Theme: COVID-19

Coronavirus disease (Covid-19) is an infectious disease caused by a newly discovered coronavirus i.e. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First identified in Wuhan, China, in December 2019, the World Health Organization (WHO) declared the outbreak to be a pandemic on 11 March, 2020.

Common Symptoms

According to the WHO, those infected with COVID can display any of the following symptoms: 

Prevention MethodsIt is also possible for a person to carry the infection without displaying any symptoms. This person can still transmit the disease to someone else.

According to the WHO, to prevent infection:

• Wash hands regularly with soap and water, or clean them with alcohol-based hand rub.
• Maintain at least 1 metre (3.2 feet) distance from people coughing or sneezing.
• Avoid touching the face.
• Cover the mouth and nose when coughing or sneezing.
• Stay home if unwell.
• Refrain from smoking and other activities that weaken the lungs.
• Practice physical distancing by avoiding unnecessary travel and staying away from large groups of people.

Read our explainer to understand more on how Covid-19 is an epidemic as well as a notified disaster in India.

New strains of the Coronavirus(( Your Health, Covid-19, Centers for Disease Control and Prevention, accessed at https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html))

Over time, multiple new variants of coronavirus have been identified in different parts of the world. These include:

•  The B.1.1.7 variant in the United Kingdom
•  The B. 1.351 variant in the South Africa 
•  The P.1 variant in Brazil 

 

Typically, the Government response to an epidemic, such as Covid-19, involves two primary laws – the Epidemic Diseases Act, 1897, and the Disaster Management Act, 2005. 

The Epidemic Diseases Act, 1897

The Epidemic Diseases Act, 1897 (“Epidemic Act”) gives the Central Government as well as State Governments the power to take special measures and prescribe regulations to prevent the spread of a dangerous epidemic disease. However, there is no definition of the term ‘Dangerous Epidemic Disease’ under this law.

Throughout the lockdown in India, the Central and State Governments took several actions to control the spread of the disease by:

• Restricting spread and movement by enforcing lockdowns or curfews.
• Conducting Covid-19 checks at airports.
• Travel bans within and between States.
• Stopping non-essential activities like movie threats, amusement parks etc.
• Stopping schools from opening and encouraging online teaching methods.
• Preventing mass gatherings at weddings, funerals etc.
• Stopping industries and construction activities.
• Shutting down offices and workplaces.

State Governments also have the power(( Seventh Schedule, Constitution of India, 1950; Section 2, Epidemic Diseases Act, 1897)) to take measures to prevent the outbreak of an epidemic, by prescribing regulations to be enforced with respect to any person or group of people. An example of this would be Delhi Epidemics Diseases, COVID-19 Regulations, 2020, continuously passed by the Delhi Government to restrict gatherings.

The Disaster Management Act, 2005

Since the Covid-19 outbreak is a “Notified Disaster”, the Disaster Management Act, 2005 applies to it and State Governments will get access to appropriate funds in order to respond and provide immediate relief to victims of the disaster. Through this law, the government can take/has taken action to manage the Covid-19 disaster by:

• Preventing its  danger or threat of spreading. For example, by enforcing lockdowns.
• Mitigating or reducing its risk, severity or consequences. For example, researching and implementing vaccine trials in India.
• Capacity-building and preparing to deal with Covid-19. For example, opening Covid-19 testing centres and camps across states.
• Assessing the severity or magnitude of the effects of Covid-19. For example, taking surveys and tracking cases through applications such as Aarogya Setu.

The Government imposes periodical lockdowns by giving a set of directions to all Ministries/Departments of the Government of India, State/Union Territory Governments and State/Union Territory Authorities.((  Disaster Management Act, 2005; Epidemic Diseases Act, 1897.)) These lockdown orders are published on the Ministry of Home Affairs website.

The COVID-19 lockdown across States is used as a measure to prevent the further spread of the disease. 

The lockdown is imposed through a set of orders by which the National Disaster Management Authority (National Authority) requests all Government Ministries/Departments including State/Union Territory Governments to take effective measures  to prevent the spread of Covid-19 in the country. The National Authority has the power to issue guidelines¹ on how the lockdown should be implemented, and can request the government to comply with their directions and implement them strictly. These lockdown orders are published on the Ministry of Home Affairs website.

