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Writings On The Chinese Wall

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Publication for Observer Research Foundation

There is an old saying – coming events cast their shadows before them. This is certainly true in India-China relations. For three years prior to the 1962 war with China, there were clear signs that disagreements on the border were becoming sharper but Prime Minister Jawaharlal Nehru was unwilling to believe that China would resort to war.

And yet again, in recent years India has ignored the writing on the Chinese wall, assuming that the slew of agreements signed, beginning in 1990s would ensure a peaceful border. Prime Minister Narendra Modi was perhaps so convinced of the virtues of his personal diplomacy with President Xi Jinping over 18 summits since 2014 that the darkening shadows cast by the cumulative evidence of increasing incursions and what these implied were disregarded. Even as the official statements talked of disengagement to ease the 45-day stand-off, the gloves came off and more than 20 Indian soldiers were killed in the fighting at Galwan Valley in Ladakh on the night of 15-16 June. Unconfirmed reports put the number of Chinese casualties at over 40.

These are the first casualties since October 1975 when four Indian soldiers from Assam Rifles were ambushed at Tulung La in Arunachal Pradesh. In keeping with the three-decade old understanding, no shots were fired; the present casualties resulted from iron rods, batons studded with barbed wire, stones and hand to hand combat which only makes it more grisly. Why have things come to such a pass when India and China have concluded multiple agreements regarding maintenance of peace and tranquillity and confidence building measures during the last three decades? How did India fail to register the changing ground reality?

The current priority will be to restore normalcy to the border through negotiations leading to disengagement and restoration of status quo ante. However, the important challenge is for India to undertake a deeper examination that has been long overdue about the premises on which its China policy has been conducted in recent decades. Growing evidence in the last decade would indicate that these premises are in need of review and many of the understandings based on them have outlived their utility.

The 1988 Opening With China

The process of re-normalising ties with China after the 1962 war began in 1988 with the visit of Prime Minister Rajiv Gandhi when both countries agreed to put the boundary dispute on the backburner and focus instead on building economic, commercial and cultural aspects of the relationship so that a more conducive environment could be created over time that would enable both sides to address the boundary issue. A Joint Working Group on Boundary Question was also set up to keep matter under review.

The underlying thinking on both sides was that while neither side was in a position in 1988 to be able to achieve an acceptable solution to the boundary dispute, hopefully, after a passage of time, it would be better placed to reach an outcome that would be better and more acceptable. Such an assumption on both sides would only be natural and reflective of a sense of pragmatism that led to the shift in the relationship in 1988.

The first major development thereafter was the Agreement on the Maintenance of Peace and Tranquillity along the Line of Actual Control in the India-China Border Areas, concluded in 1993. The clunky title reflected a compromise. The concept of a Line of Actual Control (LAC) had been suggested by the Chinese Premier Zhou Enlai to Prime Minister Nehru in his letter dated 7 November 1959 “as the line up to which each side exercises actual control”. This was significant for settling the boundary dispute in the western sector while in the eastern sector, the Chinese leader suggested that the LAC coincided broadly with the 1914 McMahon line. Nehru rejected the notion because India considered the India-China boundary in the western sector to be defined by the 1865 Johnson Line, a point disputed by China.

Following the 1962 war, China asserted that it had withdrawn 20 kms behind its claimed LAC, a notion that India had never accepted. India took the stand that China had illegally occupied Aksai Chin area which was part of Indian territory. The language of the 1993 Agreement marked a shift by acknowledging the LAC. The shift was justified on the ground that the reference to the LAC was without qualifying it either as the 1959 or the 1962 LAC; this enabled India to claim that it interpreted the reference as its own version of the LAC.

Para 1 of the 1993 Agreement commits both states to resolve the boundary question “through peaceful and friendly consultations” and that pending an ultimate solution, “the two sides shall strictly respect and observe the line of actual control between the two sides”. However, given that India and China did not share a common understanding of the LAC, the 1993 Agreement added “In case the personnel of one side cross the line of actual control, upon being cautioned by the other side, they shall immediately pull back to their own side of the line of actual control . When necessary, the two sides shall jointly check and determine the segments of the line of actual control where they have different views as to its alignment”. This fudge or creative ambiguity lay at the heart of the 1993 Agreement.

This was followed three years later by the 1996 Agreement on Confidence- Building Measures in the Military Field Along the Line of Actual Control in the India-China Border Areas. Since India and China perceived the LAC differently, any use of this term had to be accompanied with the phrase “in the India-China Border Areas”. Both sides agreed to reduce military presence in these areas and also added constraints on the size and nature of military exercises in these areas. Both sides also committed not to “open fire” within two kilometres of the line of actual control. Evidently this restraint was observed at Galwan even though more barbaric means were employed.

