hurt my heart why dontcha.

Chapter Two- “no body, no crime”

“No body, no crime. I wasn’t letting go until the day he died.”

Word Count: ~2300 words

Warnings: Drinking (legal), missing person, references to death & murder, mentions of an affair, mentions of guns and blood

Characters Mentioned: Neutral!Reader

Minor Original Characters Featured: Este, Lennox, Mark, Bella, Detective Hooper

A/N: I am soooo sorry for how long this chapter took to come out! Between college starting back up and spraining my wrist in a fall, it’s been impossible to write. But here is chapter two!! This chapter is where things really start to happen, and next chapter we’ll see some familiar faces again 😉 Anyways, I hope y’all enjoy the chapter!

Previous chapter

Next chapter

A few days later…

“I hope you don’t mind, but I might be pre-gaming for our dinner tomorrow.” You had said while on the phone with your friend Este the night before. “The last few days have been.. brutal.” You knew she could hear the shakiness in your voice, the remnants of the tears unshed as you tried to keep them at bay. But she didn’t say anything, and that’s why you loved her so much. 

“Be safe and I’ll see you tomorrow. Drink one for me.” You let out a teary laugh and hummed in agreement as you took another sip from your wine glass. “Love you, Y/N.”

“Love you, too. Goodnight.” “Goodnight.”

You rushed into Olive Garden the next day, a jacket over your head in an attempt to shelter yourself from the rain that started the second you parked at the restaurant. The cherry on top of your day. You fixed your hair haphazardly before you looked around the dining room, and you smiled when your eyes landed on your friend, at your usual booth.

“Y/N, welcome back. You know your way to your spot now, I’ll be right there with your usual.” Lennox, a familiar waiter, said as they passed you, a bright smile on their lips.

“What would we do without you, Lennox?” You offered a smile as you walked over to Este.

“I’m a big fan of the rained-on look, Y/N. Not many can rock that like you.” You rolled your eyes as you sat down across from her, and you took in your friend’s appearance. Her eyes were tired, the concealer applied a little heavier under her eyes than usual. Her outfit looked flawless, but her nail polish on her thumb was chipped. Her hair held their curls beautifully, except for the one curl that had been messed with until it was nearly straight- her nervous habit. 

“Oh, you know, nothing like a little rainstorm to spice up my outfit. Who needs to accessorize when you can get rained on?” You paused as your waiter came over with a glass of your favorite wine, and you thanked them before looking at Este. “You look tired.” You swirled your glass of wine before taking a sip, giving her a chance to speak. 

“I hate profilers, you know that?” She sighed but confessed. “It’s Mark. He’s been… off lately. I think he’s cheating on me.” You raised a brow at Este, setting your glass down to speak.

“Why do you think that?”

“He comes home from work late with the taste of cheap merlot on his mouth, and I got the latest bank statement. I don’t know what he got at the jewelers, but it isn’t mine.” She took a sip of her wine before looking at you, her eyes filled with determination. “I think I’m gonna call him out.”

“Are you sure? You don’t have any solid evidence yet, and I don’t want you rushing into something you might regret.” 

“Evidence? You’re making it sound like he committed a crime, Y/N. He may be a cheater, but he isn’t, like, a murderer.” Este drummed her fingers against the table. “And you’re right. I can’t prove it yet.” She paused as our food was set up at our table and didn’t speak again until the waiter walked off. “But I’ll catch him, and that’s a promise.” 

-

You sat at your usual booth, and you took small sips from your glass of water as you scrolled through your phone. You were distracted though, and it was obvious. Your eyes flickered from your phone, back to the dining room, back to your phone. It had been nearly half an hour since you arrived at Olive Garden, and you hadn’t heard from Este. Este had an occasional habit of running late, but she’d always text or call you saying she was on her way. You checked your messages and voicemail once more and frowned when you saw you hadn’t missed anything. You took another sip of your water as you settled back into the booth. I’ll wait another half hour, you decided.

-

Straight to voicemail. “Este. Call me back when you can, please. It’s been an hour, and I haven’t heard from you.”

Straight to voicemail. You dialed another number, panic beginning to rise in you. “Hi, Eleanor. Did Este come into work today? No? Okay, thank you. Bye.”

Straight to voicemail. “I hope you’re okay, but I’m so mad at you for scaring me like this. Let me know you’re okay, please? I’m calling Mark now. Love you.”

#

“The Fairfax City Police are asking for help regarding the disappearance of Este Williams. Mrs. Williams was reported to be seen last by her husband, Mark Williams, when she left due to an emergency call at work Monday evening. A friend of Mrs. Williams was supposed to meet with her on Tuesday evening, but Mrs. Williams never showed, leading to her husband reporting her missing that night. On screen is the most recent picture of Mrs. Williams and if anyone has any leads on her disappearance, please call the number listed below. An investigation has been opened and a local search and rescue will be organized.”

-

You couldn’t remember how long you had been in your car. You didn’t have a destination in mind when you left this morning, but you found yourself driving around Fairfax, around all of Este’s favorite spots. Sal’s Diner, the botanical garden, Wendy’s Coffee Shop. Everywhere you two frequented you had driven past that day, but there was no sign of Este anywhere. A week had passed since she was reported missing, and the local police department’s presence slowly faded into the usual patrols. Two weeks later, the search party had been called in and seemed to grow smaller and smaller with each passing day. Their discouragement was obvious due to the lack of findings regarding Este, whispers spreading through the streets that she had just left for bigger things. But you refused to believe your best friend had uprooted and disappeared without even a text. She had just been accepted into her doctorate program at Georgetown, she was supposed to attend her sister’s wedding. Something was off about this situation, and you spent your free time looking for anything that could result in finding your friend. 

By the end of the night, you found yourself in her neighborhood. You drove past her house, slowing to a stop when you noticed an unfamiliar car in the driveway. You then noticed Mark’s truck beside the car, the usually dirty vehicle now cleaned to where it almost sparkled in the moonlight. You parked off to the side, and you strained to look into the windows of the home. You could see the brief silhouette of Mark standing, and a woman on the couch. The unanswered call and texts flashed through your mind, and you gripped the steering wheel, your knuckles turning white from the harshness of your grip. Deep breath, Y/N, relax. You took a deep breath and relaxed your fingers, turned your car off, and leaned back in your seat. Not your first stakeout, and it won’t be your last. You knew Mark was involved but you just couldn’t prove it. Yet. And when you can prove it, Mark better pray to every god above.

-

Days had passed since you first started watching Mark. Your days started to blend into a cycle: your new glamorous job cleaning houses, a quick trip home to change, then driving to Este and Mark’s house. There were moving trucks the other day, Mark’s mistress moving in. Into Este’s home, where she slept. The garden she grew was torn out and covered up, every sign of Este ever existing was disappearing day by day. Deep down, you knew you couldn’t do anything to Mark. You weren’t in the FBI anymore, you couldn’t touch him. But all rationality had flown out the window when your friend’s disappearance had reached a month. You had spent hours in your car, waiting for the perfect time to find any evidence that would prove what Mark had done. And finally, an opportunity jumped out at you. 

You had a day off work and you found yourself on the front porch of Este and Mark’s house. There was Mark’s truck in the driveway, and as you knocked on the front door, you had to control your emotions. Feelings of rage coursed through your veins, and you shoved your hands into your pockets. Inhale, one two three, exhale. You are calm, cool, and collected. The door swung open and you plastered on a smile when you were greeted by Mark’s face. 

“Mark, hi. How are you? May I come in?” Mark’s confused expression morphed into a nervous expression, but he nodded and stepped aside.

“Please, come in.” Mark smiled at you, but you quickly recognized the fake smile. “I’m sorry, I wasn’t expecting company. Is everything okay?”

“Yeah. Just want to talk.” You walked through the doorway, the weight of your gun tucked into its spot in your waistband, concealed by your jacket. “About Este.” You closed the door and locked it behind you.

-

“Bella?” You asked as Este’s sister answered the phone. “I need a massive favor.”

“Of course, anything. What is it?”

“If anyone asks, I was with you today. We spent the afternoon together. Boating.” A pause.

“Is everything okay, Y/N?”

“I promise I’m okay. Speaking of boating, the Potomac River is gorgeous this time of year. We should go soon. This weekend?” 

“Sounds perfect. I’ll bring drinks, you sound like you could use a few.”

“Trust me, B. This is the best I’ve felt in a long time.”

-

A knock on the door interrupted you from your reading, and you walked to the door. You opened the door to reveal a police officer standing on your front step. 

“May I help you, Officer?”

“Detective Hooper. May I come in?” Detective Hooper flashed his badge and you nodded, letting him in.

