COVID-19, the invisible enemy, has managed to bring the world’s largest democracy to its knees, where human lives now figure as mere statistics and death is the new normal. The government’s response has been inadequate to say the least, having been left in a state of stupor by the blitzkrieg of the second wave.

On 28th January 2021, PM Narendra Modi, addressing a gathering of world leaders, said, “It would not be advisable to judge India’s success with that of another country. In a country which is home to 18 percent of the world population, that country has saved humanity from a big disaster by containing corona effectively.” This statement was followed by the Health Minister’s proclamation that India was “in the endgame of the Covid-19 pandemic” later in March, but these statements carefully ignored a parliamentary committee report that flagged the inadequacy of the existent healthcare system and the possibility of a second and third wave as far back as November 2020.

The report was further validated by testimonies of various scientists and researchers, but the government cherry picked reports and numbers suitable to its cause ignoring those that warned of subsequent waves if it did not act, the price for which has been borne by the people of India.

The situation has slightly improved, now that we’re clocking less than a lakh new cases (about 0.007% of the population) per day as against 4 lakh cases in mid-May (0.029% of the population). This has presented the Modi government with a golden opportunity to own up and seek redemption.

Lessons from South East Asia

Right now, South Korea is battling its fourth wave of COVID-19. However, almost sixteen months since cases first appeared in late January last year, the total number of cases in the country have only risen to a relatively low 1.5 lakh (less than one percent of the total population). South Korea’s response to the initial outbreak itself was one of the most successful in the world, as it managed to flatten the curve despite having an early spike in cases. Similarly, Taiwan has managed to keep the case count as low as thirteen thousand. India’s response to the ongoing crisis, and preparations for the impending third wave, can draw on the models adopted by these nations.

Before we delve into the takeaways for India, let us first try and look at the policies and models of these nations. In Taiwan, the legacy of SARS led to the creation of a legal and institutional foundation for any future outbreak and also to the development of a cohort of experienced technocrats. There is a Communicable Disease Control (CDC) Act that provides the legal framework for handling an outbreak of a communicable nature. The institutional foundation is laid in the National Health Command Centre (NHCC), which is the nodal agency when it comes to health emergencies that gains its authority from the CDC Act.

Further, the Central Epidemic Command Centre (CECC), a body under the NHCC consisting of experts from all fields, works towards mobilising and allocating resources to different levels of the government, it also focuses on effectively communicating the same with the public and hence, optimises the government’s interventions. Lastly, the CDC Act provides the framework for effective coordination and interaction between the central and local governments, empowering CECC to impose punitive measures upon those who flout government rules and guidelines.

Similarly, South Korea has the Korea Disease Control and Prevention Agency (KDCA) as the nodal agency responsible for taking public health measures, and the Central Human Infection Countermeasure Squad (CHICS) under the KDCA to manage and arrest a crisis caused by an imported infection. These existing structures in terms of law, institutions and trained technocrats coupled with the experience of handling a similar epidemic, proved key to the success of both the countries.

More than just luck

Let us club the strategies of these countries and look at them one by one. Firstly, Taiwan did not follow a one-size-fits-all strategy. Instead, it focused on synergy and communication with local governments, the private sector and civil society. An illustration of this is how the Taiwanese government worked with telecom companies for tracking people who were infected. The CDC Act provides for this right to monitor people, but instead of antagonising the population, the government got the civil society on-board, who voluntarily complied with the regulations.

Secondly, in South Korea, the state had a bitter experience during the 2012 MERS epidemic where it was condemned for lack of transparent information. Learning from that experience, laws were passed to disclose relevant information to the public. The public information on cases, and their travel history was then used by companies to develop apps for contact tracing.

Thirdly, both the South Korean and Taiwanese administrations have effectively learnt from the mishaps of SARS (which took place in 2002) and MERS. South Korea’s handling of the MERS epidemic was less than ideal, and was characterised by insufficient health personnel, inadequate and delayed testing, and delayed release of information. Their COVID response, meanwhile, has been characterised by extensive testing—including some novel ways like ‘drive-thru' testing centres, extensive contact tracing, and an adequately funded KDCA with greater capacity.