A significant addition was in Article X – “Recognising that the full implementation of some of the provisions of the present Agreement will depend on the two sides arriving at a common understanding of the alignment of the line of actual control in the India-China border areas, the two sides agree to speed up the process of clarification and confirmation of the line of actual control”. It reflected the realisation that differing perceptions of the LAC carried the potential for misunderstanding and conflict. The common understanding was to be reached through exchange of maps, an exercise completed for the middle sector (pertaining to the border falling in Uttarakhand and Himachal Pradesh) in 2001 as this was the least contentious; thereafter the process stalled.

Realising that the Joint Working Group on Boundary Question was unable to get around politically sensitive boundary issues, a new dialogue channel was added following PM Vajpayee’s visit to China in 2003. Both sides agreed to appoint a Special Representative (SR) “to explore from the political perspective of the overall bilateral relationship the framework of a boundary settlement”. On the Indian side, the National Security Adviser has been the SR while on the Chinese side it has been the State Councillor; currently Foreign Minister Wang Yi also holds this position and is the SR. Twenty-two rounds of talks have been held between the SRs but clearly, the “clarification and confirmation” of the LAC as well as the contours of a “boundary settlement” have remained elusive.

There was a sense of optimism when the Agreement on the Political Parameters and Guiding Principles for the Settlement of the India-China Boundary Question was concluded in 2005 but it turned out to be short lived. Among the principles identified were “the principle of mutual and equal security”, aligning the boundary “along well-defined and easily identifiable natural geographical features” and safeguarding “due interests of their settled populations in border areas”. These were widely interpreted to mean that Arunachal Pradesh which had a settled population would remain part of India and in the western sector, India would have to make adjustments in keeping with geographical features so that Chinese connectivity through Tibet to Xinjiang was not impaired. However, the SR level talks failed to sustain the 2005 momentum and translate these expectations into forward movement.

By 2005, the number of incidents where patrols of both countries often came face to face had started growing. Accordingly, a Protocol to the 1996 Agreement on CBMs was concluded on Modalities for the Implementation of Confidence Building Measures in the Military Field Along the Line of Actual Control in the India-China Border Areas. Article IV of the Protocol defines the procedure for exercising restraint in such situations – On coming face to face, both sides were to refrain from advancing further, return to their bases, inform their respective Headquarters to enable consultations, not use or threaten to use force, treat each other with courtesy and refrain from provocative actions. However, these provisions have been ignored in recent years as there have been increasing reports of pushing and shoving and stone throwing causing injuries though neither side suffered fatal casualties till the present showdown in Galwan area.

It is clear that 2005 was the high point in terms of registering some forward movement, though incremental, in terms of managing the situation in the border areas. After 2005, summit level meetings have continued to take place regularly and some new agreements were also concluded but these did not further the boundary dispute resolution. The SRs have met regularly but were also unable to register progress on the boundary question. Part of the reason is that in recent years, the agenda of the SR’s talks has expanded and now encompasses the entire gamut of the bilateral relationship as well as exchanging views on regional and global developments, thereby diluting the focus on the core issue.

In 2012, an Agreement on the Establishment of a Working Mechanism for Consultation and Coordination on India-China Border Affairs was concluded. It provided for the Joint Secretary level officers in the respective Foreign Ministry(s) to “study ways and means to conduct and strengthen exchanges and cooperation between military personnel and establishments of the two sides in the border areas”. Art V of this Agreement states that they “will not discuss resolution of the Boundary Question or affect the Special Representatives Mechanism”.

The following year saw another Agreement on Border Defence Cooperation being concluded after a prolonged stand-off in Depsang in Ladakh. Art VI enjoined both sides not “to follow or tail patrols of the other side in areas where there is no common understanding of the line of actual control in the India-China border areas”. It reiterated the need for exercising maximum restraint as agreed in the 2005 Protocol. Significantly, the 2012 and 2013 agreements did not reflect material progress on the LAC or boundary issue; these merely reiterated suggestions that were no longer working on the ground.

How The Ground Reality Changed
The future is always marked by uncertainty and a policy is an attempt to provide a map for the foggy road ahead. Looking continuously into the rear-view mirror for assurance that one is on the right road creates a bias that will lead to a crisis, exactly as has happened with China. Underlying political realities had changed dramatically from 1988 but Indian policy makers and leaders found reassurance in policy continuity.

In 1988, when both countries embarked on the new chapter in their relationship, Indian GDP was $296 billion (in 2010 dollar value) and Chinese GDP was $312 billion. In per capita terms, India was marginally better off. The defence budget of both countries was at par, at $20 billion each. A decade later, in 1998, Indian GDP rose to $421 billion while China moved faster to reach a trillion dollars. Indian defence spending rose to $24 billion while Chinese spending went up to $33 billion. This gap grew larger and in 2008, as Indian GDP reached $1.2 trillion, Chinese economy was nearly four times larger at $4.6 trillion. Indian defence budget was $44 billion while Chinese budget had reached $133 billion. During the last decade, the gap has further widened; Chinese GDP is estimated at five times that of India while its defence budget has climbed to four times that of India.

