📰 Covaxin not to be used in cases of allergy, fever, poor immunity
Company releases fact sheet detailing possible adverse events and those who are eligible for the vaccine
•Those with any history of allergies, fever and bleeding disorder, on blood thinners and who are immunity compromised or on medication have been told by COVAXIN manufacturer Bharat Biotech not to take the vaccine.
•A statement uploaded on the company website on Monday said the vaccine was also contraindicated for pregnant/lactating women, those using other COVID-19 vaccines and people with any other serious health related issues as determined by the vaccinator/officer supervising vaccination.
•The statement comes amidst reports of a slow uptake of the first phase of COVID-19 vaccination in the country that began on January 16.
•Bharat Biotech has now released a fact sheet detailing the possible adverse events and those who are eligible for the vaccine.
•It said, “There is remote chance that COVAXIN could cause severe allergic reaction including difficulty in breathing, swelling of face/throat/fast heart beat, rash all over the body and dizziness and weakness.’’
•The clinical efficacy of COVAXIN was yet to be established and it was still being studied in phase 3 clinical trials. Hence it was important to appreciate that receiving the vaccine did not mean that other precautions related to COVOD-19 need not be followed, it added.
•A Health Ministry order has said people currently can’t decide on which vaccine they will get. Getting vaccinated is voluntary.
IMA stand
•Health experts and the Indian Medical Association (IMA), advocating an aggressive awareness campaign, especially in the light of the 447 adverse events following immunisation that included three needing hospitalisation, said their “members have been told to reach out to population using public forums, media, social media etc to increase the awareness about the vaccine.’’
•The IMA stated that all its members would now provide the right, scientific information to people across the country and promote the vaccine.
•“The IMA lost its 732 expert doctors during the past one year and now we have a vaccine. It stands with the government during this phase where healthcare and front line workers would be vaccinated,’’ said its hony. secretary general Dr. Jayesh Lele. More than COVID-19, rumours were proving harmful.
‘People misled by myths’
•“People are getting misled by these myths. Obviously, as the modern medicine professional body, it is our responsibility also to fight with the menace of the misinformation against COVID-19,’’ he added.
•The association, in a one-page statement, noted that vaccines were for building immunity in the human body. “They help develop immunity and decrease the chances of contracting the illness. These basic facts should be brought in public awareness. This scientific and evidence based preventive medicine should be taught to the people of our country,’’ it said.
•Senior Health Ministry officials said that providing vaccination was an organised drive that also included proper history taking and follow-up of those receiving the vaccination.
•“The hesitation if any will be addressed through the ongoing awareness campaign and correct information released by the Ministry,’’ said an official.
•As per information released by the Health Ministry, India’s daily COVID-19 fatalities dropped to 145 after nearly eight months with 83 per cent of the new deaths being reported from Maharashtra (50), Kerala 21, West Bengal 12 and Delhi (8) in the past 24 hours.
The government must do all within its powers to combat vaccine hesitancy
•Faith in entities is often an act of personal commitment not amenable to falsification, but trust in a scientific process can be established with confidence-building measures and full disclosure of all relevant data. Any mass campaign that involves voluntary effort on the part of the public can succeed only when transparency and open communication channels are the tools of choice. If the poor rate of uptake of the COVID-19 vaccine in most of the States in the country is any indication, the government has not taken the people of the country along, in what is a purely voluntary exercise, but one vested with great power to retard the pace of the epidemic. For instance, Tamil Nadu, a State perceived to be largely health literate, and relatively well-equipped with health infrastructure, achieved only over 16% of its targeted coverage on the launch day. On the second day of vaccination, the compliance further dropped; in some States, vaccination was suspended. A marked favouring of the Covishield vaccine over Covaxin was also noticed in multiple States.
