On a lazy Sunday afternoon, you drag yourself out for the week’s grocery shopping. As you breeze through the not-yet-too crowded aisles of the supermarket, you suddenly spot a woman who looks visibly sick and constantly coughing. Any other day you would have zoom past that woman without any fuss. But this time, you are not too sure. You are alarmed that she might have COVID-19 and not yet be aware of it. She is walking all around, doing her grocery shopping, touching things while she tries to compose herself through her fits of cough. And the more she walks around, the more you are squeamish and indignant that she is spreading the disease. All you can do is give her a very disapproving look as you walk past her while the words “escape, escape!” blink inside your head like a neon bulb sign.
What started as “it happens only in China” has now taken a form of high vigil and fear in many people, as many countries are reeling in shock while COVID-19 cases continue to climb numbers day after day. In India, when the first three COVID-19 cases were reported in Kerala in late January/ early February, the state sprang into action to contain the spread while the rest of the country was not too shaken up by the confirmed COVID-19 cases in ‘distant lands’ of non-Hindi speaking, coconut oil dribbling, beef-eating people. Well, Keralites for that matter went into overdrive because Kerala has had enough lessons from the Nipah virus outbreak of 2018. With the three COVID-19 cases soon recovering and no further spread of the virus, the state breathed a sigh of relief in the ensuing weeks. However, the respite was shortlived.
With the recent turn of events, where three Italy returned Keralite family failing to report their travel itinerary to authorities, the COVID-19 cases spread from the family have shot up to 14. Concurrently new COVID-19 cases are being reported from different parts of India where people have had a travel history to countries with a high number of COVID-19 cases. As on 12 March 2020, India’s COVID-19 cases stand at 73; including the three recovered cases and two more new cases Kerala now has 19 registered cases, the highest so far for any Indian state. And India’s first death due to COVID-19 has been registered in Karantaka’s Kalaburgi.
Barring a few visa exemptions, the newly imposed travel ban literally has rendered India as an isolated country with a self-imposed quarantine from rest of the world and some have raised the point that countries with a far higher number of COVID-19 cases do not yet have a tight travel ban as India does. The circular issued by the Indian Government on having an all-clear health certificate for the expatriates to fly home to India has met with the stern move from the Kerala Assembly which has unanimously passed a resolution against the circular. The resolution moved by the Chief Minister Pinarayi Vijayan said the circular was “inhuman” and was akin to “cruelly abandoning” the expatriate Indians. This comes in light of the distressing messages the expatriates have been sharing with the world.
Recently the high-level meeting convened by the Cabinet Secretary has decided that all states and Union Territories should be advised by the Ministry of Health and Family Welfare to invoke provisions of Section 2 of the Epidemic Diseases Act, 1897 so that all advisories being issued from time to time by the ministry of health/State/UTs are enforceable. And Karnataka has become the first Indian state to do so by issuing ‘the Karnataka Epidemic Diseases, COVID-19 Regulations, 2020’ under the Epidemic Diseases Act,1897, Karnataka. And this is an interesting development given how a suspected case placed in quarantine had made a run in Mangaluru, Karnataka. A similar suspected-case-run-away had happened a few days before in Pathanamthitta, Kerala. With the new regulations coming into force in Karnataka, if a suspected case of COVID-19 refuses admission or isolation, the authorized officers will have powers to forcefully admit and isolate such case for a period of 14 days from the onset of symptoms or till the reports of the lab tests are received, or such period as may be necessary.
And amidst all the escalating fear and confusion, there are concerns about the balance between safety and privacy emerging from the public as well as the medical bodies like the Indian Medical Association (IMA). The IMA has appealed to the government to “classify data” of the pandemic and take appropriate action with “clinical precision”. They stressed on the point that sharing data of infected people on a daily basis with the public has created panic across the country. IMA’s action again has met with criticism from many quarters who hold the opinion that data is the way to contain the virus spread and sees no wrong in having data published as it can challenge the false safety that the public has cocooned themselves in and thus does not promote or spread panic.
However, there are numerous lessons to be picked up from countries were COVID-19 has been on the rampage for months. China, South Korea and Singapore have come down strongly on their citizens to contain the spread. While most people lean towards the idea that such draconian surveillance measures are the need of the hour to contain an outbreak irrespective of an individual’s right to privacy, what many in their myopic view miss out is the misuse of such personal data being on the public domain, as some groups can be overzealous in their ways and means to protect themselves and others from the virus. The social stigma of illness is a very serious concern which most people in their war cry of ‘desperate times call for desperate measures’ seem to have overlooked. Also, there are valid fears about the unethical use of data. Questions remain unanswered about the highly probable misuse of these personal data by any group that have vested interests.
For India, the government has not clamped down on its citizens as strongly as the aforesaid countries, but it could only be a matter of time perhaps. With the yet-problematic-Aadhar being mandated unconstitutionally for anything and everything, one can hope that government will not come up with a flimsy excuse crafted in a convincing reason to validate the induction of Aadhar in the fight against COVID-19. But before the government can contrive such a plan, all hell shall break loose by the very own public’s data dance. With the ‘post-like-comment-share-tweet-retweet’ modes of any social media and ‘type message-record audio/video-sent-forward’ modes of Whatsapp, many people with wild wild imaginations/ creativity or viciousness will have a data harvest in the ensuing weeks with data floating all around in the news channels and news portals. The needs to protect and be protected has already taken forms of threats in Kerala where Italy returned family are being subjected to viciousness both online and offline, so much so that the police are maintaining a vigil against any safety issue for the family.
What should have been the ethical and responsible handling of personal data by the authorized personnel alone to conduct disease surveillance, contact tracing; such that suspected cases are alerted and isolated with the patients’ dignity and privacy intact, can now in all likelihood, take the form of paranoia and maliciousness amongst the public, especially in these tech-driven times. Even if the state, the experts and the community are to work together for community surveillance and contact tracing, it ought to be done in the best interests of both the public and the individual rights. As much vital it is that the public has the right information from health promotion and community awareness to safeguard them, it is highly problematic that insensitive handling of data by the media and the public can lead to many suspected cases to go unreported out of the fear of the social stigma of the disease.
Let us all hope that we tide over this COVID-19 without many fatalities. As our country and the rest of the world are making sense of the unfolding events, let us all do the needful to not let COVID-19 scare and shrink us. Once this crisis is over we need to rethink about the 122-year-old Epidemic Diseases Act,1897. As a research paper authored by Dr P.S.Rakesh in the Indian Journal of Medical Ethics (IJME) has rightly pointed out, ‘the Act has major limitations in the current scenario as it is outdated, merely regulatory and not rights-based, and lacks a focus on the people. There is a need for an integrated, comprehensive, actionable and relevant legal provision for the control of outbreaks in India’, we thus need new legislation, in fact, the first-ever Public Health Act for India that takes cognisance of the highly interconnected world and scientific advancements of the current times. We need an Act which is rooted in neither purely coercive approach nor purely rights-based approach but a mixture of both. And more importantly, we need frameworks for the responsible and ethical use of data even during pandemics. Till then let us keep calm while the media continue to flash out, hour-by-hour, the COVID-19 cases in India and the world like a live cricket score.