment zones.
Note that chief minister N. Biren Singh, who has taken additional charge of the health portfolio, hasn’t held a single media briefing on COVID-19. To make matter worse, he has been in Delhi since July 31, to meet BJP leaders and Union ministers. The fact that he is heading an ‘unstable’ coalition government seems to have taken up more of his time than addressing the pandemic.
An official of the Regional Institute of Medical Sciences, Imphal, who spoke to TFM on condition of anonymity, said that proper containment measures should have been taken up in the initial stage of the second wave, like they were during the first wave. Many have entered the state without proper test reports, which may have contributed to the spread of the dreaded delta variant in the state.
He also raised concerns about the spread of the virus in rural areas. As agricultural activities pick up around this time of the year, people tend to congregate. The official contended that only if those in rural areas adhered to COVID-19 appropriate behaviour would the spread of the virus be curbed in those areas.
He suggested that face masks should be distributed free of cost to encourage such behaviour.
State’s response
The old adage “to a man with a hammer, everything looks like a nail” seems to be particularly true for the Manipur government. The state went into a lockdown a day before Prime Minister Narendra Modi announced the nationwide lockdown on March 25, 2020. Since April 2021, restrictions of some form have been imposed in the state.
It appears that the government thinks its job is done once restrictions have been put in place. In the first week of June, the Union government had deputed a two-member team to assess the ground realities in the state. Later, it directed the state government to take several measures such as effective clinical management, plan healthcare infrastructure (including oxygen supply), ramp up testing, institute strict containment measures, etc.
However, as the state continued to witness a surge in COVID-19 cases and deaths, the chief minister in a midnight video message announced a stricter ‘total curfew’ from July 18 for ten days. Desperately appealing to the public to stay indoors during the curfew, he said that rice would be delivered to doorsteps, if necessary. He also asserted that Central paramilitary forces would be called in to enforce the curfew.
But on the last day of the curfew, when ace weightlifter S. Mirabai Chanu returned to Manipur after clinching a silver medal at the Tokyo Olympic Games, Biren Singh led the crowd celebrating her feat. The chief minister himself went to the airport to receive Mirabai, while his government organised a reception at the City Convention Centre, Imphal. Thousands thronged the streets of Imphal to get a glimpse of the silver medalist.
Many took to social media to slam the government, saying the celebration could have been postponed, or that the state government could have kept it simple, considering the gravity of the COVID-19 situation.
This is not the only instance when government authorities have not been found to practice what they preach. Leaders and officials were seen wilfully disregarding COVID-19 protocols while hosting national leaders or congregating at venues for political programmes. While ordinary people were fined or thrashed by the police for not wearing masks, politicians were given special treatment to violate protocols, observers that TFM spoke to said.
Considering the track record of the present regime in intimidating anyone who dares speak up, many choose to remain silent. The state-wide curfew was extended for another seven days until August 3. It has reportedly been extended for another four days, although there is no confirmation yet.
Lack of accountability
Dr K. Rajo Singh, the director of health services, Manipur, contended that the state continues to witness a rise in COVID-19 cases and deaths for three reasons.
He argued that the nature of the virus – the delta variant which now seems to be the dominant variant in the state – has been a major factor in the spread of the virus. He also said there is vaccine hesitancy, since the drive began in January.
The third reason that Dr Rajo said has contributed to the rise in COVID-19 cases and deaths is that people are not adhering to COVID-19 appropriate behaviour: wearing masks, maintaining distance, etc. He maintained that the health department is doing its best to fight the pandemic.
When TFM spoke to experts about Rajo’s claims, they said the government cannot keep shifting the blame on to the people. If even after nearly 18 months people are not adhering to COVID-appropriate behaviour, the authorities need to explore innovative ways to reach out to the people. This would also apply to claims about vaccine hesitancy, they said.
Additionally, the government also set up very few vaccination sites in the early stages of the vaccination drive. More than hesitancy, this could have played a role in fewer people getting vaccinated.
The experts also contended that the claim that the state health department is doing its best to fight the pandemic. People are still struggling to get ICU beds in the hospitals and the state has only around 200 functional ventilators. With active cases hovering around 10,000, the situation remains grim.
Further, they said another crucial tool for fighting the pandemic is authentic real-time data. This is another aspect that the state government has utterly failed on, they alleged. Other than releasing the daily cases, deaths, availability of oxygen and beds – the last two were added after the intervention of the high court of Manipur recently, other crucial parameters are not available to the public.
For instance, the district-wise distribution of cases and cause of death are not available officially. The state also doesn’t have a dedicated dashboard on crucial data related to the pandemic, they added.
Way forward
The experts, who wanted to remain anonymous, said one of the crucial aspects that the authorities ought to act upon immediately is ‘timeliness’. This is of particular importance in secondary intervention – home isolation, community home isolation centres, COVID-19 care centres and hospitals. Timely intervention and response by healthcare workers in an effective way to save lives, they maintained.
Another aspect is the lack of an integrated command centre headed by a competent authority that will coordinate with all health facilities in the state. Such a centre will enable effective response of the public and timely allocations of hospital beds.
Experts opined that the involvement of local clubs, civil society organisations and community organisations is crucial and a must at the level of primary intervention – preventive measures like wearing masks, maintaining physical distancing. Instead of simply imposing a curfew and sitting back, the government needs to ensure that local bodies and community organisations are empowered.
(This story was published in collaboration with The Wire)
Read: https://thewire.in/health/manipur-government-covid-19-response-worsening-situation