“Please, come in. Help yourself to a seat, can I offer you a drink?” You asked as you led him to the living room, where you sat on the couch. The detective took a seat on the opposite end, and you sat up straight, attentive.

“That won’t be necessary. Y/N Y/L/N, I was the detective assigned to the case of your friend, Este Williams. As you are likely aware, there’s been no new developments in her disappearance case. Until today.” Look shocked,  you don’t know this. You looked at Detective Hooper with furrowed brows. “What was a disappearance case has now evolved into a murder case, and I believe Mrs. Williams was the first victim, Mr. Williams being the second.”

“What?” You let your head fall back against the couch and screwed your eyes shut. “She’s really- they’re really? They’re dead?”

“We still have yet to find Mrs. Williams, but we received a call that led to us recovering Mark Williams’s body in the Potomac River.” Detective Hooper looked at you with what you believed to be sympathy. The best he could show it with his job, at least. Okay, a little more sad. Your bottom lip trembled as you rubbed your eyes, taking a shaky breath. 

“What are you going to do? To find my friend? And to get justice for her husband?”

“That’s what I’m here for. We have no leads in this case, and you’re the closest person to the Williams, except for Mrs. Williams’s sister. I have a couple of questions if that’s okay?”

“It’s okay.” You sat up. “Anything to help.” You answered a few questions about how you knew the Williams, emphasis on your background with Este, and questions that delved deep into the relationship of Mark and Este. Did they have any problems? Who were their friends? Their enemies? Then the questions turned to you. What had you done the day Mr. Williams was murdered?

“Well, I’d usually have work. Cleaning houses.” You thought back to earlier, where you washed the blood splatter off your face, then cleaned your car to perfection. “But I had a day off. So I went to the docks and got my boat, it was a beautiful day on the Potomac.”

“You have a boating license?”

“My dad made me get one when I was fifteen.” You smiled. “Birthday present.”

“Were you alone?” He asked and leveled you with a look, in an attempt to see if you’d crack. 

“Este’s sister was with me.” You didn’t hesitate. “Ever since Este’s disappearance, I’ve been spending more time with her than I did before.” You admitted. Detective Hooper studied your face for a minute before he sighed.

“Thank you for answering all my questions. If you can think of anything else that could help us solve this case, please give me a call.” He handed you his card and you took it, and you tucked it into your pocket. “I’ll get out of your hair now. Thank you again for your time.” You and the detective stood and you walked with him to the door. As he let himself out, you paused to speak. 

“Detective?” He turned around to face you again. “I don’t know if this is any help, but I’d check into Mark’s mistress.”

-

“An arrest has been made in the disappearance of Este Williams and the murder of Mark Williams of Fairfax, Virginia. Mrs. Williams has yet to be found, but Mr. Williams was found to be murdered. Investigations are still underway and if there are any clues on the location of Mrs. Williams, please call the number below to be directed to our hotline.”

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A Lovelit Sky

Ships: PruHun

Characters: Prussia, Hungary; mentioned Austria

Summary: Grappling with the recent death of his beloved Old Fritz, Prussia finds himself running away from his emotions in Vienna. He winds up before Hungary, all his emotions pouring lose in his vulnerability.

 Vienna, 1786.

Prussia had never been more alone. It had been two months since his beloved king had died, two months since he had to watch Frederick be laid to rest, two months of nonstop aching. He'd become zombie-like, moving through each day in a haze. In Berlin he found himself completely alone. All of Frederick's closest friends died before him and his family hadn't been sorry to see him go, leaving Gilbert to mourn by himself. He tried burying himself in his work to take his mind off things or traveling throughout Brandenburg to escape his ghost, but it was impossible. There were remnants of Frederick everywhere in the kingdom. Home was no longer safe.

His quest to escape had led him south into Austria. By the time he was in Vienna, he had begun feeling a bit better. There were no painful memories here, no past to torment him as he tried to forget. His feet carried him to Roderich's house, his body operating on autopilot. He only fully grasped where he was once he was standing below Roderich's bedroom window. Gilbert looked around, silently cursing himself. The place was so big, he could probably break in to rest for the night without being noticed. But what was the point if he didn't see...? His heart lurched. He needed company.

Gilbert began throwing pebbles against the window, praying to Fritz that the right person would notice. A flash of brown hair. His breathing caught in his throat. He stood frozen, waiting to be discovered. Even if he wanted to flee, his feet found themselves cemented to the grass.

Erzsébet appeared before him in a sheer nightgown. His heart jumped to his feet and he stared like an idiot. "Gilbert, what are you doing here? It's the middle of the night." She examined him closely. His eyes were far away, his hair and clothes disheveled, and there was a slight tremor to him. "Are you okay?"

He tried to communicate but found it difficult to speak without breaking down right there. He weakly shook his head. "Come on, there's a bench back here we can sit on." She took his hand and led him deep into the garden. "Did you walk the whole way here? Does anyone know where you are?" His silence was telling. Erzsébet closed her eyes and shook her head. She was in for a long night.

Eventually, Gilbert regained his power of speech. "Aren't you cold?" If he focused on her, he wouldn't have to deal with his own pain. If he could take care of her then maybe he would begin to feel like a man again instead of an empty husk.

"You shouldn't be worrying about me." Her voice was stern where it normally would've been tender. "Don't deflect, you look awful. What happened to you?"

He began fidgeting his hands, staring at them intently. "The old man died. No one seems to care but me. There was a small formal mourning period, but then it was back to work like nothing happened." He sneered at the ground, the memory leaving a bitter taste within him. "The greatest man I've ever known, who I loved like a father, dies and they expect me to embrace my new king? To pretend like everything's wonderful and nothing dear to me was lost? It's disgusting, it's treacherous."

Hungary tried to be understanding but couldn't wrap her mind around being this upset over a human. They died, it's what they did. Why would that be so shocking this time? "Did you really expect him to live forever? You had to know this was coming, I can't imagine how old he was." She saw his grimace and quickly attempted a change of strategy. "Regardless, I am sorry for your loss. I suppose even knowing what's inevitable doesn't make it easier when you truly care for them." While she hadn't experienced such a loss, she remembered how hard Roderich was hit by the death of Maria-Theresa. It was the only frame of reference she had.

Prussia sniffed, offended. "Of course I knew this would happen. How stupid do you think I am? It wasn't something I ever tried to prepare for since it was something I tried to never think about." He looked up at the stars and frowned. "I only realized how alone I'd been till I was with him. Now that he's gone, the loneliness hurts even worse. I have no one back in Berlin who cares for me." He rolled his eyes. "Well, they care for Prussia, but they could give a damn about Gilbert."

She took his hand and squeezed it gently. "I think you're being a bit melodramatic. I'm sure there's plenty of people back home wondering where you ran off to. I'd be surprised if Brandenburg wasn't worried."

"Brandenburg keeps to himself. He cares for me as long as it means I'm doing all the work and he can do whatever he wants in his castle." He shook his head. "My generals only like me when I'm holding a weapon. My ministers tolerate me at best. Most of the royal family views me more as the immortal family pet, which isn't exactly said with any warmth."

Silence settled between them, only the calls of owls filled the air. Erzsébet felt a pain for Gilbert. She could understand the sense of isolation such an existence would bring. There certainly were parallels with her current home life, but at least she had people outside she could talk to. She often traveled to Warsaw to catch up with Feliks or to feel that her company was appreciated by someone. She faintly remembered Gilbert being close to Francis but couldn't imagine that friendship being very secure after the most recent wars.

He sensed her pity and tried to compensate for it. "I write letters to Ivan and still keep up a correspondence with Antonio. I've got some friends, even if I'm going years between seeing them. Please don't worry about me." He faked a smile that convinced neither of them. Giving up, he sighed and kissed the top of her head. "I've got you. I've always had you, Erzsi." It was the first sign of genuine happiness she'd seen in him the whole night.

He tucked a strand of hair behind her ear. Their eyes met and a warmth spread throughout his body. It all made sense now. They'd been by each other's side for centuries, through immense highs and lows. Whenever he felt too weak to continue, he'd always found his way to her and she would always revive his spirits. There was no one else he was able to trust with the most intimate parts of himself. He'd never been able to confide in Ivan and Antonio - and certainly not that bastard France - like he was able with her. Being with Erzsébet was so freeing, it was intoxicating. It had always been the one thing he'd wanted more than anything else in this world, and the one thing he could never quite achieve for himself. His recent loss was making him vulnerable and he couldn't stop himself. "I love you, Erzsi." Gilbert cursed himself, wanted to take it back and couldn't. "I've loved you for so long." He bit his tongue, trying to prevent himself from repeating the words like a lunatic.