A similar gap was growing in other areas too. From near zero in 1988, bilateral trade registered a modest beginning, crossing $2 billion by 1998. By 2008, China had emerged as India’s biggest trading partner with a $41 billion turnover and the imbalance was evident in India’s $21 billion trade deficit. This has only grown further to over $50 billion at present, indicating that continued engagement in the current manner was placing India at a disadvantage on account of a non-level playing field.

In other words, the growing gap in capabilities across the board was an unmistakable trend that undermined the political basis of the 1988 policy. The basic assumption in 1988 that India would be better placed after a passage of time to achieve a more acceptable resolution to the boundary dispute was no longer valid. While it is true that India had registered considerable progress between 1988 and 2008 and had improved its standing vis-à-vis many countries but relative to China, India’s position had worsened.

As the account of the discussions on boundary CBMs indicates, it is around the same time that progress in these dialogue mechanisms began to stall. References to the 21 st century as the Asian century that included the rise of both China and India had been an accepted phraseology in bilateral statements but no longer found mention after 2008.

The LAC clarification process had stalled even as both countries stepped up patrolling. The number of “transgressions” reported by India began to grow to over 400 a year. India embarked on improving its connectivity infrastructure in the border areas. Since no progress had been made on clarification of the LAC and each side was engaged in more robust patrolling up to its perception of where the LAC lay, face-offs became more frequent. Transgressions became prolonged stand-offs, requiring diplomatic and political intervention. New agreements merely reiterated restraint but remained unable to address either the underlying reasons or impose restraints on patrolling. In short, it was just a matter of time that a face-off would turn violent and get out of hand and this is what happened on the night of 15 June.

A New Policy Reset
Currently, analysts are speculating more about the proximate causes that have led to the crisis. These span a range of factors – domestic compulsions on the Chinese leadership facing troubles at home, distraction from the criticism on China’s handling of the COVID-19 pandemic, unhappiness with India’s statements following the declaration of Ladakh as a union territory last year, concerns about India’s expanding infrastructure in border areas, signalling aimed at growing Indian ties with the US as US-China ties remain locked into a downward spiral, or just part of China’s growing assertiveness also on display with Taiwan, Hong Kong and in South China Sea in recent months. However, the Indian analysis needs to dig deeper and examine the changed political drivers behind China’s behaviour.

Right now, both sides have taken firm stands but it is not in either side’s interest to escalate matters. Nevertheless, a prolonged stand-off appears likely. This will force India to review its plans on building infrastructure in border areas by ensuring adequate security and surveillance. In this case too, the Darbuk-Shyok-Daulat Beg Oldi road had been in the making for years and occupying heights at vulnerable points to secure the road would have avoided the unpleasant surprise that faced us in 2020.

Since the 2020 incursions are seen as different from the recent incidents as being larger in scale and across multiple locations, it can only be concluded that the Chinese side wanted to unilaterally force India back from its perceived LAC. India has therefore sought a restoration of status quo ante, as in April. It is difficult to predict how and when this is going to be achieved through negotiations. The Chinese attempt in Ladakh seems to be similar to its salami slicing tactics in the South China Sea where the steady land reclamation has enabled it to convert atolls into islands with runways and missile defences, creating a new military reality. But suffice to say, China’s unilateral approach has forced India to rethink on the fundamental basis of the relationship by making it clear that the 1988 assumption is no longer tenable.

Therefore, what is needed is a thorough review of the three-decade old policy. It has become evident that an ambiguous LAC is unlikely to remain peaceful and tranquil. Creative ambiguity worked for a while but its time was running out, a fact that Indian policy makers should have foreseen but were somehow reluctant to accept. China did not face a similar compulsion because it had improved its relative standing and continuing ambiguity was to its advantage. Formalising an understanding of the respective perceptions is only the first step; then will come the harder challenge of resolving the differences. And in the meantime, a new set of CBMs will need to be worked out to guide activities in the grey zone of overlapping LACs, in order to prevent future incidents.

These negotiations are going to be long and contentious. Compared to the 1990s when the early agreements were concluded, today the bilateral relationship has become multi-dimensional providing both sides with additional leverages and also a stake in not allowing the situation to spin out of control. At the same time, areas of concern have also grown. In the past, it was China’s defence, nuclear and missile cooperation with Pakistan that remained a constant irritant for India but was never discussed; it still exists today and CPEC adds to it. However there is a host of other issues – trade imbalances, market access, foreign investment entry regulations, non-tariff restrictions on commercial activities, China’s growing footprint in India’s neighbourhood including in the Indian Ocean, developments in South China Sea, BRI, interpretation of free and open Indo Pacific and role of Quad, and many more, including some that both sides have not taken up in recent years but could be revived like Tibet, Taiwan, Xinjiang.

