Quarantining people to prevent spread of disease is an age-old strategy. Yet, the practice hasn’t been easy for most coronavirus-affected countries, barring a few
In 1918, the Spanish flu killed around 50 million including 675,000 Americans, most of the infection resulting from person to person transmission as troops moved across the borders during World War I. Once it entered the community the virus mutated rapidly turning out into the deadliest pandemic in modern history. A hundred years before that in 1817, the world witnessed the outbreak of the Asiatic cholera that decimated the commands of the British Army during the Crimean War (1853–56). The pandemic originated near Calcutta and spread across various parts of the globe, believed to have been contributed by the movement of British Army and Navy ships and personnel, since the ships carried people with the disease to the shores of the Indian Ocean, from Africa to Indonesia, and north to China and Japan.
Lessons learned from the past would have made us wiser and therefore, as Covid-19 continues to spread across the globe, locking down entire nations, the call for quarantine and social distancing is growing louder. Quarantining people to prevent the spread of disease is an age-old strategy. The word ‘quarantine’ was derived from the Italian words quaranta giorni which mean 40 days, write Indian scientists Jyoti Sharma and SK Varshney in Research Matters on March 27.
Yet, the practice of this strategy hasn’t been easy for most coronavirus-affected countries barring a few like South Korea which has one of the best recovery records together with China. However, the difference with this east Asian nation which lies in the southern Korean peninsula was that it did not enforce a lockdown and yet it succeeded in keeping its people indoors for most part of the last two months.
So far, South Korea has tested over 376,000 people which amounts to more than 6,200 tests per million inhabitants — more than any other country. According to the Worldmeter website as of March 30, 2020, South Korea confirmed 9,661 cases including 158 deaths after the first case was detected in January 20. As of the same date, 5,228 patients were released from quarantine after making a full recovery from the virus.
India after lockdown
In comparison, the call for self-quarantine and social distancing is turning out to be a nightmare in India. Sitting as it were on the edge of the coronavirus pandemic, India’s handling of the situation has been far from exemplary, and a mostly a mixed bag or sorts. Whenever a country of 1.3 billion people is locked down, there’s bound be challenges, yet, there seems no justification when the very purpose of a lockdown is compromised by sheer callousness and lack of farsightedness.
Prime Minister Modi announced a complete lockdown on March 24 night with an appeal to everyone to stay indoors. His appeal and gestures with folded hands asking people to understand the importance of social distancing was undoubtedly well intended and statesmanlike, but what he overlooked were plans to help people inside the country -- the migrants, thousands of whom were left stranded along the Delhi-UP border. Images showing a sea of people near the Anand Vihar Delhi bus terminus, at the border and of those walking through the national highway braving the scorching heat and aiming to cover a distance over 200 km to reach their villages was painful and also scary, to say the least.
On the other hand, the general response to the lockdown from the citizens of the country too has been perplexing, with many following the “stay-at-home” mantra whereas many others continuing to violate the rules that were set by the national and provincial governments. With many people willing to jump the “Lakshman Rekha” at any given opportunity has defeated the very idea of social distancing.
Such episodes have promoted a deluge of opinions and arguments on social media on whether “a complete lockdown is a viable option in a democracy like India” and, more importantly, can be implemented in letter and spirit.
No lockdown in democratic South Korea
South Korea too has been debating whether a lockdown is democratic. Sciencemag website quotes Kim Woo-Joo, an infectious disease specialist at Korea University as saying, “South Korea is a democratic republic, we feel a lockdown is not a reasonable choice.” Even though the country is bracing for a resurgence with 78 new infections reported and six deaths, a complete lockdown seems a remote possibility.
A friend from Nepal who stays in Onsu, located in the outskirts of Seoul, said she has been inside her room since the day she landed in Seoul. Indu Tharu arrived in Onsu for her master’s studies at the Sungkonghoe University, on February 22 and since then it has been about “self-isolation, stay at home and check-up twice a day,” and this cuts across most of the country’s population. “After two weeks of staying in a single room, now we share rooms and free to go out and buy groceries,” she said, while summing up collective responsibility in South Korea “as everyone is so disciplined, they stayed put where they are and even if it is a dire strait situation, they have hope and help comes along soon.”