Erzsébet's body tensed up. She averted her eyes from his, focusing on the bush in front of them. What he was saying didn't surprise her, but it was the last thing she wanted to hear. If he admitted his feelings, that changed things for them. They had been having an affair for some time now, but it had remained purely physical with no deeper emotions. At least, she deluded herself that that's all it was. She'd known when she proposed the damn thing to him that he'd been enamored with her since they were children and, while she had a childhood crush on him as well, she pretended that she'd outgrown it. She refused to acknowledge that she imagined Gilbert falling asleep besides her at night, that she replaced Roderich with Gilbert when they had sex (it certainly wasn't making love!), that she didn't feel a magnetism around Gilbert when they were in a room together. Erzsébet was married, she couldn't allow herself to feel love for another man. It would make everything even more complicated.

So Erzsébet sat there, stiller than a statue, all this running through her mind while Gilbert poured his heart out to her like a lovesick moron. She bit her thumb, hoping the pain would force her to focus on anything else. She should've stayed in bed. If she'd ignored him, Gilbert would've been forced to leave eventually. None of this would've happened, they could've gone on as they always did. Eventually, he stopped talking. Erzsébet allowed herself to look at him again once he was silent. He was staring at her expectantly. She supposed she did have to speak to him. "What do you want me to say?"

"What do you think I want you to say?" She winced. His exasperation made sense. "I definitely don't want you to ask a stupid question like that!"

"Love is complicated." She felt his expectations boring down on her. Erzsébet sighed. "I think you're exhausted. How can you be so sure of yourself without being rested?"

"If you don't love me, say so. I'll be able to handle it." They both knew that was a lie. In his current state, he wouldn't be able to handle much more emotional upset.

"I'm married. I love my husband." Another lie. The expression on his face called her out. "Alright, I don't love Roderich. What good does me openly loving you do? It won't bring any of us closure. It's a pointless thing to say when loving you brings no joy." She paused, realizing she might have revealed too much. "Hypothetically loving you."

He caressed her cheek with his hand, smiling when she subconsciously leaned into his touch. "Because if we can't be together always, we can enjoy what time we do have together more. And then, no matter what, I know you’ll always have me in your heart and I’ll always have you in mine. Nothing could ever take that away from us." He kissed her forehead. "All I need is to know that, no matter how things may have to be, you'll always be mine, you'll always be the one I can turn to."

She closed her eyes, wrestling with her emotions in her mind. How lovely it all sounded, how easily she could picture it. It would be so easy, to slip into these fantasies and never come out. But reality nagged at her. In the real world, in the space she currently occupied, any happiness was fleeting. Any happiness was liable to be taken away from her. "He'll find out. What we're doing now upsets him enough, but he sees no reason to try and destroy it because there's no romance. I'm afraid that even if I whisper my feelings to you, the wind will pick them up and carry them to his ear." She shivered, the very thought chilling her to her bones. "Things are difficult for me, Gilbert. They're difficult in ways you can't quite understand. I can't be so free in my words."

"Then say so with your actions." He kissed her, his movements filled with desperation and longing. He wanted her, needed her, to confirm his feelings. To know he wasn't alone in his adoration. Despite her silent protestations, she returned his affection. Her heart cried out to her to say it, say it, say it. She wanted him to understand the conflicting nature of her desires and responsibilities. They parted and her eyes were filled with such ardor that it took his breath away. "I love you, Erzsi. You're my one constant. I would do anything for you, set the world on fire if you desired it. Anything you ask-"

She put a finger to his lips, shushing him. She quivered in anticipation. "What I want is for you to kiss me like that again and don't ever stop."

He complied. That night, they slept underneath the stars and within each other’s arms. It was the best rest Gilbert had gotten in months.

Coronavirus Outbreak: Why do grey rhino events reoccur? What important policy shifts are required? — Part 4

Grey rhino events happen all the time and everywhere. A few of the recent grey rhino events are—the 9/11 World Trade Centre bombings in New York in 2001, the 2020 Australian Bush fires, the 2008 global financial crash, the 2018 extreme rainfall event in Kerala, the 2009 swine flu. There were warning signs before each of these events; some were loud, and some were faint. We failed to hear or heed them. And each time a grey rhino lowered its head to charge, we beguiled ourselves into believing that it was only a threat and a charge will not happen. And after each charge, we paid a heavy price in the form of high death tolls, and loss of business and property.

The gap between risk and human perception of it

Human perception of risk is how humans—as individuals, organizations, and governments—subjectively assess the probability of a risk-bearing event happening. It is usually at variance with actual risk, i.e., the probability of a risk-bearing event happening. Human response to risk is driven by the human perception of risk, and not risk itself.

When risk from an event is low, human perception usually fixes it at an even lower level, consequently humans under-respond to the risk such an event poses, e.g., most smokers believe that their level of tobacco consumption will not harm them, and continue smoking. When risk is high, human perception tends to over-estimate risk and over-respond to the event, particularly if they feel that the risk is so high that death is imminent. For example, when the Bhopal gas leak happened, many persons abandoned their families and fled. Fear for their personal lives was so high that their family members no longer mattered.

Risk perceptions and responses are sometimes baffling and go contrary to trends. The Ersama super cyclone had a risk of 5,000 in a million (5000E-6) chance of death, considered as a high-risk. Yet, Odisha government’s sluggish action was due to its perception that the Ersama cyclone is likely to be of low intensity like the Ganjam cyclone that hit Odisha 10 days before the former.

In August 1994, Surat was struck by the ‘plague.’ It was a low-risk event with a mortality rate (5E-6) that was a thousand times smaller than that of the Ersama cyclone. Yet, fear of the plague caused an exodus of half million people from Surat. And that fear was not confined to Surat. A Delhi-based scientist who worked with the National Centre of Communicable Diseases, visited Surat to study the plague. When he returned home from Surat, he found that his home had no water or electricity. His neighbours had cut them to drive him out of their colony for fear that he carried back the plague. A family that fled Surat and sought shelter with friends in Thane district in Maharashtra was murdered by a neighbour for the same reason.

Risk perception is influenced by public memory which often is based on the experience of a few events. Public memory is short. In the last hundred years, India has seen several epidemics, but they have slipped from public and government memory. India lost almost 40 percent of 50 million persons who died in the 1918 Spanish flu, the largest number of deaths from any country that was hit by this pandemic. The Spanish flu contributed to an anti-British sentiment in India as this disease was brought to India by Indian soldiers who fought in World War 1 in Europe as part of the British army. But the British showed little care for India’s plight. Yet, there is little mention of the Spanish flu in Indian history.

Risk response is driven by economic status, culture, and a society’s belief in its ability to control the course of events. The confidence with which Singapore, Hong Kong, Taiwan, and South Korea fought the coronavirus is due to their experience and success in battling the SARS and other epidemics, and the knowledge that they have a robust public health-care system.

Altering risk behaviour

To mitigate risk, it is not material whether risk or human perception of it is greater. What matters is the gap between the two. The larger the gap between them, the more difficult it is to alter human behaviour to the risk and consequently mitigate risk.

Though India was aware of the Wuhan outbreak for a month before the first Indian case was reported end-January, the Indian government woke up to coronavirus risk only in mid-March. They had under-assessed the coronavirus risk and are under-prepared for it, just as they had the under-assessed risk of numerous grey rhino events that have occurred in the recent past—1984 Bhopal gas tragedy, 1999 Ersama cyclone, 2001 Bhuj earthquake, 2004 Indian Ocean tsunami, 2005 extreme rainfall event in Mumbai, the 2009 Kedarnath cloudburst 2015 extreme rainfall event in Chennai, 2018 extreme rainfall event in Kerala, 2018-19 heatwaves in India. The loss of life in these events ranges 500-50,000. The Machlipatnam cyclone is a rare success story of an impending disaster being successfully averted. India’s preparedness in disaster management is rather poor.

Attempts to reduce risk through rules, laws, legislation, curfews, fines, campaigns, and other administrative methods do little to alter human behaviour to risk unless accompanied by programmes geared to alter risk perception. For example, campaigns to wear car seat belts and helmets by 2-wheeler riders have been unsuccessful in India.

For an effective risk response, perceived risk should ideally converge actual risk. Such convergence can be achieved best through the active involvement of risk bearers in risk mitigation programmes. There is then a strong case for community participation in risk mitigation. The strength of such a programme is the community’s readiness to tackle risks they perceive as important. In the weeks after the Surat plague ended, communities in Surat cleaned up their neighbourhoods without help from the municipal corporation.

Risks are tackled at four levels—local, national, regional, and global. Dehydration can be tackled at the local level with oral hydration therapy. Extreme weather events such as the 2018 heavy rainfall event in Kerala, can be tackled at the state or the national level by preparing emergency response plans and conducting mock drills in communities. The Asian Brown Cloud requires cooperation in the South Asian region. And the ozone hole in the atmosphere needs global cooperation.

