South Korean model to control COVID 19 spread

South Korean model to control COVID 19 spread

Context: The Korean Model, a vigorous regime of “trace, test, treat”, has shown remarkable results in controlling the spread of the novel coronavirus, without putting a nationwide lockdown in place.

How is the situation in Korea?

Korea is now in full control of the spread of the disease. The number of new confirmed cases per day has been showing steady decline since hitting a peak at 989 in February to double-digit figures as of mid-March.

Korea might be the only country that hasn’t imposed a lockdown within its territories or even of its international borders.

How has this been possible? What is the ‘Korean model’?

It is grounded on concentrated testing of high-risk areas and clusters.

  • Korea found out at the beginning of the spread of the virus that a certain religious cult and its gathering was the cause of a large portion of the spread in a certain area of the country. This group had massive gatherings in a closed-off space.
  • The government listed all members of the group across the country, tracked their whereabouts and conducted tests on a massive scale, leading to the rapid increase in the number of confirmed cases.
  • However, Korea succeeded in identifying and isolating potential cases at a very early stage and finally flattened the curve.

Other best practices followed by Korea:

The moment the virus DNA pattern was confirmed in Wuhan, Korean medical teams and bio-companies were able to develop new testing kits with surprising speed. This made it possible for Korea to conduct mass-scale testing of 18,000 cases a day.

Anybody in Korea who has symptoms or reasons to be tested can get the test within minutes at ‘drive-thru’ or ‘walk-thru’ testing centres and receive the result by text message the very next day. Korea made available over 650 testing centres nationwide.

Is it possible for India to replicate this model?

Given India’s demography and medical infrastructure, lockdowns are necessary. However, openness and transparency is important to tackling this situation, and identifying and isolating the core of the spread of the virus with full medical capacity at the earliest possible stage is key. This is the essence of the ‘Korean model’.

Sources: the Hindu.

Epidemic Disease Act, 1897 and its relevancy in present times

Epidemic Disease Act, 1897 and its relevancy in present times

The Epidemic Disease Act was enacted in 1897 by way of notification dated 04.02.1897 to control the bubonic plague outbreak in Bombay (now known as Mumbai). It is a very short act consisting of only 5 sections and its violation is punishable under Section 188 of the Indian Penal Code, 1860 and other relevant sections. At the time of outspread of Covid-19 pandemic, Karnataka was the first state in India to invoke the act on 11.03.2020 and Haryana became second on 12.03.2020. The Act has been earlier used in control of various epidemics in India which spread from time to time. However, the Act sometimes is deemed to be insufficient in dealing with the purpose as the same is not exhaustive in nature and does not deal with complicated situations. It is to be noticed that India is witnessing epidemiological transition. In the 21st century, the country is facing dual burden of diseases. While struggling to combat the burden of communicable diseases, our health system is challenged to address chronic noncommunicable diseases. The burden and spectrum of infectious diseases are enormous in India. They still contribute about 30% of disease burden in India. Epidemics of communicable diseases impose a heavy economic burden on individuals, families, communities, and nation at large. We still are clueless while handling influenza pandemics and struggle to contain them. The rise in the number, geographic extent, severity of outbreaks, threat of bio-terrorism, emergence of emerging and reemerging infections, volume of air travel, globalization, and the complex lifestyle behaviors of the people has stressed the need for devising new public health interventions to respond to the epidemics effectively and swiftly.

Provisions of the Act

Section 1: Power to take special measures and prescribe regulations as to dangerous epidemic disease.—(1) When at any time the 7[State Government] is satisfied that [the State] or any part thereof is visited by, or threatened with, an outbreak of any dangerous epidemic disease, the [State Government], if [it] thinks that the ordinary provisions of the law for the time being in force are insufficient for the purpose, may take, or require or empower any person to take, such measures and, by public notice, prescribe such temporary regulations to be observed by the public or by any person or class of persons as [it] shall deem necessary to prevent the outbreak of such disease or
the spread thereof, and may determine in what manner and by whom any expenses incurred (including compensation if any) shall be defrayed.
(2) In particular and without prejudice to the generality of the foregoing provisions, the [State Government] may take measures and prescribe regulations for—
* * * * *
(b) the inspection of persons travelling by railway or otherwise, and the segregation, in hospital, temporary accommodation or otherwise, of persons suspected by the inspecting officer of being infected with any such disease.