Similarly, Taiwan ensured that its hospitals have a robust auditing system that periodically checked for availability of an adequate amount of infection control personnel and equipment. It has also routinely initiated mock drills alongside reviews for infection control.

Fourthly, the market interventions adopted towards regulating and facilitating the private sector constitute an important dimension of the mitigation strategy adopted by these countries. Taiwan, due to the experience of the SARS epidemic, was well aware of panic-buying and hoarding of essential commodities during difficult times. Hence, it started with a mask rationing system. Using its close relationship with the private sector, it took measures to ramp up mask production.

Further, the government also engaged in effective rationing by carrying out price setting mechanisms and ensuring guaranteed demand for the companies. An export ban was initially put until domestic demand was met.

Similarly, the South Korean government took care of the production, logistics and distribution of masks. It followed a five-day rotation system where a person could get two masks per week. This way the state intervened in the market to control inequity of essentials. It also improved accessibility and affordability by establishing a large number of screening centres and covering the cost of treatment and test under the National Health Insurance.

Lastly, the culture of the people of these two nations, shaped by their experiences of having lived through two epidemics must also be noted. Citizens were quick to self-discipline, practice social distancing and wear masks at all times—a stark contrast to the anti-mask rhetoric of the USA.

These strategies have come to create an oasis amidst global despair. As India sinks deeper in the COVID crisis, the appropriate application of this model can perhaps help salvage the world’s largest democracy.

Takeaways for India

Lessons to be learnt from this model are on two fronts—governance, which demands certain structural changes, and mitigation strategies.

Firstly, India needs a defined legal framework and institutional setup along the lines of the CDC Act and CECC which determines the functionality of different levels of governments and agencies involved. In India, the disaster management framework suffers from ambiguity. There is lack of coherence between the plans, policies and guidelines of the disaster management framework. There are conflicts in delegation of responsibilities both vertically and horizontally.

Secondly, the Indian government has to take the civil society into confidence and make it a stakeholder in governance. Measures with respect to the lockdown have been arbitrary and without proper consultation with different stakeholders.

There is a suppression of information from the public and the government has strained its relationship with civil society by cracking down on any criticism.

Lastly, the government needs to effectively intervene in the market to safeguard people from unequal distribution of essentials, in the context of the pandemic. The government can use the Biological Disaster Management Guidelines (BDMG) to this effect.

Building on the structural changes, the government can employ a mitigation strategy that can have short-term and long-term components. The government has to adopt the test-and-trace mantra immediately. It is important to keep in mind the centrality of contact tracing at the community level. While India focused on increasing the number of tests, not much attention was paid to contact tracing. Contact tracing is an indispensable simultaneous activity, in addition to hospital testing, that can help contain such viruses in the beginning itself.

One of the main reasons that the two East Asian countries have been able to do well is because of the seamless integration of public health institutions and technological delivery mechanisms. India must invest more in this regard to be able to deal with not just the pandemic but other future health crises in the long run.

Despite the above, it is important to understand that the response of these countries to COVID-19 and their management of the pandemic has not just been a series of smart policy decisions taken in a vacuum that other countries can replicate to achieve identical results. South Korea’s response, for instance, is the product of a public attitude and institutional framework informed by the experience of battling two epidemics of respiratory viruses in recent history, along with a level of trust and support for the government that may not be found in other countries.

With cases receding, the Indian government has an opportunity to right the wrongs. This crisis is challenging PM Modi’s personal image unlike any other ordeal he has had to face since setting foot in the office. Like Hercules whose life was not easy, the PM has had to endure many trials in the context of the pandemic, but like the reward for Hercules’ suffering was a promise, that he would live forever among the gods at Mount Olympus, PM Modi can continue to live at 7, Lok Kalyan Marg post 2024, provided he acts now.