In sum, since the basis of the old modus vivendi is no longer tenable, both sides need to start by asking how they visualise their relationship in the coming decades.

US To Withdraw From Open Skies Treaty

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Publication for Observer Research Foundation

On 21 May, US President Donald Trump announced that US was serving notice of its intent to withdraw from the Open Skies Treaty (OST). Concluded in 1992, the OST entered into force in 2002 and currently has 35 members (1) (Kyrgyzstan is a signatory but hasn’t yet ratified). Canada and Hungary are the depositary states. The reason provided is continuing Russian non-compliance with the OST which has led US to conclude that it is no longer in US interest to remain a party. Trump added that the US decision will take effect after six months (as provided in the treaty text) but US can reconsider if Russia returns to full compliance.

Unravelling Arms Control
The US decision had been anticipated and is in keeping with recent US decisions to withdraw from the Iran nuclear deal (Joint Comprehensive Plan of Action – JCPOA, signed between US, UK, France, Russia, China, Germany and EU and Iran) on 8 May 2018, followed by the withdrawal from the US-Russia Intermediate Range Nuclear Forces Treaty (INF Treaty) on 2 August 2019.

Two more nuclear related treaties are at risk. The New START treaty between Russia and the US imposes a ceiling on operational strategic nuclear weapons of 700 launchers and 1550 warheads each, was concluded in 2010 and is due to lapse in February 2021 unless extended for a period of five years. President Trump has indicated that he is not in favour of the extension.

The second is the Comprehensive Test Ban Treaty which was concluded in 1996 but has not entered into force. It prohibits countries from carrying out nuclear test explosions but earlier this year US voiced suspicions that both Russia and China were carrying out low yield nuclear tests in violation of the understanding on zero-yield threshold. US has signed but not ratified the CTBT and there are indications that it may be planning to test.

Negotiating the OST
The concept underlying the OST is aerial reconnaissance flights by unarmed aircraft over each other’s territories as a means of promoting confidence, trust and stability between potential adversaries. It was first proposed by US President Dwight Eisenhower in mid-1955 in Geneva to Soviet Premier Nikolai Bulganin but found no traction. After the fall of the Berlin Wall, the idea was revived in December 1989 by US President George Bush and accepted by Soviet President Mikhail Gorbachev. Negotiations commenced between NATO and Warsaw Pact members supported by the Organisation for Security and Cooperation in Europe (OSCE, which continues to host the Open Skies Consultative Commission in Vienna) and were concluded on 24 March 1992. It entered into force on 1 January 2002. Warsaw Pact ceased to exist in mid-1991, months before the break-up of the Soviet Union and 27 out of 29 NATO members are party to the OST.

The OST establishes a regime for conduct of short notice flights by unarmed aircraft over territories of States Parties in accordance with established “quotas” spelt out in the treaty taking into account the size of the country. For example, US has a quota of 42 flights, the same as Russia (it is a joint quota with Belarus) while Portugal has a quota of 2 flights. The quota defines both the number of flights that a country can mount as also the number of flights it can host. The latter is called a “passive quota” and the former, “active quota”. States Parties can form groups to redistribute their active quotas as long as the absolute ceilings are observed. Since 2002, nearly 1500 flights have been undertaken by member states. In recent years, US has mounted an average of 14-16 flights a year while Russia has mounted between 4 and 9 flights annually.

Time frames are stipulated for providing notice to the observed state with flight plans and possible refuelling stops which are needed, particularly across the large territories of US, Canada and Russia. The observed state can propose changes and there are rules regarding deviations. The kind of aircraft to be used by each state are already agreed upon as also the sensors to be mounted on the aircraft. Four kinds of sensors are authorised – optical panoramic and framing cameras, video cameras with real time display, infra-red line-scanning devices and sideways looking synthetic aperture radar. A copy of the data collected is provided to the observed state and other countries can also obtain access to the data. Periodic review conferences have been held where technical issues regarding developments in sensor technology are discussed to redefine approved lists.

Why US is leaving

While Russia and other countries have upgraded both the aircraft and the sensors, US surveillance aircraft modernisation has been held up for lack of funds. Part of the reason is that US is able to obtain equally good or better data from its satellites. No other country can match US’ satellite monitoring capabilities. Sharing of satellite imagery is restricted and accordingly managed bilaterally by US. For the US, the OST is not particularly useful as an intelligence gathering tool but the reality is that it was always intended as a confidence building and transparency measure. As tensions between US and Russia have grown, US has become more interested in restricting transparency over its territory.

Since 2015, US has voiced concerns about instances of Russian non- compliance in terms of either delaying clearances or imposing onerous restrictions. The recent report on compliance issued by the US State department cited instances of Russian non-compliance in 2019 by imposing a limit of 500 kms over Kaliningrad and creating highly restrictive flight corridors in the Georgian regions of Abkhazia and South Ossetia. US has also cited undue restrictions on flights over eastern Ukraine Crimea. The stage was therefore set for the US withdrawal.