Section 2A: Powers of Central Government.—When the Central Government is satisfied that India or any part thereof is visited by, or threatened with, an outbreak of any dangerous epidemic disease and that the ordinary provisions of the law for the time being in force are insufficient to prevent the outbreak of such disease or the spread thereof, the Central Government may take measures and prescribe regulations for the inspection of any ship or vessel leaving or arriving at any port in 2[the territories to which this Act extends] and for such detention thereof, or of any person intending to sail therein, or arriving thereby, as may be necessary.]

Section 3: Penalty.—Any person disobeying any regulation or order made under this Act shall be deemed to have committed an offence punishable under section 188 of the Indian Penal Code (45 of 1860).

A brief perusal of Section 2 and 2A would show that the Act empowers the Government to make such special provisions which are necessary to spread outburst of any epidemic. However, how this power is to be exercised and what measures can be taken to spread such epidemics is not clear here. Similarly, the Act doesn’t prescribe any procedure to coordinate and limits of power etc. Thus, the Act itself is very vague and only prescribes penalty for violation as prescribed under Section 188 of IPC.

Section 188 of IPC is as under:

188. Disobedience to order duly promulgated by public servant.—Whoever, knowing that, by an order promulgated by a public serv­ant lawfully empowered to promulgate such order, he is directed to abstain from a certain act, or to take certain order with certain property in his possession or under his management, disobeys such direction, shall, if such disobedience causes or tends to cause obstruction, annoyance or injury, or risk of obstruction, annoyance or injury, to any person lawfully employed, be punished with simple impris­onment for a term which may extend to one month or with fine which may extend to two hundred rupees, or with both; and if such disobedience causes or trends to cause danger to human life, health or safety, or causes or tends to cause a riot or affray, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both. Explanation.—It is not necessary that the offender should intend to produce harm, or contemplate his disobedience as likely to produce harm. It is sufficient that he knows of the order which he disobeys, and that his disobedience produces, or is likely to produce, harm. Illustration An order is promulgated by a public servant lawfully empowered to promulgate such order, directing that a religious procession shall not pass down a certain street. A knowingly disobeys the order, and thereby causes danger of riot. A has committed the offence defined in this section.

What happens if you violate the lockdown orders? 

Under Section 188, there two offences:

  1. Disobedience to an order lawfully promulgated by a public servant, If such disobedience causes obstruction, annoyance or injury to persons lawfully employed

Punishment: Simple Imprisonment for 1 month or fine of Rs 200 or both

  1. If such disobedience causes danger to human life, health or safety, etc.

Punishment: Simple Imprisonment for 6 months or fine of Rs 1000 or both

According to the First Schedule of the Criminal Procedure Code (CrPC), 1973, both offences are cognizable, bailable, and can be tried by any magistrate.

These are extraordinary times, but under what circumstances is Sec 188 IPC invoked normally?

To be punishable under S. 188, the order has to be for public purposes by public functionaries. An order made in a civil suit between two parties does not fall under this Section.

There must be evidence that the accused had knowledge of the order with the disobedience of which he is charged. Mere proof of a general notification promulgating the order does not satisfy the requirements of the section. Mere disobedience of the order does not constitute an offence in itself, it must be shown that the disobedience has or tends to a certain consequence.

A bare perusal of the Act shows that the Act is insufficient in tackling advance problems and needs to be updated to cater present needs. I personally suggest that the Act needs to be overhauled and needs to contain advance provisions like Disaster Management Act, 2005. Only reason probably for the Government of India to choose DM Act instead of EM Act is that it contains advance provisions to coordinate such extraordinary situation like present times due to outspread of Covid-19.