Unlike most other hazard issues, COVID-19 must be tackled at all four levels. Interestingly, the coronavirus war is making South Asia foster regional cooperation again.

Prioritizing profits for business over reducing risk for people

In the early-1990s, Surat was a boomtown riding the globalization wave. It became the world’s biggest diamond cutting and polishing centre because of its skilled and cheap labour. Diamond cutting business owners became millionaires overnight. But Surat neglected basic city sanitation. Filth floated in heaps all over town and Surat earned the dubious distinction of being named the filthiest town in Western India. The Surat plague caused Gujarat to state huge financial losses.

The Surat plague was a consequence of prioritizing profits for businesses first over reducing risk for all people. The COVID-19 pandemic is also a result of this global outlook.

Transmission dynamics

To win the coronavirus war, it is important to understand its transmission pathways. Early information from a study being done by virologists in Heinsberg, the epicentre of the coronavirus outbreak in Germany, tell us that major COVID-19 outbreaks resulted from close gatherings over longer periods. Spread happened in Gangelt, a village in Heinsberg after an infected couple were at a carnival there in February; in Italy, after crowds gathered to watch football matches in Bergamo; and in Austria at the Ischgl ski resort.

There is little evidence to say that transmissions occurred through contaminated surfaces. The Heinsberg researchers swabbed doorknobs, mobile phones, toilets, remote controls, and other surfaces and found evidence of the virus on the swabs, but could not replicate the virus in a laboratory, i.e., the remnants of the coronavirus on these objects were no longer infectious.

Virologist Hendrick Streeck, the principal investigator of the Heinsberg study, said in an interview to The Guardian, “On the basis of our findings we’ll be able to make recommendations, It could be that the measures currently in place are fine, and we say: ‘Don’t reduce them.’ But I don’t expect that I expect the opposite, that we will be able to come up with a range of proposals as to how the curfews can be reduced.”

The Federal Institute for Risk Assessment (BfR) emphasises that infection through contact with ‘contaminated objects’ has not yet been proven. Initial findings also indicate that that the chances of transmission in supermarkets, restaurants and hairdressers appears to be low.

A trickle of information from Wuhan points a finger in the same direction. The WHO report on the Wuhan outbreak states, “In China, human-to-human transmission of the COVID-19 virus is largely occurring in families.”

Virus transmission dynamics are contextual. While Heinsberg and Wuhan transmission dynamics may have takeaways for India, the dynamics in India needs to be understood. Being a big and diverse country, transmission dynamics may vary across the country. Consequently, disease control need not be a “one size fits all” strategy, which is what has been the thinking so far.

It is necessary for the government to explain its understanding of the transmission dynamics of coronavirus and justify its disease control strategy in that light.

Did lockdowns help?

For the last 3-4 weeks about a third of the world’s population is under some form of lockdown—local or national. Have lockdowns helped ‘flatten the curve?’ Are they more effective than other measures?

Most countries locked down when case numbers rose to high levels. India locked down when case numbers were low. A comparison of select countries that locked down and others that had not locked down but had controlled the disease (see Box 8) indicates that:

Locked down countries had a case per day growth rate mostly in double digits (7.8-17.5 percent). The high case growth rate in Germany is due to their extensive testing and detection of cases.

Despite a 4-week lockdown, India’s case growth rate for the lockdown period is 13.6 percent per day.

India’s high case growth rate during lockdown indicates that community transmission had started some time ago.

Transmission within the family may be a more important route for COVID-19 spread in India than was understood earlier.

Consequently, physical distancing, wherever possible, is an important mitigation measure.

Countries that did not lockdown but controlled the case growth rate started doing NPI early and implemented them strictly.

Countries in this sample that did not lockdown had a case growth rate largely in single digit (3.7-14.7 percent). The higher case growth rate of South Korea is attributed to extensive testing.

The NPIs generally followed by the non-locked down countries are extensive testing and surveillance, physical distancing, sanitizing, case isolation, contact tracing, quarantining suspect cases, use of personal protective equipment by health care and other personnel.

Based on the limited data from the sample of locked down and non-locked down countries presented in Box 8, the hypothesis that can be drawn is that:

Countries that acted early and adhered strictly to NPIs were able to control case growth rates without necessarily having to resort to disruptive lockdowns.

Countries that locked down generally started doing NPIs late.

Lockdowns, particularly after case growth gains momentum, have not been particularly successful in controlling case growth rates.

If India’s current case growth rate persists till May-end, there will be about 50,000 cases by April-end, 4 lakhs by mid-May, and 3 million by end-May. These numbers may move upward or downward depending on the disease control strategy changes India makes after 3 May, and how successfully they are.

Good practice case studies

Two Indian examples stand out for the outstanding work they did to control COVID-19 spread — Kerala at the state level and Bhilwara at the district level.

The growth of cases during the lockdown period, 25 March-24 April for India and Kerala were 13.6 and 4.8 percent, respectively. How did Kerala reduce COVID-19 spread? When Wuhan happened, the Kerala government knew that the coronavirus would come to Kerala through students from the state studying in Wuhan. Their experience with the Nipah virus taught them to start preparing early, so they began planning in January.

  When COVID-19 cases were first detected end-January, Kerala responded by testing aggressively for early case detection. At 610 tests per million population, Kerala’s test rates stand at one and a half the Indian average today. Kerala did painstaking contact tracing, longer quarantine periods, building thousands of shelters for stranded migrant workers, and distributing millions of cooked meals. To gain public support the Kerala government actively communicated with people, without which they could never have succeeded in doing early case detection and intense surveillance. They even planned evacuation routes for newly detected cases such that the patients had minimum contact with people along the way. The government made people their eyes and ears, and the partnership between the government and public helped to fight the coronavirus. Kerala is a model for the rest of the country.

Bhilwara, a textile town located in southeast Rajasthan, reported its first COVID-19 case on 19 March. This soon ballooned into 27 cases. Bhilwara district borders were immediately sealed, and four private hospitals and 27 hotels were commandeered by the district administration to accommodate cases. Between 22 March and 2 April, 22.4 lakh people were surveyed by nearly 2,000 health teams and 14,000 persons with flu-like symptoms were put on a watch list. The surveillance was relentless with visits to some houses made twice daily. Aggressive testing and contact tracing were done to identify cases. About 1,000 persons were put into quarantine centres and another 7,500 were home quarantined. On April 2, a complete lockdown was declared, and no one could step out of the home. Cooked food was supplied to the poor, and fodder was distributed for cattle. The outbreak was quickly controlled.

The lessons from Southeast Asian countries that were successful in controlling virus spread are like those from Kerala—prepare early, and follow WHO’s mantra ‘test, treat, trace’ aggressively. Hong Kong, Singapore, and South Korea did 30-50 times more testing per 1 million population than India has done (see the table in Part 2 of this article). These three countries along with Taiwan and Vietnam did not declare a national lockdown. Testing, case detection and isolation have a strong influence on ‘flattening the curve.’ South Korea was so confident of winning the coronavirus war that it even held national elections on 15 April when 44 million masked and gloved voters went to the polls to elect 300 representatives to the National Assembly.

India’s options to beat COVID-19

A vaccine for COVID-19 is 12-18 months away. A lockdown will not stop the spread of COVID-19. It can only slow it down. Lockdowns merely provide a little breathing space for preparing for the next move.

The lockdown in India has been extended from 15 April to 3 May and in some states a little beyond that. What will India do after 3 May? India has only two options until a vaccine becomes available or coronavirus weakens.

The first option is to do repeated lockdowns (suppression strategy) when case numbers rise after a lifting a lockdown as populations do not acquire herd immunity in a suppression strategy.

Repeated lockdowns will further disrupt the economy and cause enormous stress to people, particularly to unorganized sector labour, the self-employed, and farmers. It will also keep the supply chain of goods and services broken, which could then trigger an economic slowdown. A health crisis could develop into an economic and humanitarian crisis of a huge magnitude, with the possibility of a rise in hunger, malnutrition, and disease, resulting in possible hunger deaths and suicides.

The second option is to adopt a mix of mitigation strategy measures (physical distancing, sanitizing, case isolation, quarantining suspected carriers, aggressive testing, widespread surveillance, closing educational institutions) for the entire country, and using localized suppression strategy (localized lockdown) wherever hot spots appear. It is a mix of what is being done in Kerala and what was done in Bhilwara.

This approach allows the general population to develop herd immunity. It also gives the battered economy a fighting chance to recover and provide income to unorganized labour, self-employed and farmers. But the number of cases will rise, though more slowly. And there will be attrition. A small fraction of the cases will turn critical and require intensive care. And if the health delivery system is not ramped up sufficiently, the numbers of the critically ill who may not get adequate medical attention will rise. Mumbai is already running out of ICU beds.