The US has been increasingly concerned that Russia is using its overflights over US critical infrastructure to develop actionable intelligence and possibly mapping it for possible future offensive cyber operations. In 2017, an overflight request over the Trump golf estate in Bedford (New Jersey) raised concerns in the White House. This led the US to conclude that Russia was converting the transparency measure into an intimidation measure by weaponizing it. Reacting with a tit for tat approach was not in US interest.

US allies have expressed regret over the US decision. Russia has bluntly rejected US allegations of non-compliance, calling it a pretext for US moves to turn its back on multilaterally negotiated arms control treaties, citing the JCPOA and INF Treaty as examples. However, it has refrained from any indications regarding its response. Clearly, the OST is of limited utility for Russia if US territory is excluded and limited only to Europe and Canada. The OST may limp along for a while even after the US withdrawal takes effect after six months but the countdown for it has begun.

NOTES

(1) Belarus, Belgium, Bosnia-Herzegovina, Bulgaria, Canada, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Kyrgyzstan, Luxembourg, the Netherlands, Norway, Poland, Portugal, Romania, Russia, the Slovak Republic, Slovenia, Spain, Sweden, Turkey, Ukraine, the United Kingdom, and the United States

A Long Road Ahead

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Publication for Observer Research Foundation

As the 21-day lockdown announced on 24 March neared the end on 14 April, Prime Minister Modi delivered his much awaited address. Expectedly, he extended the lockdown by another 19 days till 3 May. Limited relief in districts where the disease is in check may be allowed after a week. Guidelines regarding these are yet to be issued.

The extension of the lockdown was inevitable. Even after 21 days, the spread of COVID-19 has continued, both horizontally and vertically. From 128 districts out of 729 that had confirmed cases on 24 March, the horizontal spread now covers 375 districts. The pace has continued to reflect a doubling rate of four days since 14 March when India crossed the 100 cases threshold. The last doubling from 3200 cases on 5 April to 6400 cases took five days and at these rates, the number of cases would exceed a lakh by the end of the lockdown. The major lacuna has been testing which has picked up only during the last ten days to about 18000 tests a day. However, the number of tests so far (2.3 lakh against the over 10000 positive cases) are about a fifth of what was needed to provide a better picture of both the vertical growth and its likely direction.

A Change in Modi’s Approach
This time there were two key differences compared to Modi’s address three weeks ago announcing the lockdown. First, it was preceded by widespread consultation with the chief ministers. This reflected an acceptance of India’s federal character and the fact that the district is the fundamental unit of administration. Any scheme or plan, in order to be implemented effectively on the ground across the country, needs a two-way up-down information flow through certain well established channels.

The second difference was the shift from the “jaan hai jahaan hai” sentiment to the “jaan bhi aur jahan bhi” objective, announced after the meeting with the state chief ministers on 11 April. Once again, it reflected an acceptance that while a national lockdown had been a top down decision announced without wide consultations and with a mere four-hour notice, it was not the solution and a staggered relaxation of the lockdown needed to be managed by each state government looking at the situation in each district. In coming days, the new guidelines will begin to delegate the responsibility of staggered relaxation to the state governments. Modi realised that even extending the lockdown was also better done following consultations.

The “jaan hai, jahaan hai” sentiment gave rise to a binary approach. Those supporting a lockdown became labelled as supporters of health security while those who asserted that a lockdown would only kill the poor person saved from coronavirus though starvation caused by economic hardship were believers in economic security.

The binary choice is a false one as it blunts critical thinking. It was convenient for the central government because instead of adopting an analytical data driven approach, it was simpler to motivate the people by evoking the image that India was fighting a “war” and victory demanded an unquestioning rallying around by the population. It fitted well with Modi’s governance style. The downside of it was that it also activated the panic virus which spread far from rapidly than the Coronavirus resulting in the unforeseen challenges (keeping essential services running, reverse migration, economic hardship of the vulnerable sections etc) and fumbling policy responses.

The reality is that India had been slow in developing its responses. India’s lead time was the month of February during which India had only three cases limited to Kerala, all of whom recovered. But that opportunity was squandered because of lack of coordination within government both at the centre and states, mixed messaging particularly by the ICMR, absence of a national policy and task force which mean that priorities and action points remained ill- defined and fuzzy. The 21-day lockdown was intended to extend the lead time for ramping up medical preparedness because Modi knew full well that the abysmal state of the health infrastructure in India would be overwhelmed very quickly unless there was a war like approach to enforce suppression.

On 14 April, it became clear that suppression had yet to show a conclusive downturn. More time was needed to build the health infrastructure as well as the database so the planners could get ahead of the curve. And so, the lockdown needed to be extended.

