As the second wave of the pandemic rips through the country, the public is asking two big questions. How prepared was the government? Did it anticipate a crisis of this magnitude to hit India?

Turns out, the Parliamentary Standing Committee on Health and Family Welfare produced a report in which it did a SWOT – strength, weaknesses, opportunities, threats – analysis back in November 2020, and predicted a severe second wave. It also noted oxygen and medicine shortages during the first wave and presented a clear picture of the chaos that would ensue if these gaps were not plugged. They weren’t and we are seeing the results now, many months later.

The committee of 31 MPs was led by Samajwadi Party’s Ram Gopal Yadav. Its report, “The outbreak of pandemic Covid-19 and its management”, was submitted to the speaker’s office on November 25 and presented to both the Rajya Sabha and the Lok Sabha on February 2, during the budget session this year.

Threats and weaknesses

In the “threats” and “weaknesses” sections of the analysis, the committee concluded that India could see an “unpredictable pandemic with possibility of second wave like in Europe”, not least because “spikes in Covid cases are still being seen in affected regions and India is yet to reach its peak”.

The day the report was presented to the Rajya Sabha chairman, India recorded 45,301 new cases, taking the total to over 90 lakh.

As of April 27, 2021, the number of cases has gone up to 1 crore 79 lakh, and the daily increase is more than 3.5 lakh.

The committee further pointed out that there was a “lack of firm action by administration to prevent large gatherings”. It said, “India must also be prepared to combat a possible second wave of Corona especially in the ensuing winter season and superspreading series of festive-events.”

The warnings were ignored, to put it mildly. In March, from Mumbai to Gorakhpur, people gathered in large crowds to celebrate Holi. Not to mention the Kumbh Mela in Haridwar, Uttarakhand, where even the last shahi snan on April 27 saw large gatherings. Indeed, Uttarakhand waited until after the final dip to impose a curfew.

The parliamentary panel pointed out that “data collection system is not providing complete, timely and accurate data on newly tested persons, ratio of RT-PCR to other tests, Covid-19 related deaths, comorbidities, antibody surveillance studies and hospital bed availability”. It also remarked that “delays in coordination between the Centre and States” was a threat.

There are reports from multiple states about how the data collection continues to be woefully inaccurate and, in some cases, states are actively suppressing actual numbers. Some estimates suggest that the death toll is 10-15 times higher than the official tally. On top of this, the second wave has already seen instances of centre-state coordination breaking down, compelling high courts and the Supreme Court to step in.

At a larger scale, the committee highlighted “inadequate healthcare spending with no focused budget for Covid” as well as “inadequate primary and secondary healthcare infrastructure and staffing in many areas”. “Absence of organized urban primary health care has been a major weakness,” the report added.

India’s public health expenditure has increased from 0.9 percent of the GDP in 2015-16 to 1.1 percent in 2020-21, but it’s much lower than comparable countries. The utilisation of the budget has been over 100 percent in the past five years. Still, the Economic Survey 2020-21 observed that India ranks 179th among 189 countries in prioritising healthcare in the government budget and called for higher spending.

Recommendations

In its report, the committee recommended several measures to deal with a possible second wave. “The committee is of the view that Districts and States with poor public health sectors need to be identified on priority and provided the required infrastructure for tracing, testing and treatment by providing the required financial aid,” it said.

It’s no secret that healthcare infrastructure in rural India is woefully inadequate, which could prove disastrous as the second wave hits villages. Already in rural Uttar Pradesh, people are reportedly dying of breathlessness and fever before they are even tested for coronavirus.

Another key recommendation concerned the lack of medical oxygen and hospital beds. Painting a picture of what was seen during the first wave, the MPs said they were aggrieved at the “poor state of the healthcare system” and recommended the government “to increase the investment in public health and take appropriate steps to decentralize the healthcare services/facilities in the country”.

“The Committee notes that lack of hospital beds and the inadequate ventilators further complicated the efficacy of the containment plan against the pandemic,” it said. “As the numbers of cases were on the rise, a frantic search for vacant hospital beds became quite harrowing. Instances of patients being turned away from overburdened hospitals due to lack of vacant beds became the new normal. The scenario of patients holding oxygen cylinders rushing from pillar to post in search of bed in AIIMS Patna is a testimony to the fact that tears apart humanity.”

Sounds familiar? This is still happening, only on a larger scale and in a more deadly fashion.

The 190-page report prepared five months ago contains many more observations, learnings, and recommendations about how to handle the impending second wave of the pandemic and what the government needed to do to prevent it. Given the horror we are witnessing now, it is doubtful any government policymaker bothered about the report.

Salil Ahuja contributed reporting.