•But none of this is a surprise. The signs, verily, were out there for everyone to see, for a long time indeed. Studies measured high levels of vaccine hesitancy among the general population, and among health-care workers, the first in the line list of people to receive free vaccination. Clearly, vaccine hesitancy was not addressed sufficiently, or not taken seriously enough. With the sequence of events that followed the clearance of Emergency Use Authorisation (in Covaxin, it is emergency use authorisation in ‘clinical trial mode’) — a high-handed announcement with little attempt to put out compelling evidence in the public domain, or answer multiple queries in press conferences — vaccine hesitancy merely dug its heels in deeper. The inability of the government and agencies involved to amicably resolve controversies surrounding the clearance for Covaxin, even before it was able to produce interim data on efficacy from phase-3 trials, has had a direct consequence, as witnessed by poor numbers in its uptake so far. A vaccine, unequivocally, is public good, but the lack of transparency surrounding the roll-out of the COVID vaccines has done little to enhance trust in this experiential principle. This uncommon haste in trying to lunge towards the tape while still some distance from the finish line might have been justified if the state had taken the people along. Vaccinating the nation, however, is less a race than a slow and steady process. Building confidence in the process is crucial to achieving the task at hand. Prime Minister Narendra Modi’s oft-repeated mantra, ‘Sabka Saath, Sabka Vikas’, is very relevant here. And the Health Ministry must do whatever it takes to make a success of the vaccination drive.
📰 Mining in India equals selling the family gold
Treating mineral sale proceeds as revenue or income hides the real transaction — the sale of inherited wealth
•The principle that the economy must be “sustainable” — we cannot compromise the ability of future generations to meet their needs — is beyond question. Climate change and high levels of consumption already threaten to rob future generations of a planet that is liveable. The principle of Intergenerational Equity would make it imperative for us to ensure future generations inherit at least as much as we did.
•If we are successful in abiding by intergenerational equity, our children will be at least as well off as we are. If we leave a bequest as well, they will be better off than us. To consume what we have inherited without a thought for generations to come will leave the whole world poorer; like an addict selling the family gold.
How it is unsustainable
•India’s National Mineral Policy 2019 states: “natural resources, including minerals, are a shared inheritance where the state is the trustee on behalf of the people to ensure that future generations receive the benefit of inheritance.” (https://bit.ly/2Xy5wyd). The primary objective of a trustee/manager is to maintain the corpus of the trust, the shared inheritance of natural resources.
•The extraction of oil, gas and minerals is effectively the sale of this inheritance, with royalties and other proceeds being the consideration paid in exchange for the mineral wealth extracted. Unfortunately, governments everywhere treat the mineral sale proceeds as revenue or income, a crucial error which hides the real transaction — a sale of inherited wealth.
•This results in governments selling minerals at prices significantly lower than what they are worth, driven by lobbying, political donations and corruption. For example, it is estimated from the annual reports of Vedanta that over eight years (2004-2012), the State of Goa lost more than 95% of the value of its minerals (https://bit.ly/39tFKQZ) — after extraction costs and a reasonable profit for the extractor. Any loss is effectively a hidden per-head tax which makes a few extractors and their cronies super rich. Inequality grows sharply. This is the economics of loot.
•Worse still, the trifles received by the government are treated as “revenue” and happily spent, leaving neither the minerals nor their value for future generations to inherit. This is just not sustainable.
Losses, error in accounting
•There is growing empirical evidence of large losses in mining from around the world (https://bit.ly/2LjmDRV).
•There is also growing evidence from the International Monetary Fund that many governments of resource-rich nations, including the United Kingdom and Norway, face declining public sector net worth, i.e., their governments are becoming poorer (https://bit.ly/3i81c21). Both indicate unsustainable mining.
•Losses in mineral value drive many of the other problems with mining. In effect, the people and future generations of Goa have sold mineral wealth worth ₹100 for ₹5, a loss of ₹95. Naturally the extractors are keen to extract as quickly as possible and move on. Trees, tigers and tribals are labelled as anti-development or anti-national.
•If ₹5 is received for allowing mining, doubling mining would result in ₹10. Politicians and voters perceive more mining equals more government revenue equals good. Further, since extraction is not recognised as the sale of inherited wealth, the true loss of ₹95 is hidden. More mining would make a bad situation significantly worse.