Government should consider lowering price of Covid-19 test kit in Private labs

Government should consider lowering price of Covid-19 test kit in Private labs

As we all are aware that Covid-19 has started showing initial trends of 3rd stage of spreading i.e. “Community Spreading”. In such condition there is every likelihood that number of patients may multiply like anything all over India or to a particular state or states. At this time, the present facilities of testing of Covid-19 may become insufficient so the Ministry of Health with the help of Indian Council for Medical Research had asked different companies/firms from all over India to come forward and submit their proposals for providing test kits for Covid-19. Further, various firms were authorized to do test of Covid-19. However, a recent notification states that maximum price has been fixed at Rs. 4500 for test of Covid-19. Tender to supply the Covid-19 test kits has been approved to a Gujarat based start-up CoSara.

Such an exorbitant price of test cannot be termed to be suitable for the people of India as more than half of Indian population lives under poverty line and doesn’t even have access to basic needs. They won’t be in position to conduct the test through a private lab which will charge amount as higher as Rs. 4500/-. It is worthwhile to mention here that WHO has already advised India to spread up tests in order to control the spread of Covid-19 to third stage. Such, a advice cannot be followed without easy access of test in private labs. If we see the proportion of spreading of the disease, the Covid-19 should be free and accessible to all even in Private Labs.

Why Covid-19 test should be free?

Article 21 of the Constitution of India guarantees right to life. It states as under:

“No person shall be deprived of his life or personal liberty except according to a procedure established by law.”

Further, Article 47 of the Constitution of India states as under:

“Duty of the State to raise the level of nutrition and the standard of living and to improve public health The State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties and, in particular, the State shall endeavour to bring about prohibition of the consumption except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health.”

Further, Article 25 of the Universal Declaration of Human Rights States:

(i) Everyone has the right to a standard of living for the health and well being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

(ii) Motherhood and childhood are entitled to special care and assistances

Supreme Court of India from time to time has emphasized that Right to life includes right to enjoy good health and have a proper medical aid. Reliance can be made to the judgment of the Supreme Court in Paschim Banga Khet Mazdoor Samithy & Ors. V. State of West Bengal & Anrs., (1996) 4 SCC 37 while widening the scope of Article 21 and the governments responsibility to provide medical aid to every person in the country, held that in a welfare state, the primary duty of the government is to secure the welfare of the people. Providing adequate medical facilities for the people is an obligation undertaken by the government in a welfare state. The government discharges this obligation by providing medical care to the persons seeking to avail of those facilities. Article 21 imposes an obligation on the State to safeguard the right to life of every person. Preservation of human life is thus, of paramount importance. The government hospitals run by the State are duly bound to extend medical assistance for preserving human life. Failure on the part of a government hospital to provide timely medical treatment to a person in need of such treatment, results in violation of his right of life guaranteed under Article 21. The petitioner should therefore, be suitably compensated for the breach of his right guaranteed under Article 21 of the Constitution. After due regard to the facts and circumstances of the case compensation of Rs. 25,000 was given.

It is no doubt true that financial resources are needed for providing free facilities. But at the same, it cannot be ignored that it is the constitutional obligation of the State to provide adequate medical services to the people. Whatever is necessary for this purpose has to be done. In the context of the constitutional obligation to provide free legal aid to a poor accused this Court has held that the state cannot avoid its constitutional obligation in that regard on account of financial constraints. Reliance may be placed to ‘Khatri (11) v. State of Bihar, 1981(1) SCC 627 at 631.

There are numerous pronouncements of similar nature, which are irrelevant to be discussed here. However, it is to be noted that Government is under Constitutional duty to give medical aid to the citizen of Country and since, the Covid-19 is declared epidemic, the duty of state is much far than what has been observed in the pronouncements of even provided in the Constitution. Thus, in the interest of society at large and in order to enable more and more people to come forward for their testing, it is necessary that the test should be cheaper and preferably free.