I couldn’t agree less, having spent a good two years of my higher education in the same university and associated with the Korean society from very close quarters. I was there during the anti-government uprising in 2008-2009 against the government decision to reverse a ban on US beef imports. The ban had been in place since December 2003, when mad cow disease was detected in US beef cattle. I was one of the few expats who had the rare distinction of participating in the protests that lasted four months from May 2008 to August 2008 starting evening and continuing through the night on the streets of Seoul and not getting arrested for it. The point is not so much about my participation but of discipline and commitment to play by the rules --no violence, chaos or destruction of public property. No beating up the police, no chaos, no police excesses barring a few arrests and minor scuffles. Footnote: I was not booked under the national security acts or deported.
Fast forward to the period between 2015-2016 when people stood behind a highly unpopular government led by Park Geun-hye of the Liberty Korea Party and daughter of former Korean dictator Park Chung Hee. The government’s decision to trace, test, and quarantine nearly 17,000 people following the outbreak of Middle East respiratory syndrome (MERS), found unflinching support from the people and the same rules of discipline and commitment as mentioned above were applied. The disease was transmitted by a South Korean businessman after returning from a visit to three Middle Eastern countries, infecting 186 persons and killing 36.
The support wasn’t conditional but it also did not derail the protest movement that was building up against Park Geun-Hye over corruption and bribery charges. The government eventually fell in 2017 after a sustained protest movement and candlelight movement and Park Geun-Hye was sentenced to 24 years jail. The moral of this episode in the history of South Korean politics, is despise for a corrupt leader did not blind South Koreans driving them to irreconcilable extremes as is usually the case in India. South Koreans accepted the reality that they were confronted with.
South Korea learned the importance of preparedness the hard way. The chain of transmission from one person that left many other infected and presented a specter of a runaway epidemic threatening the nation and its economy, united opposing forces and the outbreak of the disease was quashed in two months.
Today, it’s much easier to confront a pandemic as big as COVID-19 with a popular democratic party government in power under a highly popular President in Moon Jae-in. But that hasn’t changed the commitment which was on display when a conservative government was in power in 2015.
On hearing this, a very close Indian friend asked, “Do you expect us to become Koreans?” Frankly speaking, I don’t not anticipate a better reaction knowing how dismissive we can be of others. My response: No, I don’t and they shouldn’t, but then surely, we must show some discipline and extend the helping hand instead of sending out cocky messages on Twitter and Facebook from the comforts of our homes. If the question is should the government not plan better and ignore the migrants and the poor? The answer is anyone’s guess. But let’s say it out loud: Of course, the poor and migrants must be part of every policy that the government plans and this case and time is no different. But shall we continue to banter over this or shall we all do something about the problem first and learn from the Koreans?
The humanitarian response and India
During the past four three decades of my work as a journalist in communally sensitive regions in India, covering insurgencies in Northeast, Myanmar, Nepal and Afghanistan and having watched Kashmir from very close quarters, to my later professional life as a human rights activist and clean elections advocate working in conflict ridden Mindanao in the Philippines, Aceh in Indonesia, I came across various tribes and communities and all react differently to different situations. But something that has always fascinated during my forays in south east and east Asia is the humanitarian response from the people be it letting their vehicles out, getting private buses to ply and also sending out food and relief for migrants and the homeless that maybe stuck somewhere.
I still remember the words of friend during the 2010 brutal military crackdown on the red shirt protesters in Thailand. He said, “My friend, we can’t wait for government relief, we have to serve our people for they too deserve to see a tomorrow like you and I do….” and it had profound impact on me. During moments like this it rings in my head bringing back visuals of my friends and strangers arranging for rations, food and medical supplies for people that need it. The only thing they knew then was to reach out to the neediest, the migrants, homeless and the poor.
Sadly, India as a nation in 2020 is divided and does not present any such picture. Efforts of different individuals, social organisaotions, religious groups to donate and feed the poor and the hungry get overshadowed by police excesses, people willfully violating social distancing norms and racial discrimination of people of Northeast India by “mainland” Indians. Worst of all, house owners and apartment dwellers in big and small cities are asking doctors, nurses and health workers to vacate their houses and accommodation for fear getting infected. How does this help to lessen the spread of the disease?
In contrast, in South Korea people are “helping each other and ensuring that everyone gets food at stores and no one is left out.” “We are washing our hands, using mask whenever we go out, avoid attending public gathering and when we feel sick, we stay at home and get a check-up done,” says Kim Chanho, international manager of Korean Democracy Foundation and a member of the Korean Solidarity Network. Are police beating up people or punishing people that need to cross state borders? “We can’t imagine that. Police cannot force people to stay indoors,” says Chanho, even as he admits there have been some religious gatherings in churches.