Changing the Governance Model
Before the national curve can be flattened, each state has to flatten its curve and the credit for it will accrue to state governments that demonstrate effective governance, use technology tools, employ grass roots outreach and have better information flows with a motivated administrative machinery. The centre’s role will be providing the fiscal space and at best, access to scarce equipment like PPEs and masks. Modi now understands (perhaps reluctantly) that if there is credit for successfully curbing COVID-19, it will have to be shared with state chief ministers whether from BJP or other parties. Note that now the models for tracking and controlling spread being talked of are the Bhilwara (Rajasthan) model, the Pathanamthitta (Kerala) model and the Agra (UP) model; it is no longer the one size fits all model designed in Delhi.

This is equally true for managing the lockdown exit. The economic machine of the state was brought to a shuddering halt on the midnight of 24-25 March. The resulting demand shock and the supply squeeze sparked a series of fall-outs including highlighting the risks of a crisis in some sections of the financial sector where money circulation has slowed down exposing unsustainable debts burdens. The support needed for the informal sector of the economy in terms of welfare, food and direct benefit transfers is very different from the stimulus and tax breaks needed for the organised sector. It is clear that the economic engine cannot be kickstarted as simply as its was switched off. And therefore, managing the exit out of the economic lockdown has to be gradual and fine-tuned but will require a high level of coordination between the centre and the states, with the latter taking up a major share of the management.

The fight against COVID-19 has just begun. It will continue over time. It is possible that in some areas, gradual relaxation might lead to a spike in infections leading to a reimposition of restrictions. This process could take months or even a year till effective vaccines and therapeutics are available. Even then, the story doesn’t end.

Viruses have a tendency to mutate and sometimes become endemic in some societies. We have seen this with the H1N1 which continues to afflict India after the initial outbreak nearly a decade ago. Casualty figures have averaged over a thousand a year and some years have been difficult, the worst year being 2015 when India had more than 42000 infectious cases and nearly 3000 people died. Just last January, six Supreme Court judges tested positive for H1N1.

Even as India weathers the current crisis, the long term challenge for the government will be to build a pandemic resistant infrastructure so that artificial binaries between health security and economic security are avoided and we are better prepared in future.

What India Needs On 14 April

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Publication for Observer Research Foundation

India is halfway through the 21-day lockdown announced by Prime Minister Modi on 24 March to tackle the growing challenge of COVID-19. At the outset, it was clear that the lockdown was not a cure. It was a drastic measure to break the transmission chain and also gain an additional valuable 21 days to prepare a plan and put in place systems to implement it effectively after the lockdown was lifted.

India had an invaluable lead time in February when only three cases were registered in Kerala between 30 Jan and 3 Feb, all students returning from Wuhan. The next round of cases began in March which included patients with history of travel from other parts of the world. During this period, the numbers in China went up from 10000 to 78000 and the disease spread to 60 countries with new clusters emerging in South Korea, Italy and Iran. Yet, other than putting into place screening measures for people coming from certain countries, little was done to prepare for the impending outbreak. Universal screening was introduced on 4 March; all visas for India were suspended after a week, followed by a ban on all international flights on 18 March.

During February, no plans for procuring or producing test kits were prepared because internal debates about testing criteria continued. Even as the global numbers crossed 100000 on 6 March (it crossed a million 26 days later), India struggled with plans for adequate safety equipment like masks, gloves and protective suits for the health service workers as well as estimates for essential equipment like respirators, ventilators and adequate beds in isolation wards.

Meanwhile, the virus continued to spread. After reaching a hundred cases on 16 March, it began to double every four days. After a trial run with a “Janata Curfew” on 22 March, the 21-day lockdown began on 25 March. PM Modi has since spoken twice, once during his Mann ki Baat radio address on 29 March when he “apologised” to the people for the hardships caused by the lockdown and again on 3 April when he exhorted people to light a candle or diya for nine minutes on 5 April at 9 PM after switching off lights, in an act of solidarity. In all likelihood, he will speak again on 14 April to inform the nation of the next decision, whether to continue, partially relax or lift the lockdown. On what will this decision be based?

We know that the initial decision was intended to break the chain of transmission. So has that happened? The current assessment is that COVID-19 has a Basic Reproductive Number (Ro) of 2.9; this is the number of people that each patient is likely to infect further. Breaking the transmission chain means bringing this number to below 1, implying cutting it by two-thirds or more. A conclusive determination can only be made on the basis of data. As on 3 April, according to ICMR, only 70000 tests had been conducted across the country. The officially declared increase in the number of cases continues its four-day doubling cycle. On the basis of this limited data, the transmission chain is yet to be broken. In coming days, the data set needs to be expanded significantly; testing needs to grow to a hundred times the number of cases to enable arriving at a definitive conclusion.

However, ICMR continues its flip-flop on tests. In addition to the more accurate real-time Reverse Transcription Polymerase Reaction test (rRT-PCR), a faster and simpler (though less reliable) serum test to detect antibodies is now gaining widespread acceptance. A positive result with this needs to be further verified by using the PCR test. However, ICMR is undecided and a protocol regarding the antibody test, about where this should be employed is still awaited.