Symptoms of Covid-19

Symptoms of Covid-19

Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new coronavirus was identified as the cause of a disease outbreak that originated in China.

The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19).

Cases of COVID-19 have been reported in a growing number of countries, including the U.S. Public health groups, such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), are monitoring the situation and posting updates on their websites. WHO declared a global pandemic in March 2020. These groups have also issued recommendations for preventing and treating the illness.

Symptoms

Signs and symptoms of COVID-19 may appear two to 14 days after exposure and can include:

  • Fever
  • Cough
  • Shortness of breath or difficulty breathing

Other symptoms can include:

  • Tiredness
  • Aches
  • Runny nose
  • Sore throat

The severity of COVID-19 symptoms can range from very mild to severe. Some people have no symptoms. People who are older or have existing chronic medical conditions, such as heart or lung disease or diabetes, may be at higher risk of serious illness. This is similar to what is seen with other respiratory illnesses, such as influenza.

When to see a doctor

Contact your doctor or clinic right away if you have COVID-19 symptoms, you’ve been exposed to someone with COVID-19, or you live in or have traveled from an area with ongoing community spread of COVID-19 as determined by CDC and WHO. Call your doctor ahead to tell him or her about your symptoms and recent travels and possible exposure before you go to your appointment.

Anyone with respiratory symptoms who hasn’t been in an area with ongoing community spread can contact his or her doctor or clinic for further recommendations and guidance. Let your doctor know if you have other chronic medical conditions. As the pandemic progresses, it’s important to make sure health care is available for those in greatest need.

Causes

It’s unclear exactly how contagious the new coronavirus is. It appears to spread from person to person among those in close contact. It may be spread by respiratory droplets released when someone with the virus coughs or sneezes.

It may also be spread if a person touches a surface with the virus on it and then touches his or her mouth, nose or eyes.

Risk factors

Risk factors for COVID-19 appear to include:

  • Recent travel from or residence in an area with ongoing community spread of COVID-19 as determined by CDC or WHO
  • Close contact with someone who has COVID-19 — such as when a family member or health care worker takes care of an infected person

Complications

Complications can include:

  • Pneumonia in both lungs
  • Organ failure in several organs
  • Death

Prevention

Although there is no vaccine available to prevent infection with the new coronavirus, you can take steps to reduce your risk of infection. WHO and CDC recommend following these precautions for avoiding COVID-19:

  • Avoid large events and mass gatherings.
  • Avoid close contact (about 6 feet) with anyone who is sick or has symptoms.
  • Keep distance between yourself and others if COVID-19 is spreading in your community, especially if you have a higher risk of serious illness.
  • Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue.
  • Avoid touching your eyes, nose and mouth if your hands aren’t clean.
  • Avoid sharing dishes, glasses, bedding and other household items if you’re sick.
  • Clean and disinfect surfaces you often touch on a daily basis.
  • Stay home from work, school and public areas if you’re sick, unless you’re going to get medical care. Avoid taking public transportation if you’re sick.

CDC doesn’t recommend that healthy people wear a face mask to protect themselves from respiratory illnesses, including COVID-19. Only wear a mask if a health care provider tells you to do so.

WHO also recommends that you:

  • Avoid eating raw or undercooked meat or animal organs.
  • Avoid contact with live animals and surfaces they may have touched if you’re visiting live markets in areas that have recently had new coronavirus cases.

If you have a chronic medical condition and may have a higher risk of serious illness, check with your doctor about other ways to protect yourself.

Travel

If you’re planning to travel internationally, first check the CDC and WHO websites for updates and advice. Also look for any health advisories that may be in place where you plan to travel. You may also want to talk with your doctor if you have health conditions that make you more susceptible to respiratory infections and complications.