•It is important to understand that as long as the Government Accounting Standards Advisory Board does not correct this error in the standards for public sector accounting and reporting for mineral wealth, politicians and voters will advocate increasing extraction. This will lead to every bit of mineral being extracted if there are no moral or legal safeguards against such wanton loot. It is essential that as a nation we change our paradigm (https://bit.ly/2LIEJNd) to understand minerals as a “shared inheritance”, not a source of “windfall revenue”.
How to manage it
•Since minerals are a shared inheritance held in trust for the people and future generations, our foremost duty is to maintain the value of our children’s inheritance by avoiding theft, loss, waste or consumption. Leaving the minerals undisturbed fulfils our duty.
•Therefore, if we extract and sell our mineral wealth, the explicit objective must be to achieve zero loss in value; the state as trustee must capture the full economic rent (sale price minus cost of extraction, cost including reasonable profit for extractor). Any loss is a loss to all of us and our future generations, and makes some rich; that is patently unfair. India’s National Mineral Policy 2019 says: “State Governments will endeavour to ensure that the full value of the extracted minerals is received by the State.”
•Like Norway, the entire mineral sale proceeds must be saved in a Future Generations Fund. The Future Generations Fund could be passively invested through the National Pension Scheme framework.
•Setting a global judicial precedent, in 2014 the Supreme Court ordered the creation of a Goa Iron Ore Permanent Fund, which already has a corpus of around ₹500 crore — Goa Foundation vs UOI & Ors., WP (civil) 435 of 2012, judgment on April 21, 2014 (https://bit.ly/2Kts4gA).
•The real income of a fund of this nature may be distributed only as a citizens’ dividend, equally to all as owners. Future generations would benefit from the dividend in their turn.
On fair mining
•For the Indian economy this is sustainable — capital has been maintained; the savings rate would rise, making available more long-term domestic capital; it diversifies risk while likely improving returns — it is nearly impossible to outperform the market rate of return; the dividend is in effect a Universal Basic Income; lower inequality leads to higher economic performance, and as budgets no longer have easy mining money, public investment, and tax administration will become more effective and efficient. This is a six-fold economic boost.
•These principles of fair mining are fully constitutional, promoting justice, liberty, equality, and fraternity. They are moral, ethical, fair, right and sustainable. The reduction in losses would limit corruption, crony capitalism and growing inequality. They fulfil our duties to our future generations. Let us be the generation that changes the course of history for the better, not the one that consumed the planet.
📰 Don’t doubt Indian vaccines
Vaccination is important to prevent a second wave
•Several people have questioned the emergency approval given to the indigenously developed COVID-19 vaccine. They have demanded efficacy data and cast aspersions on the regulatory machinery. Such views will only increase vaccine hesitancy.
•It is not the case that the vaccine developed indigenously is being pushed by vested interests, while the international vaccines are great. Questions have been raised about the Moderna and Pfizer vaccines too, which have reported more than 90% efficacy. As Peter Doshi wrote in The BMJ, questions have been raised about the exclusion of individuals from the efficacy analysis for ‘important protocol deviations’; the higher rate of medication in the vaccine arm to prevent side-effects due to reactogenicity; the processes of the primary event adjudication committees, comprising the companies’ own employees; vaccine efficacy in those who already had COVID-19; the non-availability of raw trial data; and so on.
Efficacy assessment
•Efficacy would actually mean testing, say, 10,000 individuals who have been given the vaccine versus an equivalent number not given the vaccine in terms of the number who get the infection. Can these vaccines prevent transmission? We may have to wait at least six months to get meaningful results. Efficacy would reflect in the rate of hospitalisation, ICU cases and deaths. With a declining level of infection, perhaps the virus is weakening in India on its own, as is the case with most pathogens. This makes efficacy assessment of a vaccine very difficult.