During the lockdown period, the government provides and allows the provision of many essential services , whereas non-essential services are temporarily suspended. For example, essential services like medicines are available while non-essential services like amusement parks may be stopped for some time. Some of the services available also depend on the State Government, so it is important to know the directions given in the State. 

1. Section 6, Disaster Management Act, 2005 [↩]

Covid-19 Tests

The following Covid-19 tests are done in India(( Testing Stratgey, Indian Council for Medical Research, available at, https://www.icmr.gov.in/pdf/covid/strategy/Testing_Strategy_v6_04092020.pdf)):

Rapid Antigen Test (RAT): 

An antigen refers to any foreign matter or viral proteins in the body that triggers an immune response. This test helps identify the antigens related to the Covid-19 virus. Antigen test, also known as rapid antigen test, is a rapid diagnostic test, but these tests have a higher chance of missing an active infection. 

RT-PCR: 

RT-PCR is a method of testing that is used to directly detect the presence of the virus in the sample. The test detects the RNA(Ribonucleic acid) of the virus which is the genetic material of the virus. 

TrueNat 

TrueNat is a chip-based, portable RT-PCR machine, originally developed as a portable diagnostic tool for tuberculosis. The latest versions of the TrueNat machine can detect an enzyme (called RdRp) found in the RNA of the coronavirus SARS-CoV-2.

Antibody test

An antibody test, also known as Serology test, is a screening test for Covid-19 antibodies in the blood. It tells if someone was previously infected with the virus that causes Covid-19. The antibody test does not look for the active virus but checks whether the immune system has responded to the infection.

Costs of Covid-19 Tests

The Government  has arranged for  free Covid-19 testing  at approved laboratories across India. Although the test is not free in private labs and hospitals, the Supreme Court(( Shashank Deo Sudhi v. Union of India, 2020 SCC OnLine SC 358)).has stated that free testing should be done for the poor who are eligible under the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana. Beneficiaries of this scheme will be able to  access  free testing in private labs and access to Covid-19 treatment at government empanelled hospitals.

To get tested  free of cost, a person can go to any government hospital. Calling the helpline numbers before getting a test done will enable a person to get updated information. Please see here for the list of government and  private clinics for testing of Covid-19, as released by Indian Council of Medical Research.

When States impose a curfew, they pass orders under Section 144 of the Code of Criminal Procedure , 1973 (Section 144). A curfew is imposed in districts and States to prevent the localized spread of Covid-19 based on the number of cases in that particular area. This is an administrative power that rests with Magistrates in a district and they even have the power to restrict services during a curfew be it entertainment, transport etc. For example, a curfew order may be for specific districts asking people not to move out of their houses after 7 pm. This is different from lockdowns, which are imposed by the Central Government and disaster management authorities to take action and give guidelines for States as well as the whole of India to control and reduce the impact during the outbreak of any epidemic or pandemic. For example, imposing a travel ban between states to prevent movement of people during the epidemic.

The District Magistrate, Sub-Divisional Magistrate or Executive Magistrate, who is empowered by the State, passes the Section 144 order when immediate prevention is required. Such orders or directions aim at preventing or trying to prevent: 

• Any obstruction, annoyance or injury to any person
• Any danger to human life, health or safety
• Disturbance of public tranquility
• Riot or an affray (group fighting)

A Section 144 order can be directed either to a particular individual, group of persons residing in a place, or to the public in general when visiting a particular place. 

Restrictions under a curfew

The aim of the restrictions under a Section 144 order can be to¹:

• Prevent protests that can lead to unrest or riots. 
• Prevent epidemics which affect public health.
• Restrict anyone from carrying any sort of weapon. 
• Restrict movement of the public.
• Close particular educational institutions.
• Ban  any kind of public meetings or rallies. 