Since the Indian workforce is relatively young, the risk of serious illness is low. But the vulnerable sections of the population — over-65-year olds and those with co-morbidities must be protected from exposure to the coronavirus. Doing this will test India’s ingenuity.

Partnering with people

A lot that may happen in the coming critical months will depend on the disease control choices that government takes. If government adopts the second option, which can control COVID-19 as well as avert a humanitarian and economic crisis, it can be implemented effectively only with public support.

For that, government must be more forthcoming with information and become more transparent in its actions by holding public consultations on issues like virus transmission dynamics, lockdown triggers, and the pros and cons of different mitigation strategies. The government should also become more inclusive in its decision making by co-opting the public into decision-making bodies.

The chances of winning the war against coronavirus increase if government emulates the Kerala model and makes people an equal partner instead of treating them as pawns to be locked down at government’s will and without offering an explanation.

Future challenges

Climate change is a more daunting challenge than coronavirus. The average global temperature rise is now 1.1oC above pre-industrial times. In 2015 governments of the world agreed that warming should be restricted to 1.5-2oC. The United Nations Environment Programme’s Emissions Gap Report 2019” (EGR2019) indicates that to remain under the 1.5oC redline, greenhouse gas (GHG) emissions must reduce by 7.6 percent per annum for the next decade. But GHG emissions are currently growing at 1.5 percent per annum, and at the current warming rate, we will cross the 2oC redline in about 2 decades and be 3-4oC above pre-industrial times by the turn of this century.

A 3-4°C warming will cause frequent extreme weather events; alter precipitation patterns; raise sea levels by ~1-2 m by 2100; create millions of climate refugees; shrink glaciers and reduce the Arctic sea’s ice extent; cause food and water shortages, increase hunger, deprivation, malnutrition, disease and poverty; degrade and destroy forests and biodiversity and decrease water, timber and other ecosystem services they provide; cause a sixth mass species extinction; cause loss of employment; disrupt the world’s social and political order, and trigger social conflict.

Climate change impacts will be slow and almost invisible initially but will grow exponentially, like the way COVID-19 cases grew. Without downgrading the priority given to the profits for businesses first outlook and upgrading the reducing risk for all people outlook, the impending climate change challenge cannot be met.

Food, water, health, and environmental security at the global level

For a risk minimization programme, people need three basic securities: food and water security, health security for natural and manmade risks, and environmental security.

In 2018, the United Nations (UN) spent approximately 15.1 percent of its budget on food security, 7.1 percent on health security and one percent on environmental security. The UN has three organizations for food (WFP, FAO, IFAD) security, three organizations for health (WHO, PAHO, UNAIDS) security and one organization for environmental security (UNEP). It has no dedicated organization for creating water security or doing risk mitigation.

If food and water, health, and environmental securities are to be boosted, the UN must set up a dedicated organization for risk mitigation and another for water security and must readjust its US$ 53-55 trillion budget to boost spending on these three securities from the current allocation of 23 percent of its budget to 30 percent, and which may be increased by two percent each year until these three securities together get 50 percent of the UN’s budget in time.

Like climate change, the COVID-19 pandemic is a global problem and can be best solved through global cooperation. The South Asian countries have realized this and are discussing possible collective action in the war against the coronavirus.

Food, water, health, and environment security should become fundamental rights in India

Three sections of Chapter IV: Directive Principles of State Policy of the Indian Constitution deal with certain aspects of food, health, and environmental security (see Box 9). These directive principles should now be re-framed to make food and water security, health security from natural and manmade risks, and environmental security to become fundamental rights for Indian citizens. Guaranteeing these rights and delivering them is the state’s fundamental duty. Without these rights, the right to life can only mean a right to physical life and not social life.

The 2020-21 budgeted expenditure of the union government is Rs 30.4 lakh crores. Of this approximately 12.5 percent is for food and water resources (Agriculture, cooperation & farmers welfare; Food & public distribution; Fisheries; Animal husbandry & dairying; Water resources; Drinking water & sanitation) 2.4 percent is for health (Health & family welfare; Health research; AYUSH; Pharmaceuticals) and (0.1 percent) is for the environment. Fifteen per cent of the budget, i.e., Rs 4.56 lakh crores, has been allocated for ministries and departments concerned with food and water, health, and environment.

A ministry or department must be setup for risk mitigation and another for water security. To guarantee food and water security, health security and environmental security to Indian citizens, the union and state governments must allocate 30 percent of their budgets for these securities. The budget allocation for these securities may be increased by two percent each year until they become 50 percent of the union and state governments’ budgets in time.

The Economic Survey of India, 2020 states that India’s Gross Domestic Product (GDP) was Rs 202.5 lakh crores in 2018 and estimates it to be Rs 217.5 lakh crores in 2019. The survey expected a 6-6.5 percent GDP growth in 2020-21, i.e., a growth by Rs 13.6 lakh crores. After the COVID-19 outbreak, the GDP growth rate for 2020-21 has been pared down to 1.9 percent to -2 percent. The loss to the economy will range Rs 9.5-18 lakh crores.

Allocation of 30 percent of the union budget, i.e., Rs 9.1 lakh crores for food and water security, health security and environmental security is less than the lower end expected loss in GDP growth (Rs 9.5 lakh crores) and half the higher end loss in GDP growth (Rs 18 lakh crores). Even if the 30 percent allocation budget of the state and union territory budgets is added, this investment is well worth as it would more than compensate for the loss of income and additional expenses that COVID-19 caused lakhs of families. The personal loss to families that lost lives cannot be measured in monetary terms.

More importantly, an investment in people’s welfare will move India towards becoming a nation that cares for its people, particularly its poor and vulnerable, and not be a nation that merely boasts of becoming a US$ 5 trillion economy by 2025. In the final analysis, is it not better to be a nation where we feel cared for rather than be a nation with a wee bit more money but with a dog-eat-dog attitude?

Box 8: Case growth rate, hospital beds, doctors in countries that had locked down and countries that did not and hospital beds and doctors - add

Country 1st case reported dt Progression of measures Computation start dt Computation end dt No of days in this computation No of cases- computation start No of cases-computation end Growth rate of cases/ day (%) Hospital beds/1000 population

Doctors/1000 population

World 17Nov Mixed 25 Mar 24 Apr 30 422,940 2,834,697 6.3

Countries that lockdown - add table

Country 1st case reported dt Progression of measures Computation start dt Computation end dt No of days in this computation No of cases- computation start No of cases-computation end Growth rate of cases/ day (%) Hospital beds/1000 population

Doctors/1000 population

India 30Jan 30Jan-24Mar-Limited progressive restrictions, 25Mar-13Apr National lockdown 25 Mar 24 Apr 30 536 24,530 13.6 0.7 0.76 Iran 18Feb 18Feb-3Mar-No restrictions, 4Mar-1Apr-Lockdown 4 Mar 1 Apr 28 2,336 44,605 11.1 1.5 1.49 UK 30Jan 30Jan-21Mar-No restrictions, 22Mar-1 Apr-Lockdown 22 Mar 1 Apr 10 5,018 25,150 17.5 2.5 2.83 France 22Jan 22Jan-8Mar-No restrictions, 9-17 Mar National recommendations, 18Mar-1Apr national lockdown 18 Mar 1 Apr 14 7,730 52,128 14.6 6 3.24 Italy 30Jan 30Jan-18Feb-No restrictions, 18Feb-13Mar-Local lockdown, 14Mar-1Apr National lockdown 14 Mar 1 Apr 18 31,506 105,702 7 3.2 4.02 Spain 4Feb 4Feb-10Mar-No restrictions, 10-15Mar-National recommendations, 16Mar-1Apr-National lockdown 16 Mar 1 Apr 16 7,988 95,923 16.8 3 3.87 Germany 25Jan 25Jan-13Mar-No restrictions, 13-17Mar-Local recommendations, 17-19Mar-Local lockdown, 19Mar-1Apr-National lockdown 19 Mar 1 Apr 13 12,327 71,808 14.5 8 4.19

Countries that did not lockdown 

Country 1st case reported dt Progression of measures Computation start dt Computation end dt No of days in this computation No of cases- computation start No of cases-computation end Growth rate of cases/ day (%) Hospital beds/1000 population