•The question of antibody-dependent enhancement, a phenomenon in which virus-specific antibodies enhance the severity of the virus, and in some cases the replication of the virus, has been put on the backburner with experts suggesting it may not be a major issue. It depends on vaccine design and it is not known whether all the candidate vaccines have been tested for this phenomenon.
•In the case of the rabies vaccine, efficacy assessment is based on the virus neutralisation capacity of the serum from the vaccinated individual, assessed in terms of international units. It is a surrogate marker for efficacy, since the candidate vaccine cannot be tested in an experimental population that is administered the virus or bitten by rabid dogs, for validation. At this stage, no one can predict whether the COVID-19 vaccine candidates can protect against the circulating mutants. The SARS-CoV-2 virus is both intellectually and medically challenging. But there has been no prevention strategy in history other than vaccination to save lives. Therefore, vaccination of the population is very important for protection against fresh infections and a second wave, although the duration of protection is not known for any vaccine candidate. It is well known that some people take the flu vaccine every year.
•The SARS-CoV-2 pandemic has been extraordinary, both in terms of positive and negative developments. The cooperation among the scientific community, industry and regulatory agencies has been truly remarkable in making vaccine development and deployment possible in less than two years, a process that would otherwise take 10-15 years. The future timelines for research and development, product development and expectations will be very different. On the negative side, we have tall claims by political leaders in the West on vaccines, major scientific journals coming under pressure to publish data with poor peer review, vaccine nationalism, etc.
Moving ahead
•Given the context of the pandemic, it would be prudent for India to go by safety studies (Phase I and II) and assessment of virus neutralisation assays with the serum. It is also not appropriate to doubt the integrity of the expert committee advising the Drugs Controller General of India (DCGI). The DCGI is not just an individual to be pressured; it follows due process for making an informed decision regarding emergency use, or, as is called in India, approval for restricted use.
•It is understandable that limited approval has been given in clinical trial mode, where individuals vaccinated will be monitored regularly. Though no particular vaccine candidate should be favoured, candidates with proven safety studies and efficacy, as assessed based on the virus neutralisation potency of the sera, should be allowed to go ahead. One or two more months into the trial could have given partial data to satisfy interim efficacy assessment, but we will get real data on efficacy only after vaccinating the masses. Eventually, affordability could become an issue. Selective criticism of indigenous efforts will only jeopardise such efforts. India has a huge population to be vaccinated and we need to move ahead.
📰 How co-morbidities make COVID severe
Physicians are confronted with a complex problem that involves multiple organ systems
•Medical students are taught to classify diseases as either congenital or acquired. Acquired diseases are infectious or inflammatory, nutritional or metabolic, vascular or neoplastic (tumours, benign or malignant). COVID-19 is acquired, infectious/inflammatory. The microbe is SARS-CoV-2.
•What are co-morbidities and why do they make COVID-19 severe and life-threatening? Chronic nutritional/metabolic diseases start as diabetes, hypertension, metabolic syndrome or obesity. They in turn lead to chronic heart, brain and kidney diseases because of damage to the lining cells of the blood vessels, the ‘endothelium’. For someone with an acute disease, a pre-existing chronic disease is now a co-morbidity.
•The immune system is highly conserved even in undernourished people; the impact of co-morbidities on the immune system is mild. Exceptions occur: TB is more common in undernourished adults and uncontrolled diabetes; metabolic syndrome, however, is associated with over-nutrition. If someone with a co-morbidity gets COVID-19, the disease severity is increased out of proportion to any subtle or mild effect of the co-morbidity on the immune system.
Opening the lock to gain entry
•There are four ubiquitous coronaviruses, highly adapted to human hosts, causing only common cold. Three coronaviruses — SARS-CoV-1, MERS-CoV and SARS-CoV-2 — have recently jumped the host species, presumably bats or dromedary camels, and caused severe disease in humans, primarily pneumonia. SARS-CoV-1 and SARS-CoV-2 latch on to a human cell surface protein called ‘angiotensin converting enzyme 2’ (ACE2), mediated through the viral surface spike protein, a key that opens the lock to gain entry. Once inside, the virus hijacks cell functions for its own multiplication. There is no precedent of viruses using ACE2 as cell receptors.