On 24 March, PM Modi had announced a Rs 15000 crore package for rapid strengthening of the healthcare sector. The resources were intended to step up procurement of protective equipment, ventilators, build quarantine centres and train medical workers. Large orders have been placed for these but deliveries have yet to pick up. Ramping up domestic production is difficult during a lockdown because of supply chains of inputs – fabric, special coated synthetics, zips, pressure valves etc, down the chain and employment of labour at each stage; global supplies have become scarce.

It is correct to claim that the pandemic has to be fought on a war footing; however, without data and without protective equipment, it is like fighting a war blindfolded and without weapons.

Every war has its share of the unexpected. However, the impact of the lockdown on the economic chain, even if expected certainly did not anticipate the extent of the reverse migration of the migrant labour. It has thrown up new challenges of ensuring food security and adequate welfare measures. Partial reversals could ease the economic pain but would adversely affect the objective of breaking the transmission chain. Yet it is important to remember that economic pain can be reversed but death cannot be, whether due to disease or other aggravations.

It is likely that government may therefore consider a partial relaxation. Such a suggestion was implicit in the video conference that PM Modi undertook with the CMs of the states on 2 April. Yet a common exit strategy cannot be uniformly applied across all states because the spread of the disease is not uniform. From 18% districts (132 out of 729) affected when the lockdown was announced, the disease has now spread to 33% districts (238). Certain regions are more highly impacted even as there are areas that are clear. These would be likely candidates for relaxation of lockdown after 14 April so that economic activity can recommence even as careful monitoring and testing ensures that these districts remain green zones. It will also help in staggered harvesting.

Technology needs to be used extensively. Mobile phones enable location tracking, extensively employed in other countries for contact tracing provided it is accompanied by widespread testing. Road movement cross-verified with petrol/diesel offtake and mapped with disease helps anticipate and correlate spread with movement. Districts remain the fundamental administrative unit and it is here that the battle has to be fought and won.

Planning has to be done on the basis of tracking the disease using data to develop epidemiological models that can predict the movement of disease. Strategy implementation has to be done at the district level for which resource allocation and sharing becomes the state and central responsibility.

The lead time gained with the 21-day lockdown will come to an end in another ten days. It will not see the end of COVID-19 and more sacrifices by the people will still be called for. But hopefully, on 14 April, PM Modi will be able to provide the nation with a strategy based on scientific analysis developed as a result of consultations with states, based on a clear understanding of available resources at the national level. Therein lies the key to solidarity that remains the need of the hour.

India’s Lead Time on COVID-19 Is Running Out

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Publication for Observer Research Foundation

India had a generous lead time in preparing for the COVID-19 outbreak but it is running out, fast. The first case in India was recorded on 30 January, in Thrissur, of an Indian student who had returned from Wuhan. Two other Wuhan returned students also tested positive in Kerala in the next four days. All three have since recovered.

At this time, there were approx. 10000 cases recorded in China, concentrated in Wuhan, and another 98 in 18 other countries. Wuhan city with a population of 11 million and Hubei province with a population of 60 million had been sealed off from the rest of the country on 23 January though by then nearly 5 million people had travelled out, for the Chinese New Year holidays, beginning that weekend, including the three Indian students. On 31 January, WHO declared 2019-nCoV a “Public Health Emergency of International Concern” and on 11 February, the disease was baptised by the International Committee on Taxonomy of Viruses as COVID-19.

The month of February was India’s lead time as no further cases were recorded even as 5000 cases were recorded in over 60 countries including new clusters emerging in South Korea, Italy and Iran. By end February, China had exceeded 77000 cases with over 2700 deaths. In early March, came the report of one case in Hyderabad (travel history to UAE), one in Delhi (travel from Italy) and an Italian in Jaipur. Numbers went up when all 14 Italians in the group tested positive. By the end of the first week, the number had crossed 30 and then 100 by mid-March. The following week has seen a further jump to over 250 cases.

By this time China had succeeded in bringing the spread under control with cases having crossed 80000 and casualties at 3245. However, infections in other countries had zoomed to over 160000 now spread over 148 countries. Italy was badly hit with 47000 cases and over 4000 dead, followed by Spain, France and Germany. Cases in US crossed 17000 after the first having been reported on 21 January. On 11 March, WHO declared the outbreak a global pandemic.

PM addresses the nation
India’s lead time is clearly running out. Prime Minister Modi addressed the nation on 19 March highlighting the enormity of the crisis facing the nation. His speech was motivational, urging people to adopt social distancing, refrain from panic buying, displaying generosity towards weaker and economically vulnerable sections and observing a self-imposed curfew on Sunday 22 March. It however fell short in identifying and putting forward measures taken by the government to deal with the challenge.

