Uttar Pradesh’s Strategic Preparedness and Response to COVID-19

By Shashank Khare

In this unprecedented time of COVID-19 outbreak, governments of many nations are facing a hard time placing strategic guidelines and response activities to control its further spread. Most countries have seen an alarming rise in coronavirus cases, and many are experiencing large-scale outbreaks. Developed nations, like the United States and the United Kingdom, are badly affected and are still struggling to prevent, detect, and respond to the pandemic and are relying on temporary solutions.

In India, the number of cases has already crossed 45,000 despite strategic preparedness and response plans by the Central government. The Government of Uttar Pradesh (UP) is taking strict measures to control the spread of the coronavirus along with providing continued relief measures like ensuring food security for the marginalized, securing access to basic essential household items through government-appointed delivery agents, and using technology-based solutions to ensure the education of the children during this crisis. The government is also nominating willing civil societies and corporates to join hands to fight this pandemic together by assisting it in mobilizing resources. A combination of government policies and technology-based solutions has been put in place to ensure the safety and well-being of people along with the smooth functioning of the state.

Uttar Pradesh is the largest state in the country in terms of population and hence, the battle against COVID-19 becomes more challenging. The UP government has been working hard to turn every challenge into an opportunity, responding quickly and ensuring that the best strategies are in place. The state’s population equals that of Indonesia (one of the most densely populated nations) but the number of coronavirus positive cases in Indonesia is 8 times that in Uttar Pradesh. Therefore, we can say that the government’s response and the measures taken to control this pandemic have been successful so far.

The alarm for coronavirus in UP, as in the entire nation, was sounded a little late as compared to other countries. The first case in the state was reported on March 5, 2020, but as soon as the alarm went off, the government started taking rapid measures and formulating strategies to find the best solution through mobilizing resources and planned approaches. This response of the UP government, like measures taken by other governments, is two-fold. On the one hand, measures were taken to curb the spread of the disease and on the other, relief measures were carried out to minimize the negative impact of such interventions.

Let us try to analyse the response in detail to understand the two-fold model adopted by the government and the receptivity of these measures by the public.

Measures taken to control the outbreak

The rate of success of the government’s actions to curb the outbreak of the disease can be reckoned by the relatively low coronavirus positive cases in the state given the high population density and the low literacy levels in the state which makes handling the situation difficult.  To get a clearer idea about the measures adopted by the government, I am dividing the timeline of its actions into pre-lockdown and post-lockdown actions taken to control the spread of the disease.

Pre-lockdown situation
The proceedings for the prevention of coronavirus outbreak started in the first week of March (before the first lockdown was announced on March 25, 2020).

Special training programs for frontline workers like medical professionals, police personnel, etc. were initiated. The Panchayati Raj and the rural and urban development departments were directed to conduct comprehensive awareness programs. Through a Chief Minister helpline number, the village heads were asked to make villagers aware of the threat of the new virus. The government issued advisories about the do’s & don’ts, and tips to stay healthy during this time.

The government ordered a shutdown of all places of public gathering, such as educational institutions, cinemas, shopping malls, swimming pools, gyms, multiplexes, and tourist spots till April 2. Public transport was put on hold and it was ensured that nobody roamed the streets. A helpline was started to assist the public regarding the information about the outbreak. The public was advised to postpone all family events and celebrations like marriage functions. For any gathering, prior approval had to be taken from the district authority.

On March 21, the Chief Minister ordered lockdown from March 22-25 in 15 districts of the state where cases had started to appear.

Post-lockdown situation
Soon after the lockdown was declared by the Prime Minister from the midnight of March 24-25, Agra was declared as the first COVID-19 cluster in India with one of the first cluster cases identified in the city. However, Agra was quick to curb the spread of the virus, and the numbers stopped rising rapidly within a few days. The strategy and response adopted by the district authorities were so successful that it was praised by the Central Government and came to be known as the Agra Model.

The Agra Model was a containment strategy which included the following:

• Identifying areas within 3 km of the epicentre as ‘Containment Zones’.
• Over 1200 teams conducting door-to-door surveys of 9.3 lakh people.
• Converting Smart City control rooms into ‘war rooms’ where a central helpline was started.
• Monitoring the movement of infected people by drones, CCTV cameras, and mobile phone GPS.
• Active contact tracing and isolation.
• Citizen awareness and data-driven response.

The success of the model lay in it being able to stop the disease from spreading beyond the clusters/areas where positive cases were first detected. The district administration of Agra said that the success of the model was due to three key points, a) isolation; b) expansion; and, c) containment.

Agra, however, witnessed a spike in coronavirus positive cases when Paras Hospital, a private hospital in Agra, reportedly withheld information about a patient who had tested positive. A total of 79 cases in Agra today are from this hospital and subsequently, more cases were traced to their contacts.