•ACE1 and ACE2 are widely distributed on the lining ‘endothelial’ cells of all arterial, venous and capillary blood vessels and on smooth muscles that surround them. They also abound on the lining epithelial cells of the respiratory tract, kidneys and gut. Blood carries oxygen and nutrition to all organs; anything that affects the blood vessels affects the organs as well. Contrast this with influenza virus receptors that are present only on epithelial cells of the respiratory tract – the virus cannot invade and infect inner organs and tissues. COVID-19 may invade and infect any tissue or organ from the head to the toes and cause damage through reduced blood supply.
•Physiologically ACE1 and ACE2 play critical roles in regulating blood pressure, and blood flow to organs. They act on angiotensin-1 and convert it to active peptides. ACE1 converts angiotensin-1 to angiotensin-2, a potent constrictor of blood vessels. ACE2, on the other hand, converts angiotensin-1 and angiotensin-2 to peptides that dilate blood vessels. Through their balanced and contrasting effects on blood vessels, these peptides regulate regional blood flow in organs and tissues. In chronic diseases there is widespread dysfunction of these activities.
•By occupying ACE2, COVID-19 interferes with angiotensin conversion to vaso-dilatory peptides; the balance tilts in favour of vaso-constriction resulting in decreased oxygen and nutrient supply to organs. If the person’s blood sugar level is very high, the blood becomes viscous. Damaged endothelial cells hasten blood clotting and further reduce blood supply. If someone has, say, diabetes, SARS-CoV-2 can further severely reduce oxygen supply to tissues. This synergy could be fatal. Well-controlled diabetes carries less risk as damage to the endothelial cells is minimal.
•COVID-19 is an infectious disease and especially affects the lungs. The immune system responds as best as it can. Within 2-3 weeks of infection, when immunity is at its peak, the immune system may clear the virus from the organs, but the damages to the organs take time to repair. In the absence of co-morbidities, the body physiology can bounce back to normalcy quickly, but in those with co-morbidities, the ailing organs may not recover in time to avert death due to damage to the lungs, heart, kidney or brain. The borders between infectious pathology and metabolic/vascular pathology are blurred or breached.
A complex problem
•The poor response to convalescent plasma that rapidly reduces virus load in the body surprised experts. Once the vascular and clotting cascade sets in, even if you remove the virus, the downhill course continues. If you want prevention of disease progression in those at high risk of death, either the coronaviruses must be neutralised very early, even before or early after onset of symptoms, or you must be vaccinated. This illustrates the need for vaccine emergency use authorisation for the elderly and those with co-morbidities. Vaccination will confer some protection to those at high risk of death through the sinister synergy of COVID-19 and co-morbidities. The elderly are vulnerable due to senile degeneration, decline of immune functions and elements of co-morbidities.
•There is another sinister association: the insulin-secreting Beta cells in the pancreas are studded with ACE2 and are easy targets for COVID-19. In COVID-19, insulin secretion is decreased. Non-diabetics sometimes develop diabetes for the first time after COVID-19 and those with diabetes may develop very high blood sugar levels.
•Those who recover from COVID-19 are prone to develop chronic diseases. Those with obesity, diabetes and hypertension who recover from COVID-19 are at increased risk of heart attack and stroke because of severe blood vessel narrowing during COVID-19. Some people develop chronic sequelae, called chronic or ‘long’ COVID-19 — some of them due to damage to blood vessels in the lungs, kidneys, heart and brain. COVID-19 also seems to trigger auto-immunity, that is, one’s immune system turns against one’s own tissues/organs. These conditions may lead to severe muscle or joint pain, severe fatigue, memory loss and mental depression.
•The damage to the lungs in COVID-19 starts as infection, but quickly becomes massive inflammation with outpouring of plasma into the air sacs, sludging of blood flow in capillaries and clotting. The reason for these is what is called a ‘cytokine storm’: a reaction of blood vessels to substances called cytokines that are excessively secreted by immune cells. This cascade leads to further decreased oxygen in blood. The widespread narrowing of blood vessels and hypoxia serve as twin triggers to damage vital body organs.