Violating curfew orders

Some of the punishments for violating Covid-19 curfew orders are(( Section 269, Indian Penal Code, 1860; Section 188, Indian Penal Code, 1860, Section 143, Indian Penal Code, 1860, Section 147, Indian Penal Code, 1860, Section 55, National Disaster Management Act, 2005)):

• Negligently spreading infection of a disease. The punishment is jail time up to six months and/or  fine.
• Disobeying an order issued by a public servant . The punishment is jail time up to six months and/or Rs. 1000.
• Being a member of an unlawful assembly. The punishment is jail time up to six months and/or  fine. 
• Rioting.The punishment is jail time up to two years and/or  fine.
• Punishment for Obstructing an officer or Government employee. The punishment is jail time up to one year and/or fine.

 

1. Section 144, Code of Criminal Procedure, 1973 [↩]

The Central Government has released an official Covid-19 tracker app i.e. the Aarogya Setu app. It tracks  community transmission and traces the contact and travel history of individuals who are quarantined, using both location data and Bluetooth-based proximity tracking on users’ phones. This is one means of contact tracing.

Certain states also have applications that track  the mobiles of people who are under quarantine. Some examples of such apps are Quarantine Watch by the Government of Karnataka, SMC COVID-19 Tracker by the Surat Municipal Corporation, Gujarat,  Mahakavach by the Government of Maharashtra, etc.

The patient’s health also gets monitored regularly by the District Surveillance Officer at a district level, who facilitates further follow up by the surveillance teams. The health status of those under home isolation is monitored by the field staff/surveillance teams through personal visits along with a dedicated call center to follow up with the patients on a daily basis. The clinical status of each case is also recorded by the field staff/call center (body temperature, pulse rate and oxygen saturation)(( Revised guidelines for Home Isolation of very mild/pre-symptomatic/asymptomatic COVID-19 cases, Ministry of Health & Family Welfare, accessed at https://www.mohfw.gov.in/pdf/RevisedHomeIsolationGuidelines.pdf)).

 

In India, the Drugs and Cosmetics Act, 1940 regulates the manufacture and distribution of  drugs and vaccines.

Authority regulating vaccines

The Central Drugs Standard Control Organization (CDSCO) is the main regulatory authority. The Drugs Controller General of India (DCGI) is an official member of the CDSCO who is the final regulatory authority for the approval of clinical trials in India.

Procedure for approval for vaccines

The detailed procedure that needs to be followed to get approval for producing vaccines that can be used by the public involves :

Application for approval to manufacture the vaccine 

No vaccine can be manufactured for sale without approval from the Licensing Authority appointed by the Central Government. The manufacturer must apply to the Licensing Authority to allow manufacture of the vaccine((  Section 122B, Drugs and Cosmetics Act, 1940)).

Application for permission to conduct clinical trials for the vaccine 

• Clinical trials need to be conducted for the vaccine with the permission of the Licensing Authority.
• The Licensing Authority will give permission to conduct the clinical trials based on a few conditions. The clinical trial has to be conducted according to specified protocols and ‘Good Clinical Practice Guidelines’, and the approval of an Ethics Committee is needed before conducting the trial. Further, the clinical trial must be registered at the Clinical Trials Registry of India. The Licensing Authority’s permission is required to import a vaccine from a foreign country. While applying for permission, the vaccine importer must submit data on the results of local clinical trials of the vaccine carried out according to the specified guidelines. However, this is not necessary if the drug is of such a nature that the Licensing Authority in public interest decides to grant permission on the basis of data available from other countries((Section 122DA, Drugs and Cosmetics Act, 1940)).

Suspension or cancellation of permission 

If the Licensing Authority feels that all the required conditions are not fulfilled, it can also cancel the permission for conducting trials after giving reasons for such cancellation. A person can approach the Central Government to appeal against any order of the Licensing Authority(( Section 122DB, Drugs and Cosmetics Act, 1940)).

In India, the Government’s regulator for drugs CDSCO (Central Drugs Standard Control Organization) has allowed two vaccines which are:

• Covishield (Oxford-AstraZeneca vaccine developed in the UK) and 
• Covaxin (by Bharat Biotech). 