During March, government progressively curtailed entry into India from other countries, finally prohibiting all international flights from 22 March till the end of the month. Most states have banned public gatherings, closed down schools and colleges, shopping malls, clubs, cinemas and restaurants though in some cases, restaurants with limited seating can function. Public transport systems are shut down for Sunday, but this cannot be continued if essential services like health, banking, power, communications etc have to be maintained.

Dr Balram Bhargava, head of Indian Council of Medical Research declared on 13 March that India had had 30 days to prevent community transmission, the third stage in transmission which catapults the outbreak into an epidemic. The first two stages related to the import of the virus followed by the local spread through direct contact with those infected. The confirmatory test for the virus is rRT-PCR (real-time reverse-transcription polychromase chain reaction). It is a two-stage test, first to confirm that the virus belongs to the Coronavirus family and the second to identify it as 2019-nCoV. ICMR had identified about 60 government labs and was in the process of building up stocks of testing kits from a lakh to a million. Accordingly, ICMR was in favour of testing only those
with symptoms (fever, cough and respiratory distress) who had either a travel history or had been in contact with an infected person.

The head of WHO Dr Tedros Adhanom Ghebreyesus urged countries “to test, test, test; test every suspected case”. Reacting to this Dr Bhargava said on 17 March that this doesn’t apply to India. At the same time, clearance has now been given for 51 private labs to also undertake PCR testing. However, ICMR has neither assured them of adequate testing kits nor provided costing guidelines. During the H1N1 outbreak in 2009, private labs were brought in and the rate fixed at Rs 4500. ICMR is importing two large units that permit rapid testing of 1400 samples daily but this will take another two weeks. The low numbers are used as evidence by ICMR that community transmission has not taken place though the critics allege that you can’t find evidence if you don’t look for it.

Many other countries have resorted to large scale testing. China resorted to it in early February, testing 10000 samples a day. South Korea had 28 cases on 15 February and adoption of early large-scale testing of 20000 samples daily enabled it to limit the cases to 8600 whereas Italy which had 3 cases on 15 February ended up with 47000 cases having adopted large scale testing three weeks later.

On 18 March, Roche Diagnostics was approved by ICMR to undertake testing. Other applications for approval of diagnostic kits by Indian private companies are still pending. Given that the genome sequence had been put out in the public domain on 24 January and the National Institute of Virology in Pune independently isolated a pure strain of the virus, early development and approval of diagnostic kits would have helped generate a greater sense of assurance. Larger volumes would help in bringing down the cost of the test, currently estimated at Rs 5000. Mechanisms to provide the kits to the approved private sector labs would enable them to offer tests freely and on widespread basis. Separately, ICMR is still working on a Rapid Response Regulatory Framework.

Chinese negligence
From the information now being pieced together, it seems clear that the disease surfaced in China in late November/early December in Wuhan. It was initially diagnosed as a new disease with pneumonia like symptoms resistant to known anti-flu drugs. Dr Li Wenliang who chatted about a “new SARS like virus” in a WeChat group on 30 December was severely chastised by the local authorities. He later contracted the infection and died on 7 February.

WHO was informed about the new illness on 31 January but continued to parrot the Chinese view that there was no evidence of human-to-human transmission till 21 January even as the Wuhan authorities held the biggest dinner party for the Lunar New Year for 40000 families on 18 January. By the time Beijing locked down Wuhan on 23 January, cases had been reported in South Korea, Japan, Hong Kong, Taiwan, Thailand, Singapore and US.

After the crackdown, the narrative changed from China’s initial negligence to how China bought time for the rest of the world with its draconian quarantine amid stories of how quickly temporary hospitals were being put up and 30000 medical personnel moved to Wuhan; in short how well the system had responded. China may now be offering assistance to other countries like Italy and Iran but there is no denying that its negligence over weeks has severely damaged the image of a responsible global stakeholder that President Xi Jinping was eager to cement.

India’s challenge
The global health challenge is being closely shadowed by an economic challenge in many countries. For a country like India with a large unorganised labour sector this makes the challenge greater. Right now there are trainloads of migrant labour from Gujarat and Maharashtra who have been laid off heading back to their villages. Only Kerala government has come out with a plan to provide resources for the economically vulnerable who run the risk of losing their livelihood. a national strategy would provide guidance to the states as also the assurance of resources.

With seven beds per 10000 of the population compared to 29 in US and 34 in Italy, India has a weak public health system. To deal with such a challenge needs not just all of government but government, private sector and civil society to work together. What is needed is a national task force and clear targets regarding testing kits, hospital beds, and lead funding the biotech industry to work collectively for a vaccine and not inconsistent messaging. Exhorting the people to exercise Sainyam (restraint) and Sankalp (determination) is certainly the task of a political leader but it will carry greater conviction if there is also evidence of sharp focus and coordination. Government cannot afford to waste the valuable lead time that India gained for it is fast ending.