•Physicians are confronted with a complex problem that involves multiple organ systems. For the elderly and those with co-morbidities, prevention is better than cure. COVID-19 vaccines should induce protective immunity in youngsters, adults and the elderly, except in those with diseases or treatments that directly suppress the immune system (such as those with cancers and organ transplants). As the immune system is only modestly affected by co-morbidities, we expect vaccine-induced immunity sufficient to avert severe disease. Yet, there may be disappointing surprises. Therefore, people with obesity, diabetes and hypertension should ensure that they are diligent in the practices of mask wearing, physical distancing, hand hygiene and avoiding crowds. Until we know more details, vaccination, good control of co-morbidity parameters and good infection control practices together will save lives.
📰 Being tethered to bars during a pandemic
In India, COVID-19 must lead to an immediate review of the vulnerability of those in jail and the issue of decongestion
•A distance of two yards — do ghazh ki duri — we are enjoined to maintain between oneself and anyone else. The ‘pandemic’ message is relayed on recorded caller messages in all our official languages.
•But there is a category of persons by which the injunction cannot be observed — prisoners. By the very nature of their situation, the physical limits of their confinement, they are obliged to stay in poorly ventilated and over-crowded cells. Being holed up in that condition almost seems to form part of the punishment. A jail and a dungeon are almost interchangeable terms.
Data from the U.S., the U.K.
•Criminal justice has ‘activists’ in the United States observing with a sharp eye, prison conditions. We do not. At least not in the same numbers or with the same capacity to influence policy. Writing in Diplomatic Courier on December 29, 2020 (https://bit.ly/2M4IHiT), Carolyn Nash reported that in March 27, last year, a letter signed by over 40 public health experts called federal prisons and immigration detention centers “breeding grounds for uncontrolled transmission” of the virus. By September, 44 of 50 COVID-19 clusters were found to be located in prisons. In Texas, the virus had, by then, killed more than 230 people in jails and prisons, 80% of whom had not been convicted of a crime. By November, the number of cases in Michigan prisons more than doubled in two weeks. A Minnesota organiser called his state’s soaring rate of prison infections “a human rights disaster”, she says.
•England and Wales have 121 prisons housing about 79,000 prisoners. As the novel coronavirus grew alarmingly in Britain, a mass testing programme commenced for all prisoners in 28 of these prisons in July, starting with symptomatic prisoners. The United Kingdom Ministry of Justice figures (The Guardian, November, 2020; https://bit.ly/39Itmg5) showed that prisoners testing positive in September stood at 883 (By October the number rose to 1,529, with five deaths. This rise was doubtless computed on account of increased testing.
The Indian situation
•Do we have such statistics for India?
•They do exist, surely but not in handy, ready form in the public domain.
•But the tragedy in human terms is that such statistics are not being demanded of our criminal justice system. In the United States and in the U.K., pandemic control in prisons is being driven by enlightened public opinion. Not so in India. When we hail an ‘unlocking’, we are not thinking of our lock-ups. This is not surprising in a society such as ours which seems to have concluded, prematurely, that the novel coronavirus is behind us, which is not the case. But more pertinently, this is not surprising in a society that has a poor tradition of human rights activism.
•It takes a prominent prisoner such as the writer, Varavara Rao, or the Khudai Khidmatgar Faisal Khan going down with the virus for the enormity of the disease combining with imprisonment to dawn on us. That our 1,400 or so prisons, ‘housing’ over 4.5 lakh prisoners are breeding grounds for the virus does not occupy our thoughts, even our virus-related thoughts.
•But how about the Indian state ?