The Agra model, which focused on cluster containment strategies, was adopted by the entire state. It aimed to contain the outbreak within defined geographical areas by making early detection and breaking the chain of transmission.  This containment strategy is implemented by the Rapid Response Teams (RRTs) that comprise civic and police personnel coordinating with grassroots-level health workers, such as Assisted Social Health Activists (ASHA).

Timeline of coronavirus spread in the state

The graph of COVID 19 confirmed cases in UP was flat until the first week of April; cases were limited to people with a foreign travel history and their close contacts. A sudden rise in positive cases was witnessed after April 10 when attendees of the Tablighi Jamaat event at Delhi Markaz started testing positive. Thereafter, there was a surge in cases in Lucknow, Kanpur, Agra, Saharanpur, and Moradabad. Here also, most cases were from various clusters, and the administration has been successful in stopping the spread to other parts of the city given the challenge of its population density.

As of May 4, the state has 2766 confirmed cases of which 1140 patients are from the Tablighi Jamaat event. Another daunting task for the administration was to track down the people who had attended the Markaz event and trace their contacts. Several incidents of stone-pelting and attacks on the medical staff and police personnel were reported throughout the state when the medical staff was trying to test the contacts of patients and put them in isolation.

The hotspots or the Red Zone districts in UP account for 90% of the total cases in the state. Within these districts, positive cases have been more or less restricted to the containment zones. The government had announced a sealing of these containment areas in all the Red Zones and imposed strict restrictions on any kind of movement.

The lockdown, as a visionary strategy, has been successful in not allowing the curve of positive cases to spiral upwards at a rapid rate as is seen in other countries. But this has had a colossal impact on the economy, food security, and livelihoods of people. The lockdown’s negative impacts have been experienced by all but the most affected are the marginalized sections of society, even when the government is doing its best to ensure that human suffering is minimal.

Government’s relief measures

The Chief Minister of Uttar Pradesh was the first to declare that people need not step out of their homes even for essentials such as groceries and medicines as these would be delivered to their doorsteps by police personnel and government-appointed delivery agents following all safety precautions. Supply lines were created, and a helpline number was established as the primary emergency number for all purposes. Apart from the government helpline numbers, the government also issued numbers of grocery stores on March 25-26 which it had enlisted for door-to-door delivery of essentials.

Migrants are the worst affected in such times not only due to their socio-economic status, congested neighbourhoods, and lack of requisite information but also because they lie outside the state support systems. The UP government has done its best to cater to all vulnerable sections of the society including daily wage labourers, MNREGA workers, hawkers, and migrants stuck in other states. It announced several relief packages, including direct money transfers to bank accounts. A financial package of 395 crores was announced for 3.53 million beneficiaries including registered labourers, rickshaw pullers, hawkers, and kiosk owners. Immediately after the lockdown was announced, the government also started the distribution of cooked meals and dry rations kits through police response vehicles to various areas. Free food grains were distributed for the month of April and May to 8.38 million widows, senior citizens, and handicapped pensioners. Further, 16.53 million beneficiaries were provided with a month’s free ration and an amount of Rs 1000/- was deposited into the bank accounts of 11 lakh construction workers. Apart from this, the UP government created a record by distributing 1.5 lakh metric tons of rice to 3 crore people from 75 lakh families in a single day.

Major credit for the success of the state’s efforts can be attributed to the freehand given to the police and security personnel owing to which, UP witnessed one of the most efficient and stringent implementations of the lockdown measures compared to other large states. The Uttar Pradesh Police, which has always been criticized for its lack of action and empathy towards the public, has done commendable work during these testing times. The Commissioner of Police, Lucknow commented that there were several instances when the traffic police personnel were seen feeding the needy out of their own pockets (the administration assured that they would be reimbursed). The administration was highly praised for conducting timely, technology-based online training for frontline workers and ensuring safety gear like Personal Protective Equipment (PPE), alcohol-based sanitizers, gloves, masks, etc. for them.

Apart from these steps to ease the life of its citizens, the UP government also did its best to bring back the thousands of migrants who were stuck outside the state due to the lockdown. After the migrant labour crisis in Delhi, the UP government was the first to announce and bring back its residents. Later, many students stuck in Kota and labourers in other states, like Haryana, were also brought back in buses after completing 14 days’ quarantine.

As one of the states where 80% population is dependent on agriculture, Chief Minister Yogi also announced several relief packages for farmers. It being the harvest season, the government encouraged institutions and agencies to purchase food grains from the growers.

