Much has been written about India’s unprecedented Covid crisis that began with the second wave of infections in March. Our healthcare system is overburdened, and states ran out of hospital beds, medicine, and oxygen.

But how sudden was the crisis? How much did our policymakers know in advance? Did the possibility of a crisis ever come up in the parliament?

We do know that a parliamentary panel predicted the second wave back in November, noting the gaps in oxygen and medical supplies. The government seems to have ignored its report.

On February 10 during zero hour, Kerala MP Kodikunnil Suresh briefly drew the attention of the parliament to the situation in Kerala and other parts of the country. “...with test positivity reaching 10.94 percent and infection rates remaining high,” Suresh said, “Kerala is moving towards a serious crisis.”

A few sittings later, the parliament session was cut short by two weeks because party leaders were busy campaigning for the assembly elections taking place in Kerala, Tamil Nadu, Assam, West Bengal, and Puducherry.

But between February 1 and March 25, what discussions took place in the parliament about Covid and the prospect of a second wave?

The union budget announcement on February 1 paved the way for a rather productive session of the parliament. Out of 3,850 questions posed by members to different ministries in the Rajya Sabha, 249 were directed to the ministry of health and family welfare.

In the Lok Sabha, out of a total of 5,497 questions, 292 were directed to the health minister. Most of the questions were not Covid-related. There were, for instance, questions on soya milk and almond milk being sold as “milk”.

But there were also enough questions on the spike in Covid cases and what measures the health ministry was putting in place. Concerns on Covid mutations, availability of beds, and shortage of vaccines were also flagged well before the chaos of the second wave unfolded across the country.

Let us look at them in detail.

The spread of Covid and mutations

In early March, Bengal MPs Bikash Ranjan and Derek O’Brien asked the health ministry about rising Covid cases.

Ashwini Kumar Choubey, the minister of state in the ministry, replied that they were “actively monitoring” the spike in cases and had advised states to “upscale surveillance, contact tracing, and testing”, ensure adequate hospital infrastructure, and “increase the pace” of vaccinations.

Ranjan told Newslaundry that the rise in Covid cases in some parts of India had prompted him to ask the question. However, he said, questions around Covid at the time were seen as “malign the government”. He viewed Choubey’s response as “chest thumping” that the government had everything under control.

On March 23, the health ministry responded to BJP MP Brijlal's question about new Covid mutations being found in Maharashtra, Punjab and Kerala. Choubey replied that “no new strains” were detected in the three states but “a number of samples” had tested positive for the variants from South Africa, Brazil and the United Kingdom – 400 cases as of March 18.

Vaccination

BJP MP Sambhaji Chhatrapati asked the health ministry about India's plans to export Covid vaccines to other nations. Would it be viable, he asked, “in a scenario where the country itself needs a huge number of vaccine doses for inoculation of its own people”?

On March 23, Choubey replied that a national expert group on Covid vaccination was closely monitoring the domestic production and supply of vaccines and would “take necessary decisions”. He added that as of March 17, nearly 45 percent of India’s vaccine production was being exported, of which nearly 56 percent was sold commercially.

Meenakshi Lekhi and three others asked about the number of Covid mutations present in India, the efficacy of vaccines against them, and what sort of research the government was doing on the issue. On March 19, the ministry said there were four mutations: two from the UK and one each from Brazil and South Africa. On efficacy, it clearly stated that Covishield had 10 percent efficacy against the South African variant and that Oxford-AstraZeneca were “tweaking” it.

About Covaxin, the ministry said, “The need to change composition of Covaxin has not been felt yet in view of good efficacy of the vaccine against variants.”

Congress MP Anand Sharma asked about the government’s percentage target for vaccination of the Indian population in 2021. The ministry replied on March 23 that “no fixed number or percentage of population, at present, can be indicated for the vaccination drive”.

Similarly, BJP MP KJ Alphons wanted to know how long it would take to vaccinate half the population. The ministry said it could not provide a “fixed timeline”. Subramanian Swamy asked whether one of the two vaccines made in India would be manufactured from vaccine supplies from abroad. The ministry said the Central Drugs Standard Control Organisation had not granted import permission to import vaccine supplies to manufacture either of the vaccines being made in India.

Hospitals and healthcare professionals

Nama Nageswara Rao asked whether the government had reviewed the impact of the pandemic on India’s healthcare system and infrastructure. Choubey replied on February 12, on behalf of the ministry, that “public health and hospitals” is a state subject and, therefore, the “primary responsibility of impact assessment of Covid” on healthcare systems lay with the states.

The ministry added that the central government “has not conducted any study/survey on impact of Covid-19 on healthcare system”.

A similar response was received by MP Elamaram Kareem who asked the ministry if it had faced a shortage of healthcare professionals and infrastructure during the first phase of the pandemic.

Also in February, MP Mallikarjun Kharge pointed out that India’s Covid-related deaths per million was much higher than other South Asian countries, including Bangladesh, Sri Lanka and Pakistan, despite the “imposition of one of the harshest lockdowns in the world”. In its response, the ministry concurred while pointing out multiple factors like “ varied geographies, island nation, case definitions, surveillance, testing and reporting protocols, attribution of death”. It also said India’s deaths per million were significantly lower than Spain, the United States, Russia, Brazil, France and the UK.

CPIM MP KK Ragesh asked whether all the AIIMS institutions across the country were functional. Choubey said that out of 22 proposed AIIMS, only six were fully functional and had dedicated Covid facilities as of 2020.

Beds, ventilators and oxygen

In February, Congress MP Chhaya Verma and three others asked the health ministry about assistance and material provided to states to fight Covid. Choubey said, again, that public health is a state subject. However, he said that states and union territories “are being provided required technical and financial assistance for strengthening of their healthcare system including management of the COVID-19 Public Health Challenge from time to time”.

Chhaya Verma told Newslaundry that the “assistance that the government had claimed to provide in its response never reached us”. She continued, “Whatever assistance that did actually come, such as ventilators and oximeters, was of poor quality and not working properly.”

Newslaundry also contacted Congress MP Deepak Baij, who had asked the ministry in September whether it had noted the shortage of beds and ventilators for Covid patients in the country. In its response, the ministry had said there was a “sufficient number of beds and ventilators” for Covid patients.

Baij told Newslaundry, “The quality of ventilators we received via the PM-Cares fund is such that the ventilators seem to be on a ventilator themselves. They could stop working at any point. For now, we have only kept them for emergency use.”

In March, BJP MP Jyotiraditya Scindia pointed out that India ranked 155 out of 167 countries in terms of availability of beds, according to the Human Development Report 2020. Choubey said Scindia’s information was based on “newspaper articles” and that the ministry did not know the “methodology of the ranking adopted by the concerned newspapers”. Choubey also said health was a state subject and the responsibility of setting up new beds lay with the states.

Conclusion

So, the data gathered from the parliamentary questions makes a compelling case that the government was familiar with the impending Covid crisis weeks before it struck. While health is, as the ministry said several times, a state subject,the central government controls the supply of essential commodities.

Looking back, a little more prudence and a little less diffusion of responsibility might have helped India be better prepared for the second wave.