A checklist on how India as India has so far responded to the emerging crisis would invariably be in stark contrast to that of countries like South Korea. For instance, for South Koreans it would be a “no” to a total lockdown yet a “yes” to social distancing and following mandatory self-isolation etc. while for many Indians there’d always be a reason to jump the checklist just like we are so adept at jump queues. The rest is anyone’s guess really and does not warrant further elaboration.
India and Korea in the disease arc
It’s not as though an epidemic like situation is completely new to us. From cholera, to leprosy, to tuberculosis and vector borne diseases -- malaria, dengue, Japanese encephalitis, kala-azar, lymphatic filariasis -- have been India’s disease burden.
In the late 19th and 20th centuries, India saw the outbreak of the bubonic plague in 1903 and then in 1974 it was hit by the smallpox epidemic and then again in 1994 by the plague in Surat. In the 21st century India has experienced the outbreak of dengue and chikungunya virus in 2006 and it still continues to be a major concern. In 2008 India was hit by cholera leaving 49 people dead, in 2009 it saw the Gujarat hepatitis outbreak which claimed as many lives and in 2014-2015 the Indian state of Odisha was hit by the jaundice outbreak caused primarily by Hepatitis E and Hepatitis A. Then again, in 2015, the country experienced the outbreak of the swine flu caused by Influenza virus subtype H1N1 which left some 2035 people dead. Very recently in 2017 and 2018 Japanese encephalitis caused in the city of Gorakhpur in UP claiming 64 lives, mostly children and then the Nipah virus outbreak in the State of Kerala which claimed 18 lives.
The list of the diseases reflected above should give sufficient reason to believe that the Indian health system should have been ready by now and learned the hard way like did the South Koreans did in 2015 when MERS threatened to ruin their lives and economy. India in comparison has had more opportunities than South Korea (on record South Korea has had only one in the 21st Century) but it continues to be badly under prepared especially with an overstretched and under-funded health infrastructure.
That one experience has made the South Koreans wiser and it is no wonder therefore that they lead all the countries in terms of tracing, testing and recovery. The Sciencemag website quotes professor Kim Woo-Joo, of the Korea University as saying, “That experience showed that laboratory testing is essential to control an emerging infectious disease”. In addition, it also quotes Oh Myoung-Don, an infectious disease specialist at Seoul National University who says, “The MERS experience certainly helped us to improve hospital infection prevention and control.” So far, there are no reports of infections of COVID-19 among South Korean health care workers, he says.
I am not entirely certain we could say the same thing about our health systems like the Koreans and remember South Korea is not China nor North Korea, it is as much a democracy like us even though the population size maybe smaller. The comparison is not a la communist China’s modus operandi in dealing with the problem. Questions over the disappearance of journalists, lawyers, activists and a film maker who was filming the manner in which dead bodies were being carried in the city of Wuhan by the Chinese government and also that of Ren Zhiqiang a party member who was critical of Premier Xi ‘s policies and is now reported missing are being raised within and outside China. Like it or not, in Modi’s India, we are still debating openly about “authorianism,” and even “Nazism” and are still doing it now, however ill-timed it may be.
This attempt at comparison is merely a reality check of where we are with our preparations, nay any intention to ridicule and undermine the efforts of our scientists and medical practitioners who have always given their all on the frontline to confront such critical moments in our young democratic lifetime thus far. Not to forget executive director of the World Health Organisation (WHO), Michael Ryan who said that India, the world's second most populous country, has a tremendous capacity to deal with the coronavirus outbreak as it has the experience of eradicating the small-pox and polio through targeted public intervention.
However, we still cannot be removed from the truth that we are confronted with right now and that is we could be facing a catastrophe. Repeating what has been already said about lack of sufficient COVID-19 testing kits, personal protection equipment (PPEs), masks and ventilators, is meaningless, as first and foremost we must reflect on our actions and behavior so far and judge for ourselves if we are responsible for creating a recipe for disaster and push the nation and people into the brink of despair.
(The writer is a senior journalist and a human rights advocate. He has extensively covered South and South East Asia, in particular Myanmar. He can be reached at email@example.com)