This is the second part of our series of articles that track various steps taken by the Government of India to manage the COVID-19 crisis. First part is here

When the first COVID-19 wave struck India, PM Narendra Modi announced a nation-wide lockdown so that adequate preparations may be made to trace – test – treat those infected and production capacities of materials like drugs, PPE kits, ventilators etc. can be augmented. As a result, even after the lockdown was relaxed and economic activities were restored, the curve had been flattened for India to deal with the cases on a day-to-day basis.

A year later, as the raging second wave of COVID-19 pandemic chokes our system and puts tremendous pressure on our medical infrastructure, logistics and overall socio-economic landscape, there is a woefully unfortunate campaign being run by certain interests to dent the image of India on the global front; now it is clear that these interests are vested because they information they peddle is incomplete and far from truth.

An oft mentioned argument is that the Indian Government did not do enough in the past one year, as a result of which India is facing the surge in COVID-19 infections. In order to arrest the misinformation campaign launched to defame the country and weaken the trust of common people in India’s leadership, here is a detailed compilation of various actions undertaken by the Government of India through direct intervention and federal collaboration.

Review Meetings

Prime Minister’s Review Meetings

Since September 2020, Prime Minister Narendra Modi has chaired 14 meetings to review COVID-19 situation in the country; two meetings were held in September 2020, two in October, one in November, two in January ’21, one in March and six in April ’21. Each of these meetings were attended by States, relevant Central Ministries, Cabinet Secretariat and relevant Departments.

Moreover, Union Minister for Health & Family Welfare has held 12 video conferences with States since September 2020.

Review Meetings by Group of Ministers

  • Group of Ministers headed by Minister for Health & Family Welfare including Ministers from the Ministry of Civil Aviation, External Affairs, Home Affairs, Shipping, Chemical & Fertilizers conducted a total of 24 meetings since inception including 4 meetings since October 2020.

Other multi-level Reviews

  • 12 Joint Monitoring Group meetings were held under Director General of Health Services (DGHS) since September 2020 to review public health preparedness and response action. This group consist of experts from eminent public health institutions including NCDC, ICMR and Clinicians from AIIMS-Delhi besides WHO.
  • 19 review meetings and 7 video conferences with States were held since October 2020 at the level of Cabinet Secretary to review the COVID-19 situation.
  • Health Secretary held 24 video conferences with States/UTs to review the evolving situation, containment and surveillance, testing, hospital infrastructure upgradation, Covid vaccination and implementation of Covid appropriate behavior.
Cooperative Federalism

Communication with States/UTs

  • Formal communications were regularly being sent out to States on cases, adherence to Test-Track-Treat policy, COVID appropriate behavior, vaccination, and other related issues.
  • States were repeatedly cautioned and advised not to lower their guard and even plan for a possible resurgence of COVID-19:
    • 25th November 2020 and then on, orders were issued by MHA on containment and surveillance under DM Act, 2005 to ensure strict adherence to COVID 19 protocols.
    • 4th December 2020: States were conveyed with estimates on future requirements of beds at COVID health care facilities based on the then existing case trends.
    • 5th January 2021: States were advised against any laxity which may squander the gains, prompt steps were advised along with directives to keep a ‘strict vigil’ to curb the recent spike in COVID cases.
    • 21st February 2021: MoHFW wrote to States/UTs witnessing spike in cases to immediately make requisite public health interventions.
    • 27th February 2021: MoHFW advised all States not to lower their guard, enforce COVID appropriate behavior, deal firmly with violations and follow effective surveillance and tracking strategies in respect of potential super spreading events.
    • 20th April, 2021: MoHFW wrote to all States/UTs regarding projections, infrastructure and logistic requirement. Various funding avenues being made available under NHM funding, State Disaster Response Fund etc. were also conveyed

Deployment of Central Teams to States & Districts

  • Since September 2020, 75 high level and multi-disciplinary teams have been deployed to 22 States/UTs to review current situation of COVID-19, preparedness and response infrastructure.
  • These teams comprised of public health experts and clinicians from institutions like AIIMS, Delhi, National Center for Disease Control, All India Institute of Hygiene and Public Health, Kolkata, Institutions under Indian Council of Medical Research including National Institute of Epidemiology, Chennai and others. They also included Dr. V K Paul, Member (Health), NITI Aayog, Dr. Randeep Guleria, Director, AIIMS, New Delhi, Director – NCDC, DDG- Disaster Management Cell among other experts.
  • 53 of these Central teams were stationed in 30 districts of Maharashtra, 11 districts of Chhattisgarh, 9 districts of Punjab and 3 districts of Gujarat in April ’21. These teams gave cogent feedback such as poor perimeter control, high bed occupancy rates, overwhelming of testing capacities in districts reporting high case load etc. Appropriate actions at the level of Govt. of India were also initiated.
Provisioning of sufficient funds for COVID-19 response

State Disaster Response Fund

  • Ministry of Home Affairs increased the overall capping for COVID-19 related expenditure to 50% of SDRF in September 2020. In April ’21, It also allowed States to utilize up to 50% of their annual allocation of SDRF for containment measures of COVID-19 in conformity with approved items and norms for the FY 2021-22.
  • This additional funding could be used for providing temporary accommodation, food, clothing, medical care, etc. for people affected and sheltered in quarantine camps, along with procuring essential equipment and consumables for screening and testing.

Funds under National Health Mission (NHM)

  • Under NHM, in FY 19-20, an amount of INR 1,113.2 crore was released to the states/ UTs during March-April 2020 for immediate support to manage the pandemic.
  • Under India COVID-19 Emergency Response and Health System Preparedness Package (COVID Package) an amount of INR 8,147.28 crore was released till March 2021 to support the States for the critical activities for surveillance and containment, for ramping up of testing and treatment facilities, for procurement of essential supplies, for engagement of critical HR etc.
  • States were also allowed to utilize the uncommitted unspent opening balance under NHM of FY 21-22 from the previous year releases.
  • States/UTs are to submit their Emergency COVID-19 Response Plan (ECRP) of FY 21-22) for requisite approvals.
Regular Advisories

International flight restrictions from January’21

  • On reports of detection of UK variant of SARS-CoV-2, flights to and from United Kingdom were suspended till 7th January 2021.
  • Later following a decision to allow regulated resumption of flights from UK, an SOP for Epidemiological Surveillance & Response for the new variant of SARS-CoV-2, issued on 1st January 2021 was extended till 14th February 2021.
  • As variants of SARS-CoV-2 got reported from South Africa and Brazil too, guidelines for international arrivals were amended and issued on 17th February 2021

Other advisories

  • Series of guidelines, advisories and standard operating procedures were issued by Ministry of Health & Family Welfare for markets, religious places, malls, hotels, gymnasium, workplaces, containment and surveillance, patient management, treatment protocols, etc.
  • More than 20 advisories have been between September 2020 and April 2021.
Formation of INSACOG

The Indian SARS-CoV-2 Consortium on Genomics (INSACOG) is a grouping of 10 National Laboratories established by Ministry of Health and Family Welfare, Govt of India in December 2020. INSACOG is carrying out genomic sequencing and analysis of circulating COVID-19 viruses and correlating epidemiological trends with genomic variants. Genome sequencing and analysis have been carried out on samples from arriving international travelers, contacts of those positive for Variants of Concern (VOC) and community samples from most of the States at INSACOG partner laboratories.

It is telling how even after the velocity of COVID-19 cases declined since mid-September last year, the Government of India was prepared to face the asks of a possible second-wave. It continued to maintain caution, closely monitored situation up to district level and put implements in place for any exigencies that may arise due to subsequent increase in cases.