Could we know the exact or even approximate number of deaths caused due to Covid-19 and related symptoms which took place in last one month in Uttar Pradesh and which continue to take place every day? Perhaps never! Although the social and print media is full of stories, images, videos and narratives related to huge number of deaths taking place in almost every district of Uttar Pradesh, we do not have specific confirmed information about the numbers and statistically relevant categories except what is called the lump sum official data which seldom match the actual numbers at the ground level. Many experts are repeatedly saying that the actual number of possible deaths could be many times more than the officially reported numbers (based on crematorium statistics Dr. Ashish Jha of Brown University has recently estimated the number of deaths at all India level to be over 20,000 a day, almost five times more than the official figures; some experts say that these could be even higher!).
Several complex situations are prevailing at the ground level which minimise the possibility of having a fair head count of every Covid-19 related death: not everybody who is witnessing Covid-19 like symptoms is recommended to go for the necessary tests for confirmation; people dying without a Covid-19 positive test result are generally not getting counted as Covid-19 deaths; not every death is often getting counted officially because of several local administrative reasons; not every family is actually aware of the Covid-19 related situation prevailing in the country; many other political and administrative factors prevailing in general at the larger level. And hence, there is dearth of specific data related to Covid-19 deaths prevailing even in the state of Uttar Pradesh (the situation could be similar in other Indian states) and the numbers coming from Aligarh Muslim University, Aligarh, Uttar Pradesh, India, related to Covid-19 and related deaths are surprising all of us and presenting a very sad state of affairs. These surprising numbers also raise several questions related to ground realities prevailing in the state of Uttar Pradesh and even at all India level, which are neither raised nor answered, at least at political level. Answering all these questions would not be possible here but the relevant questions need to be raised and I have included some of these also here besides trying to situate the AMU tragedy at a larger context.
AMU figures suggests an unimaginable death rate of teachers
The death count of 20 existing faculty members of AMU (there deaths of several non-teaching staff and dozens of retired faculty members also but not including these number here for the issues related to precision) speak more than volumes in these situations. It gives a specific and precise number within a specific context (say sample) and this number is very alarming and disturbing. AMU has approximately 1500-1600 serving faculty members (the numbers keep varying because of inclusion of the contractual faculty members). Death of 20 faculty members (no matter whether they were tested Covid-19 positive or not but these are generally perceived as Covid-19 related deaths) out of these existing 1500-1600 faculty members show an overall death rate of around one percent within a very short span of less than one month. This is a very dangerous proportion and needs a thorough assessment on the basis of epidemiological studies and statistical estimations, but unfortunately such estimates are missing. The epidemiologists and statisticians are rarely seen to be working in the state at least in the context of the Covid-19 related deaths. What we can see these days is official (bureaucratic and political) figures only. I understand that faculty members of a university do not represent the general population of a state in terms of representative sample and heterogeneity prevailing at the ground level but still the figures do represent the situation prevailing among university and college teachers which in itself is a very big population. Few precise questions that could be raised here is: Are teachers (university, college and school levels) more vulnerable to Covid-19? Does focus on mental work (and online teaching???) and lesser physical activity in last one year make them more vulnerable to Covid-19 and other related comorbidities? Is it relevant to see the Covid-19 and related deaths in terms of professions and occupations of the deceased?
The figures coming from AMU further indicate the state of penetration of the pandemic and the lack of preparedness of the healthcare system to meet such a gigantic prevalence of the pandemic. The rapid spread of the virus and related morbidity conditions is very disturbing. Questions come to mind that what unfortunate things may happen (or happening right now) if these figures are assumed to be also a representations of the prevailing conditions of the other academic institutions situated in the state and for the worst, at the level of other professional and occupational classes where working conditions are similar to the teaching profession ie. more mental work and lesser physical activity? Unfortunately, such precise numbers from other institutions are not available in public domain for any confirmation. But lack of data is not denying the possibility of such losses; it can only delay the possible assessment of such losses. The various images and obituaries appearing in the social and print media are just indication of the confirmation of the hypothesis. More systematic data, if made available be the affected institutions, can help in identifying the vulnerable groups in a more precise way. Are the governments interested in knowing these details? Will the precise data start new episodes of ‘blame the victim’ approach? Some political expressions do suggest a blame the victim approach prevailing among many ruling regimes.
