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Emerging Infectious diseases like COVID-19, Laws and Opinion

Coronavirus disease (hereinafter referred to as COVID-19) is the biggest cause of concern all around the world today. It originated in China in a seafood market of Wuhan (though the exact animal source is not ascertained) and became epidemic in that region. Due to its novel and communicable character it was soon declared a ‘pandemic' by the World Health Organisation (WHO).

History Of Infectious Diseases
As per the definition from WHO, Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly, from one person to another.[1] If one looks into the website of WHO, one can find a list of infectious diseases which have impacted the humankind. Relooking at the history of such infectious diseases (limiting the review to pandemic diseases beginning the 21st century) one can realise the importance of medical research and preemptive steps to preclude their recurrence (though this may not be an exhaustive list it gives the extent of catastrophe).

The Spanish Flu (H1N1 virus) occurred post world war 1 in the year 1918 when the world was not prepared to tackle such infection. It infected 500 million people and claimed the lives of more than one tenth of them. Lesson learnt was the betterment and improvisation of public health facilities to contain the virus at early stage and treat the affected at the earliest.

Hong Kong Flu (H3N2 virus) similar to the Spanish Flu occurred in the year and claimed the lives of about one million people globally. Lesson learnt was the vital role of vaccinations to preclude such recurrences.
AIDS (HIV Virus) cases started occurring in 1981 and are prevalent till date. Many people in this world are HIV positive, and it has claimed the lives of about 32 million people globally. However it is not an air borne infection and is a Sexually transmitted disease. There has not been a cure for AIDS but antiretroviral therapy medications slow the effect helping the person lead a longer life.

Swine Flu (novel H1N1), infected more than 60 million people in the year 2009 and caused deaths ranging between 151,700 and 575,400. A kind of zoonotic virus, it was transmitted from pigs to humans. A lesson learnt from this experience was how quickly a virus can spread at the blink of an eye and therefore additional health care preparedness was pertinent to tackle such viruses in future. Even the countries investing hugely on their healthcare and allocating hefty budgets could not react to its spread.

Ebola Virus occurred in the year 2014 but was not a global pandemic in the sense of its geographic spread. It was limited to the West African region but was deadly enough in its impact claiming more than 11,000 lives. Here lesson learnt was the virus infected countries least prepared to tackle the spread.

Finally, Coronavirus disease became a pandemic on March 11, 2020 (by WHO). Despite lessons learnt earlier, especially from the swine flu experience, there was lack of preparedness. The countries with high health expenditure are suffering due to this. Italy has recorded the highest number of cases and the US is no less in terms of cases.[2]

Coronavirus Disease
Covid-19 is caused due to the virus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The name comes from its crown-like structure due to the pointed projections coming out of the circumference, as can be seen from the figure below.

In the year 2003, a virus (namely SARS-CoV) belonging to the same genus as that of the virus causing COVID-19 had originated in China and resulted in 8000 cases. However SARS-CoV-2, has claimed 67,594 lives and 1,210,956 cases.[4] Therefore both are different and hence require a different treatment.  

Testing
RT-PCR (Reverse Transcriptase Polymerase Chain Reaction)test is being conducted to detect the virus. RT converts RNA to DNA as COVID 19 is caused due to an RNA virus and PCR increases the quantity significantly, doubles it, makes it sufficient for it to get detected.
Antibody tests have been conducted in South Korea. When the body is attacked by foriegn antigen antibodies are released in response to counter them. However the body takes time to produce antibodies. So doctors rely on both these tests to detect a patient.

In an article[6] it was satisfactorily explained why Covid 19 impact could perhaps not be that grave in Indian scenario. Author highlighted a few points like the epigenetic factors which are innate in Indian population due to food habits, environment etc. Another interesting aspect was the role of  Human Leukocyte Antigen HLA (or simply immune response genes) in Indian population. These help as support system to T cells (they kill the pathogens also called as special ops of the immune system[7]) by identifying the pathogen and facilitating the attack on them. Such microbial load tolerance level is not present among European/white skin races he puts in. This is also observed from the reported deaths when one looks across the geographic spread of infection.

Religion Against Covid-19
Religion is the opium of the masses [8]
World comprises of Christians (31%), Muslims (24%), Hindus (15%) which is about 70% of the world population.[9] Understanding the position of these major religions on the pandemic is helpful in light of the speculations and events that are turning around for instance Tablighi Jamaat's Nizamuddin Markaz gathering in New Delhi.

Without getting into the politics of matter it is clear that there should be complete social distancing and such gatherings are condemnable and should be avoided and dealt with strictly. In one of the briefings by Jt. Secretary of Health Ministry it was said that  the rate of doubling of COVID-19 cases has increased to 7.4 days which would have been 4.1 days had Jamaat not been held.

Pope Francis has announced to give special blessings to the world to fight COVID-19 which is rather uncommon as such blessings are generally given during Easter and Christmas. He has also appealed for unity and called for prayers to respond to the disease.

Similarly, The Prophet has said:
If you hear that there is a plague in a land, do not enter it; and if it (plague) visits a land while you are therein, do not go out of it (Sahih Bukhari).[10]

Which speaks for itself that lockdowns and quarantine is for the larger welfare of the people when the land is infected with a deadly virus.
 
Even in hinduism, the religious offerings and conduct is expected to be done with clean hands and hygiene. Also the concept of omnipresence of god paves the way to stay at home and pray as god is everywhere. Therefore one need not visit dharmic or religious sites or temples during this pandemic.

Laws Dealing With Covid-19
Law is with us from cradle till the grave

International Laws
Universal Declaration of Human Rights (UDHR) recognizes Right to health and ancillary rights and is guaranteed under International Law. Article 25 of UDHR clause 1 says, Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. [11]

Even the International Covenant on Economic, Social and Cultural Rights (ICESC) hold The Right to health as an essential human right.