Doctors/1000 population

South Korea 20Jan 20Jan-21Feb- No restrictions, 22Feb-1Apr- No lockdown. National recommendations-Widespread testing and contact tracing 22 Feb 8 Apr 35 209 10,156 11.7 12.3 2.33 Taiwan9 21Jan 21Jan-21Mar No restrictions, 22Mar-1 Apr National recommendations 22 Mar 8 Apr 17 153 379 5.4 Hong Kong9 23Jan 23Jan-8Feb- No restrictions, 9Feb-1Apr- National recommendations 16 Feb 8 Apr 53 56 961 5.5 Singapore9 23Jan 23Jan-7Mar- No restrictions, 8Mar-1Apr National recommendations 8 Mar 8 Apr 62 138 1,623 4.1 2.4 2.28 Vietnam 20Jan 20Jan-12Feb-Nno restrictions, 13Feb-3Mar- Local lockdown, 4Mar-26Mar No restrictions, 27Mar-14Apr National recommendations 27 Mar 14 Apr 18 163 266 2.8 2.6 0.82 Japan 16Jan 16Jan-20Feb- No restrictions, 21Feb-1 Apr National recommendations 22 Feb 1 Apr 49 109 2,178 6.3 13 2.37 Sweden 30Jan 30Jan-11Mar- No restrictions, 12Mar-1Apr- National recommendations 12 Mar 1 Apr 20 500 4,435 8.8 2.2 4.19 Norway 21Feb 21Feb-13Mar- National recommendations, 14Mar-1Apr-Local lockdown 14 Mar 1 Apr 18 996 4,641 8.9 3.6 4.38 USA 18Jan 18Jan-17Mar- No restrictions, 18Mar-24Apr- Local lockdown 17 Mar 4 Apr 38 4,596 925,758 15 2.8 2.57

Box 9: Sections from the Chapter 4 Directive Principles of the Indian Constitution

41. The State shall, within the limits of its economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement, and in other cases of undeserved want.

47. The State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties

48A. The State shall endeavour to protect and improve the environment and to safeguard the forests and wildlife of the country

The author is an environmental engineer with specialization in risk analysis

Also read:

