India’s Deadly Cytokine Storm

Satya Sagar

Two months after imposition of the most stringent and large-scale lockdown in the world, with the pandemic still undefeated, it is the Indian Republic that is looking more and more like a struggling COVID-19 patient.

It is running low on oxygen in its blood, several organs are already failing, costs of treatment shooting up and the country’s leadership looks utterly confused and in delirium.

For, what the Narendra Modi regime has set in motion, is a deadly ‘cytokine storm’, a phenomenon that turns the body’s immune system against itself. Through its incompetent and arrogant response to the COVID-19 crisis it has effectively turned all institutions meant to protect lives of citizens into their worst enemies.

The poorly planned and chaotically implemented lockdown, has not only failed to prevent a rapid rise in infections, it has laid waste the country’s economy and sparked a massive humanitarian crisis involving millions of desperate migrant workers. With no income, no food, water or even space to stay, the country’s laboring classes are dying by the dozens of heat, exhaustion, hunger or in various accidents – as they flee the cities.

Showing a pitifully poor grasp of Indian realities, the lockdown – an idea blindly copied from overseas  – completely failed to account for anyone in India’s vast informal economy, which employs over 80% of the country’s labour force. National planners also had no policy on how to deal with crowded urban slums, where millions of Indians live in conditions that make any kind of ‘social distancing’ impossible. The needs of much of the rural population, especially farmers unable to harvest their crops, lacking labour or transport, were completely ignored.

The Indian health bureaucracy, on its part, failed to take advantage of slowing down of COVID-19 infection rates – the only real rationale for the lockdown-  to carry out nationwide detection, isolation and treatment of those already infected. Nor did they ensure healthcare access to those with existing medical problems – like cancer, cardiac conditions or tuberculosis – the consequences of which will be evident in horrific excess mortality in the days to come.

The Indian Supreme Court – resembling a red-beaked, green bird in a golden cage these days –  failed to provide justice to Indian citizens subject to intense suffering, often life threatening, due to the harsh lockdown.  The worst case of institutional failure however has been the Indian police, strangely thrust into a front line role during a health emergency.  An unreformed colonial-era force, the police brutalized the poor at whim, confirming widespread suspicion of it being the most organized criminal force in the country.

There is a reason why this analogy of India’s current fate with that of a COVID-19 patient works quite well. It is simply because nations are not just dead territory but primarily living entities, just like any multi-cellular plant, animal or human being. This implies they are mortal and have a certain life expectancy – which in turn depends on a variety of factors including inherited genes, dietary and lifestyle habits, stress levels and health-seeking behavior.

To remain in good health nations need good nourishment in various forms – the breath of a vibrant democracy, the sunshine of public scrutiny and participation, the water of universal values like compassion, tolerance and humility.

On all these fronts, unfortunately the record of this patient called India, since independence in 1947, has been abysmal. In its infancy, some of India’s ailments could of course be attributed to its difficult, C-section birth, when much blood was lost and the child itself born quite deformed.

The real problem, however was, that as the country gained strength in its youth, it refused to share these gains equitably throughout the body of the nation, leading to an unhealthy concentration of power and resources among those already at the top of the traditional Indian caste order.  As a result, for the first five decades of its existence India grew to resemble someone afflicted by Kwashiorkor, a disease of severe malnourishment – with a swollen head and protruding belly but also weak legs and emaciated body.

And as it crossed the age of fifty the Indian Republic suddenly bloated up due to opening of the economy, which brought in a rich diet of foreign funds. Even this was never shared equally but with more crumbs going around, millions of poor and unemployed Indians flocked to the cities, lured by the dream of a decent livelihood (the same ones trudging back to the villages now).

The rising overall wealth was also not invested wisely in improving the lives of workers, farmers, youth or investments in health, education or even ensuring good nutrition and safe drinking water for everyone. Instead, the gluttonous the Indian elite – better dubbed the Feast India Company-  binged on national resources at the expense of poorer citizens and the nation’s future.

As a consequence, the Indian Republic, now in its early seventies, looks like a typical RWA[i] uncle of similar age – diabetic, hypertensive, with arthritic knees and severe pain in the lower back. Someone, who does not care much for his own physical well-being as his children are ‘well-settled abroad’ but will do a full throated ‘Bharat Mata ki Jai’ to confirm the body still belongs to him.

What is worse, this upper caste Hindu uncle has in recent times become completely addicted to the narcotic of communal hatred, often homemade but sometimes imported. He shoots the poison up his veins to distract attention from various bodily aches and shows homicidal impulses by abusing or threatening his neighbours, usually weaker or less privileged than him.

Well, with so many co-morbidities, if India were indeed a COVID-19 patient, any good doctor would by now have put it on a ventilator, while advising close relatives to pray hard. The prognosis for the patient’s survival or escaping with least damage to vital organs does not seem very good at the moment – especially as he is blabbering something about ‘self-reliance’, blissfully unaware of impending danger.

A lot depends on not just skills of health personnel involved but critically on the quality of the ventilator itself. Going by experience though, one can safely say, if the device was anything procured from the state of Gujarat, we should keep firewood for the funeral ready and prepare to chant  with great sorrow ‘Ram Nam Satya Hai’.