It is because of these extreme negative experiences and possibilities that the figures coming out from AMU is creating those panic alarms. The news related to death of existing faculty members has attracted the national electronic and print media and even I am receiving several panic calls from students, colleagues, friends and relatives spread all over the country about what is going wrong here. I am sure similar is the situation with all other colleagues working here. We got to know that the Vice Chancellor (VC) of AMU has written a letter to the Director, Indian Council of Medical research (ICMR) to look into the possibility of presence and spread of any deadly local variant of the virus in the locality surrounding AMU campus. We do not know, as of now, what response may come from ICMR, but we know, for sure, that even the well identified variants of the virus are no lesser deadlier. Any further delay, in identification of this variant, if any, would create further devastations. We also know that the VC talked to the HRD minister over telephone and got several assurances. We are also aware of the telephonic talk of the Chief Minister (CM) of Uttar Pradesh with the VC and visit of the CM to the university campus two days back and several announcements made by the CM. It will take few months to see what impact this visit would create.
Pathetic medical care facilities and raising the relevant questions
With lots of pain and apprehension prevailing at the level of the families of the affected colleagues, other colleagues, and their family members, I am compelled to write this note that we are aware of the situation that medical care facilities and infrastructure support that most of the infected and affected persons are getting at the places of care are very insufficient. We are aware of the fact that how shortage of oxygen supply, lack of ventilators and non-availability specific medicines have snatched the lives of our near and dear ones here. We are equally apprehensive about the situations prevailing in all other localities of Aligarh city and all other districts of Uttar Pradesh. Lack of specific information is further deepening all these apprehensions.
Do the medical care institutions need correction and improvement in the standard operating procedures (SOPs) which are generally followed in the hospitals here? Do we need any better monitoring on whether the private institutions and practitioners are following the SOPs or not? Do we need special and well trained monitoring teams at the level of each and every district of the state? Do we need to immediately start mobile medical units for rural areas which are witnessing rise in the cases and mortalities? Does the state need to start special arrangement for telemedicine facility supported by ambulance and mobile healthcare services? Does Uttar Pradesh need special vaccination derive for teachers and more vulnerable categories at super emergency level? Are the post Covid-19 needs of people getting addressed properly? The questions are never ending but the possible answers are missing. These questions become very important because we have seen that the SOPs related vaccination is changing but the SOPs related to medical care of Covid-19 patients and especially supply and availability of Oxygen, medicines, and ventilators are either stagnant or almost missing. The death of the existing faculty members of AMU are certainly huge national loss but such deaths are only an indication of the problems appearing as the tip of the iceberg… the larger problem is almost invisible and needs to be deconstructed and unfolded well. Shouldn’t the officials start making use of all available resources to control the spread of the pandemic and in the rectification of the adverse consequences caused by it? Shouldn’t the government engage all political leaders, even those belonging to the opposition, and remind the almost invisible opposition about their constitutional obligations?
Implications for Uttar Pradesh and immediate interventions required
The problem of ever increasing Covid-19 and related deaths is not confined to university or college faculty members, as it may appear in this discussion so far. Several existing legislatures of even the ruling political party have succumbed to Covid-19 deaths. Dozens of top bureaucrats have lost lives recently due to it. Unverified number of schools teachers have already seen similar fatal deaths during and after their recently conducted panchayat election duties. The floating dead bodies found in the sacred rivers like the Ganga and the Yamuna passing through the state tell hundreds of other untold stories. The dead bodies found alongside the river banks in the state two days back is again creating shivers. The long queues at the burial sites or last rite sites have been telling the sad stories of thousands of untimely deaths from all over the state. And the remaining stories could be seen at the level of the hospitals which are packed with Covid-19 patients. The AMU deaths has attracted the national and international attention because of the individual reputation of the teachers who are no more with us and the collective reputation of the institution but not all those who are leaving this world during this pandemic are getting this much media attention. Lack of media attention or lack of mention in record books does not mean that these deaths are non-existent!
It is high time (already much delayed) for the state machinery to call for all possible help from all possible agencies (national or international). The second wave of the pandemic may get weaken in a month or two in some districts but the danger of the next wave could not be eliminated. A rapid action plan needs to be prepared and implemented following professional ethics and honesty. Why can’t the state have emergency military hospitals and health camps for all seriously affected districts? Why can’t there be immediate installation of hygienic medical oxygen production plants? Why can’t all needy people have access to oxygen cylinders, ventilators and specific medicines in a hygienic and appropriate manner? Why can’t the state go for ensuring international support in procuring necessary medicines and vaccines? What information do we have about the possible availability of the vaccines in next few months at the level of the state? All these interventions need to be made immediately otherwise it would be too late! May good sense prevail among our political leaders! Denial of healthcare is denial of right to life and no democratic regime can sustain on the epitome of denial of right to life to its people!
Prof Mohammad Akram is Professor of Sociology at Department of Sociology, Aligarh Muslim University, Aligarh, Uttar Pradesh (India) and has written few books and several research papers on issues related sociology of health, sanitation, education and social policies. The author could be contacted at e mail: firstname.lastname@example.org