“Govt must share health data, consult with civil society before exiting lockdown”

strategy for exiting lockdown

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Police restricting movement during lockdown. Pic Credit: Twitter handle of Chikkajala Traffic Police

Media reports indicate that the Centre and state governments are looking at options for a graded exit from the lockdown. This note lists certain factors to be kept in mind before deciding that strategy.

The consequences of the lockdown have been felt most sharply by urban daily wage earners like street vendors, auto drivers, migrant workers, and marginalised and stigmatised communities like sex workers and transgender communities, nomadic communities who earn as they move, frontline workers engaged in cleaning and health, farmers and landless farm workers.

There has been a severe impact on food security, livelihood, security and health. Besides, the issue of domestic violence could not be addressed effectively since there has been no opportunity for women to speak out or access support services. Around100 non-Covid deaths have been reported across the country among patients who faced difficulty in accessing hospitals, among farmers unable to sell their produce, etc., during the lockdown. Continuing the lockdown will severely exacerbate these impacts. The measures announced so far by the Centre and State governments are nowhere near enough to overcome these.

Impact of the lockdown

Urban Daily Wage Workers: Migrant workers and locals who earn on a daily basis, mostly live in rented houses and need to pay rent. A two-phase survey in Bengaluru looking at their situation was conducted by trade unions – the first on March 21-22 (before the nationwide lockdown) and the second on March 27-28, during lockdown.

Highlights of the second phase of the survey: 

Incomes have continued to fall: 83% have stopped work fully. Majority of daily wage workers have no income at all; some like app-based workers have seen a fall of over 50 percent in their daily earnings. Among monthly wage workers, most were not sure of receiving full salaries. It is most likely that over 80 percent of workers will have earned half or less than half their average monthly earnings

Food Security: Lockdown has meant that poor families are paying more but are eating less. Some families are on the verge of starvation. The survey’s first phase showed only 44% said food prices had increased. The second phase saw 97% saying food prices had increased. Only 66% had ration Cards, which leaves the rest without any rations.

Besides, a large proportion of informal sector workers owe money to loan sharks at exorbitantly high interest rates. Without any income, these workers won’t be able to repay their loans, and are in danger of facing violence.

Healthcare workers are continuing to risk their lives without health security or additional allowances: In the absence of public transport, they are spending more time and money and taking risks to travel back and forth from their workplace. 

Impact on the Public Health System: The lockdown has hit patients with chronic illnesses hard as they haven’t been able to access medicines and treatment. The draconian police pass system has contributed to turning non-emergencies into emergencies. Public hospitals have been turned into COVID-only centres, impacting several thousands who are not sure where to access treatment. Medicines and blood too are in short supply.

Communalisation and criminalisation: Vested interests have used the pandemic to deliberately spread fake news about Muslims. This has led to the criminalisation of those who attended the Tableeghi Jamaat meeting; and also in the loss of livelihoods and dignity of lakhs of Muslims in Karnataka.

Impact on women and children: Due to the lockdown, there has been an increase in cases of domestic violence and abuse, as reported by the National Commission of Women. The government did not put in place helplines or mechanisms to rescue these women.

Rural Distress: Farmer organisations like the Karnataka Rajya Raitha Sangha have written to the Chief Minister, on how farmers are throwing away milk or leaving produce to rot in the fields. Inability to sell/transport food, crashing prices of certain produce, and inability to sow for next season, are all affecting farmers. On April 1, Chandrakant Biradar, 47, a farmer based in Bidar, committed suicide due to inability to transport his produce. Such instances are likely to increase in the coming days, and food supply may also be hit.

Failure of state and central government schemes to alleviate problems: While the state and central government have several schemes for migrant workers and urban daily wage workers, these have not alleviated the situation. For instance, Karnataka government is doing a cash transfer of Rs 2000, but only to construction workers. For a family which has to pay Rs 4000 as monthly rent alone, this will leave a huge gap. The central government’s cash transfer to Jan Dhan accounts is a mere Rs 500 per month.

Government schemes leave huge gaps in food supply too The Karnataka governmenthas announced that it is supplying only rice and wheat, but no dal, to PDS card holders. Similarly, the Indira canteens have now begun charging for food. Also, many people who live far from Indira canteens have not been able to access the canteens as police have prevented them from walking there. The elderly and people with disabilities too have not been able access this food.

A rapid survey by Karnataka chapter of the People’s Union for Civil Liberties has highlighted several discrepancies in the supply of food to children, pregnant and lactating women and to adolescent girls. In fact, only 13.75% of adolescent girls were being given food. All PDS shops aren’t open as yet, with the majority of them asking for OTP verification even after government waived this requirement off. PDS card holders are getting only rice in some places.

Similarly, the central government passed an order asking house owners not to evict tenants who are migrant workers, but the implementation of this order has been a huge challenge. Workers do not know of this order and find it difficult to enlist police support.

