Mains Paper 2: Health
Prelims level: Not much
Mains level: Issues relating to development and management of Social Sector/Services relating to Health
• As the number of cases of COVID-19 in Karnataka and Telangana begins to surge, there is a corresponding urge to affix blame to a cause.
• This has happened earlier too when there was a rise in cases in other States — evidence that governments had failed and had shielded numbers finally appeared to be here.
• But the knee-jerk response to bad numbers is actually causing great harm.
AFFECTS LESSON LEARNING:
• When we react with outrage to the rising numbers alone, we get no closer to finding out or fixing what is wrong.
• If we were to react with horror to bad processes instead, we would have some hope of mitigating the worst of the crisis.
• This is particularly important in the context of a disease that, in most of the country, can only be identified when a doctor prescribes a test based on limited criteria.
• Reported new cases are a direct consequence of the decision and ability of State and city administrations to expand the parameters of testing, and numbers need to be viewed in that context.
• Roughly 5,000 COVID-19 cases are what separate Telangana from Andhra Pradesh, but it would be a mistake to see this as an indication that the two States are in a similar situation.
• Telangana discovered these 34,000 cases by testing just 1.7 lakh tests, while Andhra Pradesh discovered its 30,000 cases by conducting 11.5 lakh tests.
• Then there is the question of what type of test is being conducted.
• Delhi now conducts more than twice as many tests each day than it did a month only to discover fewer cases.
• But well over half of its tests are the far less sensitive and reliable antigen tests.
COMBINATION OF FACTORS:
• What all of this means is that the number of new cases reported each day in a city or State is not a purely mathematical fact.
• It is a combination of not just the city’s disease environment but also its political economy.
• Reacting to its numbers without accounting for this will lead us to the wrong lessons.
• We have seen this tendency to view higher numbers as a lack of governance than a success of reporting, and it has had similarly deleterious consequences.
• The publication of India’s annual crime statistics is met every year with headlines about relatively developed States having among the highest rates of reported crime, particularly against women.
• But until we reach the point of “full registration” — which means a country that is confident it is capturing the full extent of crime — more reported crime is for the most part a good thing.
FEAR OF CRITICISM:
• Instead, the outrage following “bad” new numbers is already creating perverse incentives against honest reporting.
• While investigating the working of committees set up by State governments to audit COVID-19 deaths, this writer found that not all deaths of those who were COVID-19 positive were being recorded as COVID-19 deaths.
• What was more worrying was that Chennai, New Delhi and Mumbai had recorded zero “suspected or probable” COVID-19 deaths — deaths of people who presented like COVID-19 patients but had not had a positive test prior to death.
• This means that such cities could be missing 20-30% or more of true COVID-19 deaths.
• In each of these three cities, health administration officials said reporting more deaths would lead to their cities and States being heavily criticised, and unfairly so, they thought.
• An adviser to the Delhi government said, “If we start adding suspected deaths, no one’s going to praise us for it.
• All we’ll get is ‘Deaths shoot up in Delhi’ sort of headlines.”
THE DELAY FACTOR:
• Such concerns have been borne out by recent media coverage of similar attempts.
• Reconciliation exercises aimed at fixing delayed data in the three cities and were reported as if hidden deaths had been “exposed”.
• Delayed reporting and reconciliation are a feature of epidemic reporting the world over, and the new numbers were the result of these audit committees doing the job they were set up to do.
• When missing deaths are discovered, they are slowly added to the total over the next few days by administrations that fear people becoming angry or panic-stricken if they read about or see a sudden spike.
• From a public health perspective, the attempts of State governments to restrict the numbers of deaths being reported so as not to show a higher burden than other States is a loss of valuable knowledge.
• It would of course be a mistake to celebrate every increase in numbers, particularly in the case of a pandemic that is causing such devastation.
• But parsing the numbers to see what is driving the increase, and whether the underlying processes are working well is key.
• Without that, all that our outrage would do would be to create incentives to suppress numbers.
• That is a decline in data that we should not celebrate.
Q.1) With reference to the Affordable Rental Housing Complexes (AHRCs), consider the following statements:
1. The Union Cabinet has given its approval for developing of Affordable Rental Housing Complexes (AHRCs) for urban migrants/poor as a sub-scheme under Atal Mission for Rejuvenation and Urban Transformation.
2. Existing vacant government-funded housing complexes will be converted in ARHCs through Concession Agreements for 25 years
Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2
Q.1) How are bad coronavirus figures causing great harm? Critically explain.