Is the COVID-19 pandemic a black swan or a grey rhino event? — Part 1

Coping with the lockdown but is India prepared for an outbreak? — Part 2

How do we mitigate the impact of grey rhino events in the future?— Part 3

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Grey rhino events happen all the time and everywhere. A few of the recent grey rhino events are—the 9/11 World Trade Centre bombings in New York in 2001, the 2020 Australian Bush fires, the 2008 global financial crash, the 2018 extreme rainfall event in Kerala, the 2009 swine flu. There were warning signs before each of these events; some were loud, and some were faint. We failed to hear or heed them. And each time a grey rhino lowered its head to charge, we beguiled ourselves into believing that it was only a threat and a charge will not happen. And after each charge, we paid a heavy price in the form of high death tolls, and loss of business and property. The gap between risk and human perception of it Human perception of risk is how humans—as individuals, organizations, and governments—subjectively assess the probability of a risk-bearing event happening. It is usually at variance with actual risk, i.e., the probability of a risk-bearing event happening. Human response to risk is driven by the human perception of risk, and not risk itself. When risk from an event is low, human perception usually fixes it at an even lower level, consequently humans under-respond to the risk such an event poses, e.g., most smokers believe that their level of tobacco consumption will not harm them, and continue smoking. When risk is high, human perception tends to over-estimate risk and over-respond to the event, particularly if they feel that the risk is so high that death is imminent. For example, when the Bhopal gas leak happened, many persons abandoned their families and fled. Fear for their personal lives was so high that their family members no longer mattered. Risk perceptions and responses are sometimes baffling and go contrary to trends. The Ersama super cyclone had a risk of 5,000 in a million (5000E-6) chance of death, considered as a high-risk. Yet, Odisha government’s sluggish action was due to its perception that the Ersama cyclone is likely to be of low intensity like the Ganjam cyclone that hit Odisha 10 days before the former. In August 1994, Surat was struck by the ‘plague.’ It was a low-risk event with a mortality rate (5E-6) that was a thousand times smaller than that of the Ersama cyclone. Yet, fear of the plague caused an exodus of half million people from Surat. And that fear was not confined to Surat. A Delhi-based scientist who worked with the National Centre of Communicable Diseases, visited Surat to study the plague. When he returned home from Surat, he found that his home had no water or electricity. His neighbours had cut them to drive him out of their colony for fear that he carried back the plague. A family that fled Surat and sought shelter with friends in Thane district in Maharashtra was murdered by a neighbour for the same reason. Risk perception is influenced by public memory which often is based on the experience of a few events. Public memory is short. In the last hundred years, India has seen several epidemics, but they have slipped from public and government memory. India lost almost 40 percent of 50 million persons who died in the 1918 Spanish flu, the largest number of deaths from any country that was hit by this pandemic. The Spanish flu contributed to an anti-British sentiment in India as this disease was brought to India by Indian soldiers who fought in World War 1 in Europe as part of the British army. But the British showed little care for India’s plight. Yet, there is little mention of the Spanish flu in Indian history. Risk response is driven by economic status, culture, and a society’s belief in its ability to control the course of events. The confidence with which Singapore, Hong Kong, Taiwan, and South Korea fought the coronavirus is due to their experience and success in battling the SARS and other epidemics, and the knowledge that they have a robust public health-care system. Altering risk behaviour To mitigate risk, it is not material whether risk or human perception of it is greater. What matters is the gap between the two. The larger the gap between them, the more difficult it is to alter human behaviour to the risk and consequently mitigate risk. Though India was aware of the Wuhan outbreak for a month before the first Indian case was reported end-January, the Indian government woke up to coronavirus risk only in mid-March. They had under-assessed the coronavirus risk and are under-prepared for it, just as they had the under-assessed risk of numerous grey rhino events that have occurred in the recent past—1984 Bhopal gas tragedy, 1999 Ersama cyclone, 2001 Bhuj earthquake, 2004 Indian Ocean tsunami, 2005 extreme rainfall event in Mumbai, the 2009 Kedarnath cloudburst 2015 extreme rainfall event in Chennai, 2018 extreme rainfall event in Kerala, 2018-19 heatwaves in India. The loss of life in these events ranges 500-50,000. The Machlipatnam cyclone is a rare success story of an impending disaster being successfully averted. India’s preparedness in disaster management is rather poor. Attempts to reduce risk through rules, laws, legislation, curfews, fines, campaigns, and other administrative methods do little to alter human behaviour to risk unless accompanied by programmes geared to alter risk perception. For example, campaigns to wear car seat belts and helmets by 2-wheeler riders have been unsuccessful in India. For an effective risk response, perceived risk should ideally converge actual risk. Such convergence can be achieved best through the active involvement of risk bearers in risk mitigation programmes. There is then a strong case for community participation in risk mitigation. The strength of such a programme is the community’s readiness to tackle risks they perceive as important. In the weeks after the Surat plague ended, communities in Surat cleaned up their neighbourhoods without help from the municipal corporation. Risks are tackled at four levels—local, national, regional, and global. Dehydration can be tackled at the local level with oral hydration therapy. Extreme weather events such as the 2018 heavy rainfall event in Kerala, can be tackled at the state or the national level by preparing emergency response plans and conducting mock drills in communities. The Asian Brown Cloud requires cooperation in the South Asian region. And the ozone hole in the atmosphere needs global cooperation. Unlike most other hazard issues, COVID-19 must be tackled at all four levels. Interestingly, the coronavirus war is making South Asia foster regional cooperation again. Prioritizing profits for business over reducing risk for people In the early-1990s, Surat was a boomtown riding the globalization wave. It became the world’s biggest diamond cutting and polishing centre because of its skilled and cheap labour. Diamond cutting business owners became millionaires overnight. But Surat neglected basic city sanitation. Filth floated in heaps all over town and Surat earned the dubious distinction of being named the filthiest town in Western India. The Surat plague caused Gujarat to state huge financial losses. The Surat plague was a consequence of prioritizing profits for businesses first over reducing risk for all people. The COVID-19 pandemic is also a result of this global outlook. Transmission dynamics To win the coronavirus war, it is important to understand its transmission pathways. Early information from a study being done by virologists in Heinsberg, the epicentre of the coronavirus outbreak in Germany, tell us that major COVID-19 outbreaks resulted from close gatherings over longer periods. Spread happened in Gangelt, a village in Heinsberg after an infected couple were at a carnival there in February; in Italy, after crowds gathered to watch football matches in Bergamo; and in Austria at the Ischgl ski resort. There is little evidence to say that transmissions occurred through contaminated surfaces. The Heinsberg researchers swabbed doorknobs, mobile phones, toilets, remote controls, and other surfaces and found evidence of the virus on the swabs, but could not replicate the virus in a laboratory, i.e., the remnants of the coronavirus on these objects were no longer infectious. Virologist Hendrick Streeck, the principal investigator of the Heinsberg study, said in an interview to The Guardian, “On the basis of our findings we’ll be able to make recommendations, It could be that the measures currently in place are fine, and we say: ‘Don’t reduce them.’ But I don’t expect that I expect the opposite, that we will be able to come up with a range of proposals as to how the curfews can be reduced.” The Federal Institute for Risk Assessment (BfR) emphasises that infection through contact with ‘contaminated objects’ has not yet been proven. Initial findings also indicate that that the chances of transmission in supermarkets, restaurants and hairdressers appears to be low. A trickle of information from Wuhan points a finger in the same direction. The WHO report on the Wuhan outbreak states, “In China, human-to-human transmission of the COVID-19 virus is largely occurring in families.” Virus transmission dynamics are contextual. While Heinsberg and Wuhan transmission dynamics may have takeaways for India, the dynamics in India needs to be understood. Being a big and diverse country, transmission dynamics may vary across the country. Consequently, disease control need not be a “one size fits all” strategy, which is what has been the thinking so far. It is necessary for the government to explain its understanding of the transmission dynamics of coronavirus and justify its disease control strategy in that light. Did lockdowns help? For the last 3-4 weeks about a third of the world’s population is under some form of lockdown—local or national. Have lockdowns helped ‘flatten the curve?’ Are they more effective than other measures? Most countries locked down when case numbers rose to high levels. India locked down when case numbers were low. A comparison of select countries that locked down and others that had not locked down but had controlled the disease (see Box 8) indicates that: Locked down countries had a case per day growth rate mostly in double digits (7.8-17.5 percent). The high case growth rate in Germany is due to their extensive testing and detection of cases. Despite a 4-week lockdown, India’s case growth rate for the lockdown period is 13.6 percent per day. India’s high case growth rate during lockdown indicates that community transmission had started some time ago. Transmission within the family may be a more important route for COVID-19 spread in India than was understood earlier. Consequently, physical distancing, wherever possible, is an important mitigation measure. Countries that did not lockdown but controlled the case growth rate started doing NPI early and implemented them strictly. Countries in this sample that did not lockdown had a case growth rate largely in single digit (3.7-14.7 percent). The higher case growth rate of South Korea is attributed to extensive testing. The NPIs generally followed by the non-locked down countries are extensive testing and surveillance, physical distancing, sanitizing, case isolation, contact tracing, quarantining suspect cases, use of personal protective equipment by health care and other personnel. Based on the limited data from the sample of locked down and non-locked down countries presented in Box 8, the hypothesis that can be drawn is that: Countries that acted early and adhered strictly to NPIs were able to control case growth rates without necessarily having to resort to disruptive lockdowns. Countries that locked down generally started doing NPIs late. Lockdowns, particularly after case growth gains momentum, have not been particularly successful in controlling case growth rates. If India’s current case growth rate persists till May-end, there will be about 50,000 cases by April-end, 4 lakhs by mid-May, and 3 million by end-May. These numbers may move upward or downward depending on the disease control strategy changes India makes after 3 May, and how successfully they are. Good practice case studies Two Indian examples stand out for the outstanding work they did to control COVID-19 spread — Kerala at the state level and Bhilwara at the district level. The growth of cases during the lockdown period, 25 March-24 April for India and Kerala were 13.6 and 4.8 percent, respectively. How did Kerala reduce COVID-19 spread? When Wuhan happened, the Kerala government knew that the coronavirus would come to Kerala through students from the state studying in Wuhan. Their experience with the Nipah virus taught them to start preparing early, so they began planning in January.   When COVID-19 cases were first detected end-January, Kerala responded by testing aggressively for early case detection. At 610 tests per million population, Kerala’s test rates stand at one and a half the Indian average today. Kerala did painstaking contact tracing, longer quarantine periods, building thousands of shelters for stranded migrant workers, and distributing millions of cooked meals. To gain public support the Kerala government actively communicated with people, without which they could never have succeeded in doing early case detection and intense surveillance. They even planned evacuation routes for newly detected cases such that the patients had minimum contact with people along the way. The government made people their eyes and ears, and the partnership between the government and public helped to fight the coronavirus. Kerala is a model for the rest of the country. Bhilwara, a textile town located in southeast Rajasthan, reported its first COVID-19 case on 19 March. This soon ballooned into 27 cases. Bhilwara district borders were immediately sealed, and four private hospitals and 27 hotels were commandeered by the district administration to accommodate cases. Between 22 March and 2 April, 22.4 lakh people were surveyed by nearly 2,000 health teams and 14,000 persons with flu-like symptoms were put on a watch list. The surveillance was relentless with visits to some houses made twice daily. Aggressive testing and contact tracing were done to identify cases. About 1,000 persons were put into quarantine centres and another 7,500 were home quarantined. On April 2, a complete lockdown was declared, and no one could step out of the home. Cooked food was supplied to the poor, and fodder was distributed for cattle. The outbreak was quickly controlled. The lessons from Southeast Asian countries that were successful in controlling virus spread are like those from Kerala—prepare early, and follow WHO’s mantra ‘test, treat, trace’ aggressively. Hong Kong, Singapore, and South Korea did 30-50 times more testing per 1 million population than India has done (see the table in Part 2 of this article). These three countries along with Taiwan and Vietnam did not declare a national lockdown. Testing, case detection and isolation have a strong influence on ‘flattening the curve.’ South Korea was so confident of winning the coronavirus war that it even held national elections on 15 April when 44 million masked and gloved voters went to the polls to elect 300 representatives to the National Assembly. India’s options to beat COVID-19 A vaccine for COVID-19 is 12-18 months away. A lockdown will not stop the spread of COVID-19. It can only slow it down. Lockdowns merely provide a little breathing space for preparing for the next move. The lockdown in India has been extended from 15 April to 3 May and in some states a little beyond that. What will India do after 3 May? India has only two options until a vaccine becomes available or coronavirus weakens. The first option is to do repeated lockdowns (suppression strategy) when case numbers rise after a lifting a lockdown as populations do not acquire herd immunity in a suppression strategy. Repeated lockdowns will further disrupt the economy and cause enormous stress to people, particularly to unorganized sector labour, the self-employed, and farmers. It will also keep the supply chain of goods and services broken, which could then trigger an economic slowdown. A health crisis could develop into an economic and humanitarian crisis of a huge magnitude, with the possibility of a rise in hunger, malnutrition, and disease, resulting in possible hunger deaths and suicides. The second option is to adopt a mix of mitigation strategy measures (physical distancing, sanitizing, case isolation, quarantining suspected carriers, aggressive testing, widespread surveillance, closing educational institutions) for the entire country, and using localized suppression strategy (localized lockdown) wherever hot spots appear. It is a mix of what is being done in Kerala and what was done in Bhilwara. This approach allows the general population to develop herd immunity. It also gives the battered economy a fighting chance to recover and provide income to unorganized labour, self-employed and farmers. But the number of cases will rise, though more slowly. And there will be attrition. A small fraction of the cases will turn critical and require intensive care. And if the health delivery system is not ramped up sufficiently, the numbers of the critically ill who may not get adequate medical attention will rise. Mumbai is already running out of ICU beds. Since the Indian workforce is relatively young, the risk of serious illness is low. But the vulnerable sections of the population — over-65-year olds and those with co-morbidities must be protected from exposure to the coronavirus. Doing this will test India’s ingenuity. Partnering with people A lot that may happen in the coming critical months will depend on the disease control choices that government takes. If government adopts the second option, which can control COVID-19 as well as avert a humanitarian and economic crisis, it can be implemented effectively only with public support. For that, government must be more forthcoming with information and become more transparent in its actions by holding public consultations on issues like virus transmission dynamics, lockdown triggers, and the pros and cons of different mitigation strategies. The government should also become more inclusive in its decision making by co-opting the public into decision-making bodies. The chances of winning the war against coronavirus increase if government emulates the Kerala model and makes people an equal partner instead of treating them as pawns to be locked down at government’s will and without offering an explanation. Future challenges Climate change is a more daunting challenge than coronavirus. The average global temperature rise is now 1.1oC above pre-industrial times. In 2015 governments of the world agreed that warming should be restricted to 1.5-2oC. The United Nations Environment Programme’s Emissions Gap Report 2019” (EGR2019) indicates that to remain under the 1.5oC redline, greenhouse gas (GHG) emissions must reduce by 7.6 percent per annum for the next decade. But GHG emissions are currently growing at 1.5 percent per annum, and at the current warming rate, we will cross the 2oC redline in about 2 decades and be 3-4oC above pre-industrial times by the turn of this century. A 3-4°C warming will cause frequent extreme weather events; alter precipitation patterns; raise sea levels by ~1-2 m by 2100; create millions of climate refugees; shrink glaciers and reduce the Arctic sea’s ice extent; cause food and water shortages, increase hunger, deprivation, malnutrition, disease and poverty; degrade and destroy forests and biodiversity and decrease water, timber and other ecosystem services they provide; cause a sixth mass species extinction; cause loss of employment; disrupt the world’s social and political order, and trigger social conflict. Climate change impacts will be slow and almost invisible initially but will grow exponentially, like the way COVID-19 cases grew. Without downgrading the priority given to the profits for businesses first outlook and upgrading the reducing risk for all people outlook, the impending climate change challenge cannot be met. Food, water, health, and environmental security at the global level For a risk minimization programme, people need three basic securities: food and water security, health security for natural and manmade risks, and environmental security. In 2018, the United Nations (UN) spent approximately 15.1 percent of its budget on food security, 7.1 percent on health security and one percent on environmental security. The UN has three organizations for food (WFP, FAO, IFAD) security, three organizations for health (WHO, PAHO, UNAIDS) security and one organization for environmental security (UNEP). It has no dedicated organization for creating water security or doing risk mitigation. If food and water, health, and environmental securities are to be boosted, the UN must set up a dedicated organization for risk mitigation and another for water security and must readjust its US$ 53-55 trillion budget to boost spending on these three securities from the current allocation of 23 percent of its budget to 30 percent, and which may be increased by two percent each year until these three securities together get 50 percent of the UN’s budget in time. Like climate change, the COVID-19 pandemic is a global problem and can be best solved through global cooperation. The South Asian countries have realized this and are discussing possible collective action in the war against the coronavirus. Food, water, health, and environment security should become fundamental rights in India Three sections of Chapter IV: Directive Principles of State Policy of the Indian Constitution deal with certain aspects of food, health, and environmental security (see Box 9). These directive principles should now be re-framed to make food and water security, health security from natural and manmade risks, and environmental security to become fundamental rights for Indian citizens. Guaranteeing these rights and delivering them is the state’s fundamental duty. Without these rights, the right to life can only mean a right to physical life and not social life. The 2020-21 budgeted expenditure of the union government is Rs 30.4 lakh crores. Of this approximately 12.5 percent is for food and water resources (Agriculture, cooperation & farmers welfare; Food & public distribution; Fisheries; Animal husbandry & dairying; Water resources; Drinking water & sanitation) 2.4 percent is for health (Health & family welfare; Health research; AYUSH; Pharmaceuticals) and (0.1 percent) is for the environment. Fifteen per cent of the budget, i.e., Rs 4.56 lakh crores, has been allocated for ministries and departments concerned with food and water, health, and environment. A ministry or department must be setup for risk mitigation and another for water security. To guarantee food and water security, health security and environmental security to Indian citizens, the union and state governments must allocate 30 percent of their budgets for these securities. The budget allocation for these securities may be increased by two percent each year until they become 50 percent of the union and state governments’ budgets in time. The Economic Survey of India, 2020 states that India’s Gross Domestic Product (GDP) was Rs 202.5 lakh crores in 2018 and estimates it to be Rs 217.5 lakh crores in 2019. The survey expected a 6-6.5 percent GDP growth in 2020-21, i.e., a growth by Rs 13.6 lakh crores. After the COVID-19 outbreak, the GDP growth rate for 2020-21 has been pared down to 1.9 percent to -2 percent. The loss to the economy will range Rs 9.5-18 lakh crores. Allocation of 30 percent of the union budget, i.e., Rs 9.1 lakh crores for food and water security, health security and environmental security is less than the lower end expected loss in GDP growth (Rs 9.5 lakh crores) and half the higher end loss in GDP growth (Rs 18 lakh crores). Even if the 30 percent allocation budget of the state and union territory budgets is added, this investment is well worth as it would more than compensate for the loss of income and additional expenses that COVID-19 caused lakhs of families. The personal loss to families that lost lives cannot be measured in monetary terms. More importantly, an investment in people’s welfare will move India towards becoming a nation that cares for its people, particularly its poor and vulnerable, and not be a nation that merely boasts of becoming a US$ 5 trillion economy by 2025. In the final analysis, is it not better to be a nation where we feel cared for rather than be a nation with a wee bit more money but with a dog-eat-dog attitude? Box 8: Case growth rate, hospital beds, doctors in countries that had locked down and countries that did not and hospital beds and doctors - add Country 1st case reported dt Progression of measures Computation start dt Computation end dt No of days in this computation No of cases- computation start No of cases-computation end Growth rate of cases/ day (%) Hospital beds/1000 population Doctors/1000 population World 17Nov Mixed 25 Mar 24 Apr 30 422,940 2,834,697 6.3 Countries that lockdown - add table Country 1st case reported dt Progression of measures Computation start dt Computation end dt No of days in this computation No of cases- computation start No of cases-computation end Growth rate of cases/ day (%) Hospital beds/1000 population Doctors/1000 population India 30Jan 30Jan-24Mar-Limited progressive restrictions, 25Mar-13Apr National lockdown 25 Mar 24 Apr 30 536 24,530 13.6 0.7 0.76 Iran 18Feb 18Feb-3Mar-No restrictions, 4Mar-1Apr-Lockdown 4 Mar 1 Apr 28 2,336 44,605 11.1 1.5 1.49 UK 30Jan 30Jan-21Mar-No restrictions, 22Mar-1 Apr-Lockdown 22 Mar 1 Apr 10 5,018 25,150 17.5 2.5 2.83 France 22Jan 22Jan-8Mar-No restrictions, 9-17 Mar National recommendations, 18Mar-1Apr national lockdown 18 Mar 1 Apr 14 7,730 52,128 14.6 6 3.24 Italy 30Jan 30Jan-18Feb-No restrictions, 18Feb-13Mar-Local lockdown, 14Mar-1Apr National lockdown 14 Mar 1 Apr 18 31,506 105,702 7 3.2 4.02 Spain 4Feb 4Feb-10Mar-No restrictions, 10-15Mar-National recommendations, 16Mar-1Apr-National lockdown 16 Mar 1 Apr 16 7,988 95,923 16.8 3 3.87 Germany 25Jan 25Jan-13Mar-No restrictions, 13-17Mar-Local recommendations, 17-19Mar-Local lockdown, 19Mar-1Apr-National lockdown 19 Mar 1 Apr 13 12,327 71,808 14.5 8 4.19 Countries that did not lockdown  Country 1st case reported dt Progression of measures Computation start dt Computation end dt No of days in this computation No of cases- computation start No of cases-computation end Growth rate of cases/ day (%) Hospital beds/1000 population Doctors/1000 population South Korea 20Jan 20Jan-21Feb- No restrictions, 22Feb-1Apr- No lockdown. National recommendations-Widespread testing and contact tracing 22 Feb 8 Apr 35 209 10,156 11.7 12.3 2.33 Taiwan9 21Jan 21Jan-21Mar No restrictions, 22Mar-1 Apr National recommendations 22 Mar 8 Apr 17 153 379 5.4 Hong Kong9 23Jan 23Jan-8Feb- No restrictions, 9Feb-1Apr- National recommendations 16 Feb 8 Apr 53 56 961 5.5 Singapore9 23Jan 23Jan-7Mar- No restrictions, 8Mar-1Apr National recommendations 8 Mar 8 Apr 62 138 1,623 4.1 2.4 2.28 Vietnam 20Jan 20Jan-12Feb-Nno restrictions, 13Feb-3Mar- Local lockdown, 4Mar-26Mar No restrictions, 27Mar-14Apr National recommendations 27 Mar 14 Apr 18 163 266 2.8 2.6 0.82 Japan 16Jan 16Jan-20Feb- No restrictions, 21Feb-1 Apr National recommendations 22 Feb 1 Apr 49 109 2,178 6.3 13 2.37 Sweden 30Jan 30Jan-11Mar- No restrictions, 12Mar-1Apr- National recommendations 12 Mar 1 Apr 20 500 4,435 8.8 2.2 4.19 Norway 21Feb 21Feb-13Mar- National recommendations, 14Mar-1Apr-Local lockdown 14 Mar 1 Apr 18 996 4,641 8.9 3.6 4.38 USA 18Jan 18Jan-17Mar- No restrictions, 18Mar-24Apr- Local lockdown 17 Mar 4 Apr 38 4,596 925,758 15 2.8 2.57 Box 9: Sections from the Chapter 4 Directive Principles of the Indian Constitution 41. The State shall, within the limits of its economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement, and in other cases of undeserved want. 47. The State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties 48A. The State shall endeavour to protect and improve the environment and to safeguard the forests and wildlife of the country The author is an environmental engineer with specialization in risk analysis Also read: Is the COVID-19 pandemic a black swan or a grey rhino event? — Part 1 Coping with the lockdown but is India prepared for an outbreak? — Part 2 How do we mitigate the impact of grey rhino events in the future?— Part 3  

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