Apart from these humanitarian steps, the government also focused on the need for continued education and learning of students. Soon after the lockdown was announced, the government ordered the officials to start technology-based online classes for students from primary up to class 12 and students of nursing and paramedical studies so that their academic schedule is not disturbed.  The UP government also started broadcasting a 90-minute education program on Doordarshan Uttar Pradesh for the students of classes 1-8. This step is taken to ensure that the students remain associated with learning and make constructive use of the lockdown period. The Department of Basic Education, Uttar Pradesh also started the E-Paathsaala initiative for students, making the best use of the limited resources available, as there is no certainty regarding the reopening of schools even after the lockdown is over.

What really underscores the Chief Minister’s 360-degree vision is his ambitious plan to attract MNCs and manufacturers from China to set up their units in Uttar Pradesh. Officials have been instructed to come up with lucrative packages to attract these companies. The Chief Minister has personally ensured tailor-made facilities to FedEx, Cisco and Adobe. This is an ambitious plan to create lakhs of jobs for the state’s youth and to help propel India in becoming an international manufacturing hub.

The government has more or less done everything right until now from lodging FIRs against lockdown violators and taking strict actions against stone pelters engaging in violence against corona warriors to depositing crores in the bank account of lakhs of daily wage workers in the state. From enforcing a strict lockdown, maintaining law and order and ensuring that the poor and hungry are properly fed, to taking advantage of China’s dwindling goodwill on the international stage, the Government of Uttar Pradesh has demonstrated the right combination of strictness, humanitarianism and a visionary approach. But the real challenge will start when the lockdown ends, and life starts returning to normalcy. The pandemic of COVID-19 is far from over and the numbers are continuously rising in the state (though at a steady pace). Even some of the districts which were till now in the Orange Zone have shown a sudden increase in the number of positive cases. We, therefore, need to analyse what the government should have done to control the spread of disease even further.

Shortcomings of the government’s actions

The Government of Uttar Pradesh was fast to move into action, but it waited for the first few cases to appear in the state before taking any measures. Even when the entire world had started experiencing the effects of the horrific virus, the UP government did not start improving the medical infrastructure or working on awareness programs about the virus and its seriousness. It was only after the first few cases started to appear and when Agra became one of the first cities to witness a cluster of COVID-19 positive cases that the government got into action. From procuring testing kits and PPEs to preparing the medical staff for the upcoming crisis, everything was done only after there was an outbreak. The state should have been better prepared to tackle the crisis.

Many critics argue that the numbers in Uttar Pradesh are still limited because the state is simply not testing enough. In a population of 220 million people, the government has conducted only 1,05,234 tests to date. The strategy adopted by the government cannot to relied upon completely because the actual figures of positive cases can be way more than the numbers simply because the strain of the virus in India is such that the infected does not necessarily show symptoms. In fact, the maximum cases that have been reported have either been asymptomatic or have shown very mild symptoms. In such a scenario, testing only those people who have symptoms or are close contacts of a confirmed corona positive patient is flawed. It is high time the government starts door-to-door testing in containment areas within the Red Zones and pool testing in other areas of the Red Zones.

As the lockdown phase nears completion, the real challenge that emerges is how to ease out of the lockdown in a phased manner so that the economy can start to breathe, and at the same time, the safety of the people is not compromised. In a densely populated state like UP, a minor mistake, be it of the administration, a medical professional or a citizen can easily wash off all the hard work that has been done until now.

As all major cities of the nation, including almost all state capitals, are in the Red Zone, they are to remain under lockdown for another phase until corona curve starts to flatten. But most of the private offices have been allowed to reopen with a few restrictions. This creates various challenges for the citizens as well as the administration. According to the latest list of zones designated by the Government of India, Uttar Pradesh’s 19 districts are in the Red Zone, 36 in the Orange Zone, and 20 in the Green Zone.

In order to prevent a second wave of the disease, we have to brace for a phased return to normalcy. Most of the restrictions (barring places of entertainment including malls, cinemas, restaurants), have been eased out in Green Zones post-May 3. There are considerable relaxations in the Orange Zone as well, but the situation remains the same in Red Zones with strict restrictions on movement in containment areas.

Thus, the coming three to four weeks will decide the fate of the state as most of the industries (barring all entertainment industries), public and private offices will slowly reopen. The next few weeks are crucial for the state, and the administration needs to remember that it is more important to flatten the curve of the coronavirus cases in the state than to boost the economy and give people back their normal lives. Once we achieve this, we can return to the ‘new normal’ in a post coronavirus world.

AUTHOR

Shashank Khare is an alumnus of the Azim Premji University, Developed Program, Batch of 2013-15. He is currently heading the Education projects of HCL Foundation in Lucknow and also responsible for the organization’s government relations.

Disclaimer: The views and opinions expressed in this article are those of the author/s and do not necessarily reflect the official policy or position of Azim Premji University or Foundation.