•The Prisons Act of 1894 (https://bit.ly/39G9473) makes prisons the exclusive responsibility of State governments. Over the years the condition of prison life has moved up on the human civility and dignity scale, with the venues now being called correctional homes and over 60 ‘minimum security’ open prisons having been set up. Of the 4.5 lakh prisoners that our correctional homes hold, according to the National Crime Records Bureau’s report for 2019 (https://bit.ly/3qIbl8T), about 3.3 lakh are ‘under-trial prisoners’ , against whom investigation or trial is supposed to be ‘in progress’. These 3.3 lakh ‘under-trial prisoners’ have been detained under Section 167 of the Code of Criminal Procedure (CrPC) which provides for “Procedure when investigation cannot be completed in 24 hours”. The original CrPC of 1898 specified the period of detention as 15 days. This has, by amendments, been extended to periods that can go up to 90 days and, in some exceptional situations, even indefinitely.
Violation of rights
•Surendra Nath, a former Additional Secretary in the Ministry of Justice, Government of India and member of the Constitutional Conduct Group, has pointed out : “…(O)ut of 3.3 lakh, about 2.2 lakh are either not likely to be even charge-sheeted, or they are likely to be acquitted.”
•B.D. Sharma, a former Head of Correctional Services in West Bengal, who has done amazing work in giving that nomenclature true meaning, describes their condition thus: “This huge violation of the basic human rights of UTPs in such large numbers is made further unbearable by overcrowding, poor living conditions, inadequate healthcare facilities and torture by other rowdy prisoners (which often occurs with the connivance of jail staff) in our prisons.” And he highlights the huge injustice caused to the families of the ‘under-trial prisoners’ “languishing in prisons for long years particularly their children who are denied a normal childhood, proper education, and are exploited by cruel sections of the society in various way especially the girl children and many of whom are forced to take to the path of crime”.
Double punishment
•So, while the plight — to use a cliché — of all prisoners is by definition bad, in terms of exposure to disease, it is 10 times worse for ‘under-trial prisoners’, for the majority of them are and are likely to be found to be innocent. Theirs is a case of innocence in jail and in jeopardy — the jeopardy of a potentially fatal infection contracted while in detention.
•Is this acceptable in a country which boasts of a Constitution, in the Preamble to which we give unto ourselves, before anything else — Justice?
•The virus gives cause for an immediate review of all prisoners’ vulnerability to the epidemic, starting with that of ‘under-trial prisoners’ who are suffering two privations — one, being immobilised, most probably unjustly, and two, being tethered to the risk of infection.
•This review has to comprise 100% and repeated testing procedures in all prisons, especially sub-jails, which form the biggest category among them and the least ‘equipped’ and an arrangement for the isolating and hospitalisation of those testing positive. No prisoner who has tested positive can be allowed to remain within the crowded confines of that venue without transmitting the disease to a progressively rising concentric circle of inmates.
•But above all, the population of prisons has to be vigorously bought down.
A case for prison reform
•Through a salutary amendment, the Code Of Criminal Procedure (Amendment) Act, 2005, a much-needed Section 436-A has been introduced in the CrPC. Excluding offences for which capital punishment is envisaged, it provides for an under-trial to be released on a personal bond, with or without sureties if the period spent in detention by the under-trial has been for more than half the maximum period of imprisonment prescribed for that offence. (The public prosecutor can move the court to deviate from this.)
•The 2005 amendment had two aims : one, de-congestion and two, fairness. Today, in our COVID-19 times, if congestion is per se held to be dangerous, de-congestion in prisons through a prescribed legal procedure becomes not just a desirability but a duty. And I urge the immediate and massive activation of Section 436-A without sureties so as to benefit all under-trials eligible for it.
•It is not just desirable but axiomatic that the 2005 amendment to the CrPC be activated on a nation-wide and urgent basis as a penological imperative, a state duty and a human right. And while their release is being actuated, it also follows that even as anyone in a state hospital may rightly expect to be vaccinated on a priority against the virus, so should inmates of the ‘Hospitals of Correction’.
•While ‘Prisons’ is in the ‘State List’, as is ‘Public Health’, the Constitutional responsibility of handling infectious and contagious diseases figures in the Concurrent List. It is the Centre that must show the States its concern in this and lead from the front.