With the state unwilling to ensure a universal basic income of at least Rs 10,000 a month until the lockdown is lifted and daily wage earners allowed to resume working, food and nutrition issues will become worse, making these people susceptible to the virus while worsening the state’s already-poor health indicators.

Suggestions on ways to exit the lockdown

Before exiting the lockdown, the government must hold consultations with civil society, especially those representing marginalised communities like transgenders, and Adivasi and Dalit communities. An all-party discussion must also be held, and suggestions sought from ULBs and panchayats. 

A task force has to be immediately set up that represents geographic, caste, class, trade, sexual identity, ability, gender and other such interests. This task force should be involved in planning the lifting of lockdown and preparing a long-term strategy. Experts from other states such as Kerala and Tamil Nadu can be consulted to learn from their experiences.

The government must also publicly share credible information about testing as there seems to be a credibility gap about the scale of testing. Karnataka government has announced that it would follow the South Korean approach and test more. But it’s unclear if this approach has been successful. There has also been no official information on how ready they are to handle the situation.

Extending the lockdown in this situation is not only unethical but also pointless as it would only postpone an impending public health crisis. It will also arbitrarily prolong the misery of migrants, daily wage earners, and other vulnerable groups.

We therefore first expect the state to share publicly:

  • What it expected to achieve from the lockdown
  • Whether those measures have been achieved; and if not, what more is required to achieve those objectives
  • What it feels should be the approach to contain the spread of the virus
  • Whether the government has data on hospitals that had a surge in cases of people with pneumonia-like symptoms/breathing issues who were not tested (to indicate the spread among non-tested people)?
  • What is the strategy for testing? Will we need/plan to have government testing centres in each district? 
  • Has the preparedness for a surge in cases improved over the lockdown period? 
  • Many communities have not been able to follow physical distancing during the lockdown since they live in cramped housing in slums or in workers’ colonies. What is the plan to ensure that these communities are safe from infection – lockdown or otherwise?
  • Many migrant workers have moved back to their hometowns in other districts in Karnataka, but only a few districts have testing centres. How then do we ensure that the pandemic has not already spread to those districts? What is the government strategy for containing the spread there? 

Post this, an informed decision can be taken about the lockdown. 

Strategies for exit

An exit from lockdown is imperative for an economy like ours, where several people are on daily wages, social security net is weak, and even some salaried groups like domestic workers are below the poverty line. How the government phases out the lockdown must be decided on the basis of health data which the government must make public.

Following are some indicative strategies that can be adopted while exiting the lockdown:

  1. Street vendors must be allowed access to playgrounds, stadiums and open spaces. At the moment, while some food-related street vending is open, all vendors must be allowed to operate (e.g. flowers, clothes, plastic items etc)
  2. Full fleet of buses must be made available – this will allow for social distancing. Spain, which is worse off than India, has allowed for limited public transport . Autos, Ola and Uber  must be allowed to ply with emphasis on using hand sanitizers before and after receiving a cash payment. This will allow lakhs of drivers to have an income.
  3.  A separate fleet for patients and their carers must be provided with all safety measures in place for drivers and the passengers.
  4. Food security – Community kitchens employing street vendors and SHG members can be set up to provide free food for those in need, in addition to Indira Canteens. These kitchens can be in slums and in workers’ clusters so they do not have to travel far. A dry ration kit for all families must be supplied at the doorstep which will last for two months. Fruits and vegetables should also be delivered to the homes. Autos can be employed for both measures, providing livelihoods for auto drivers. 
  5. Government must source from farmers directly and encourage small scale industries as opposed to large industries. 
  6.  All BPL families, migrant workers, and undocumented and marginalized communities should be given a monthly income of at least Rs 9,600 for the period from March 23 till the lockdown ends.
  7. Preferably the government should take over private hospitals for COVID-19, and not government hospitals since this would deprive marginalised communities of access to health care.
  8. The government needs to focus on strengthening the public health system across Karnataka after identifying the gaps.
  9. A grievance redressal mechanism should be set up to address issues of denial of care and/or negligence.
  10. Blood banks, ambulances, immunisation services, emergency services, tertiary care should continue undisturbed and should not be compromised.
  11. Workers who are doing essential duty – powrakarmikas, hospital workers, shop assistants, bank staff, especially cleaning staff – should have protective equipment and a transport system.

From the experience of dealing with the fallout of the lockdown, it is imperative that a clearly coordinated system to monitor and implement the exit strategy be put in place, that involves all concerned stakeholders. Especially NGOs and civil society organisations that have been extensively involved in relief work and have abundant ground level data and information on the nature and scale of the problem.

[This article is based on press releases from the social welfare organisation Naavu Bharateeyaru, and has been published after edits.]

About Dr Sylvia Karpagam 7 Articles
Dr Sylvia Karpagam is a public health doctor and researcher working with urban marginalised communities.