These vaccines have only received the permit to be used in a restricted manner for emergency situations. This means that they can be used despite the companies not having completed the entire procedure of clinical trials(( Press Statement by the Drugs Controller General of India (DCGI) on Restricted Emergency Approval of COVID-19 Virus Vaccine,  accessed at https://pib.gov.in/Pressreleaseshare.aspx?PRID=1685761#:~:text=The%20Subject%20Expert%20Committee%20of,III%20clinical%20trial%20of%20M. Covishield and Covaxin Is in Phase II/III and in Phase III of clinical trails respectively (as on Jan 2021.)). 

Cost and manner of vaccination

Currently, the vaccine provided in the first phase of vaccination will be given free of cost. Two doses of the same vaccine, given 28 days apart, will be required to be taken by an individual to complete the vaccination(( FAQ on COVID-19 Vaccines,  Ministry of Health and Family Welfare, accessed at https://www.mohfw.gov.in/pdf/FAQsonCOVID19VaccineDecember2020.pdf))

Priority groups getting vaccinations

The first phase of the Covid-19 vaccine will be administered to priority groups including:

• Health Care Workers (HCWs): Health care providers and workers in health care settings (Public and Private), including ICDS (Integrated Child Development Services) workers. 
• Frontline Workers (FLWs): Personnel from State and Central police department, armed forces, home guard, prison staff, disaster management volunteers and civil defense organization(( Directorate General, Fire Services, Civil Defence & Home Guards, Ministry of Home Affairs, available at https://dgfscdhg.gov.in/civil-defence.)), municipal workers and revenue officials engaged in Covid-19 prevention, containment, surveillance and associated activities. 
• Persons More than 50 years of age and less than 50 years with co-morbidities like diabetes, hypertension, cancer, lung diseases etc(( COVID-19 Vaccines Operational Guidelines, Ministry of Health and Family Welfare, accessed at https://main.mohfw.gov.in/newshighlights-3)).

Process to get vaccinated in India 

Covid-19 vaccine will be provided only to beneficiaries pre-registered in the COVID Vaccine Intelligence Network (Co-WIN) system at www.cowin.gov.in(( COVID-19 Vaccines Operational Guidelines, Ministry of Health and Family Welfare, accessed at https://www.mohfw.gov.in/pdf/FAQsonCOVID19VaccineDecember2020.pdf)).

Step 1: Registration

Any person can register  by providing  basic demographic details like name, date of birth, permanent and current address, and details of co-morbidities, if any.  They will be required to provide their photo identity from one of the following: 

• Aadhaar Card
• Driving License
• Health Insurance Smart Card issued under the scheme of Ministry of Labour
• MGNREGA Job Card 
• Official identity cards issued to MPs/MLAs/MLCs
• PAN Card
• Passbook issued by Bank/Post Office
• Passport
• Pension Document
• Service Identity Card issued to employees by Central/State Govt./PSUs/ Public Limited Companies
• Smart Card issued by RGI under NPR 
• Voter ID Card

Step 2: Date and Place of Vaccination

Following online registration, the beneficiary will receive an SMS on their registered mobile number regarding the Health Facility where the vaccination will be provided, along with the scheduled date and time for the same. 

Step 3: Verification of Identification Proof

The Photo ID produced at the time of registration must be produced to the health officials and they will verify it  at the time of vaccination(( FAQ on COVID-19 Vaccines,  Ministry of Health and Family Welfare, accessed at https://main.mohfw.gov.in/newshighlights-31)). 

Step 4: Acknowledgment after receiving the vaccination

On getting a due dose of Covid-19 vaccine, the beneficiary will receive SMS on their registered mobile number. 

Step 5: Results

After all doses of vaccine are administered, a QR code based certificate will  be sent to the registered mobile number of the beneficiary. Their information will be uploaded on the Co-WIN platform(( FAQ on COVID-19 Vaccines,  Ministry of Health and Family Welfare, accessed at  https://main.mohfw.gov.in/newshighlights-31)). 

Even after getting vaccinated, people are required to continue taking the key precautions like wearing a mask, maintaining hand sanitization and physical distance ( 6 feet or Do Gaj)(( FAQ on COVID-19 Vaccines, Ministry of Health and Family Welfare, accessed at  https://main.mohfw.gov.in/newshighlights-31)).