International Sanitary Convention is the law dealing with situations of outbreak of infectious diseases. Even there the quarantine and travel restrictions are justified to contain the spread of infection and the right to liberty of an individual can be curtailed.

Indian Laws
In the case of India, Public Health is under the State list in the Indian Constitution (entry no. 6 in List II) which means that this domain is under the ambit of different states respectively. In a landmark case of Consumer Education and Research center and Ors. vs. Union of India (UOI)[12] Right to Life under Article 21 of Indian Constitution was given a wider interpretation to include Right to clean and healthy environment and the Right to Health.

As far as the deterrence of the law goes, those violating the government directions are to be booked and punished under relevant sections of relevant laws. For instance, Chapter IV of Indian Penal Code contains sections to deal with the violators. Sections 269 and 270 of IPC  preclude one from spreading the infectious disease and puts a duty of care on an individual towards the society at large. Under Section 271 and 188 of IPC, punishment is attracted to the acts in violation of quarantine rule issued by public authority under GoI.

Epidemic Diseases Act of 1897 (one of the smallest Act) is a special law to tackle such situation 
on similar lines with that of provisions mentioned in the preceding paragraph.
There are few other laws being used by GoI to tackle the spread of the infection but are almost moribund and not precise and direct in nature.

A Case Against China
China's response in dealing with COVID-19 has triggered anger among a battery of lawyers who are now ready to sue China for reparations for causing irreparable loss of lives and economies. Different estimates have shown unprecedented loss in the world economy and China is being accused for its delay in sharing of information with the WHO. 

International Health Regulations which are binding in nature (of the WHO) among the member states encourage and direct member states to report such incidences of outbreak within 24 hours.
China has also thereby violated the Responsibility of States for Internationally Wrongful Act, 2001 (of the UN).

Different allegations from the International Council of Jurists (ICJ) have come forward accusing China of not only developing the virus but also planting the infected people across the world.
Only time will reveal the true intent (if any) of the Chinese to wage a war against mankind.

Critical Analysis
Every civilized society, citizens can claim their right against the state only if they respect and follow their duties and obligations diligently, which is the essence of the Hohfeldian matrix which establishes legal relationships. Therefore the citizens must follow the mantra of 3 ‘H', i.e, Hygiene, Home and History. 

Firstly, Hygiene is necessary as the virus deposits on the surface and the WHO has stressed upon repeatedly washing of hands and keeping them clean. 

Secondly, people are requested by all the governments of almost all the countries affected with the virus to stay at home and follow the quarantine and lockdown period to contain the spread and preclude the virus from spreading to society at large. Therefore mass gatherings are strictly looked upon and freedom of movement should be restricted.

Thirdly, history pertaining to travel must not be hidden from authorities. For instance people travelling from abroad took paracetamol tablets before landing in India to conceal any signs of fever which is a symptom of COVID-19. Also, people are expected to report to the designated numbers or helplines in case they suffer from any of the symptoms associated with COVID-19.

As far as the role of the government goes, Delhi CM Kejriwal had recently come out with a ‘‘5-T action plan'' which is self-explanatory and can be considered positively by all other stakeholders and authorities. He emphasised upon Testing, Tracing, Treating, Team-work, Tracking & monitoring. All these are necessary to stem out the infection from its roots.

GoI had recently announced the PM CARES fund and we have seen numerous personalities donating for the cause. Also the GoI announced various economic benefits for the poor and the health workers (Gods in white costume) under Pradhan Mantri Garib Kalyan Scheme which include direct benefit transfers and food security related benefits. It must be ensured that all these schemes are well implemented.

When it comes to laws to tackle infectious diseases, it is high time that in such situations a strong law in the hands of the Centre is provided considering that the colonial era law (Epidemic Diseases Act) was a hurriedly drafted law to tackle bubonic plague in the year 1896.

Using it today is like fighting the world war with a sword. Had Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Bill 2017 been passed, it would have helped in dealing with the situation in a much effective manner. Considering emerging areas like bioterrorism and novel infections it is the need of the hour to have a robust law at place to tackle untoward situations.

Conclusion
Internationalism and globalisation is integral to any economy's growth. Due to WTO or opportunities abroad people travel to favourable destinations for various purposes and there is always a chance of imminent threat from foreign soil. 

Today, the world is more integrated and united to fight against problems threatening mankind like terrorism, human rights, environment and global warming, diseases, etc. without any geographic limits or race. This notion is encapsulated in a famous Sanskrit dictum vasudhaiva kutumbakam which means the world is one family. With that Mantra all stakeholders need to unite and fight against this infection to restore the lives of people and the economy.

References:

  1. https://www.who.int/topics/infectious_diseases/en/
  2. https://www.businessinsider.in/slideshows/miscellaneous/11-pandemics-that-changed-the-course-of-human-history-from-the-black-death-to-hiv/aids-to-coronavirus/coronavirus-or-covid-19-2019-present/slideshow/74695588.cms
  3. https://www.niaid.nih.gov/news-events/covid-19-reminder-challenge-emerging-infectious-diseases?utm_campaign=+41838272&utm_content=&utm_medium=email&utm_source=govdelivery&utm_term=
  4. COVID-19, Situation report-77,WHO (06.04.20)
  5. https://who.sprinklr.com/ visited on 06.04.20
  6. https://www.hindustantimes.com/analysis/can-india-be-an-outlier-in-the-spread-of-covid-19/story-OS2c161BQhD7Ne33x26h0L.html visited on 06.04.20
  7. https://www.cancercenter.com/community/blog/2017/05/whats-the-difference-b-cells-and-t-cells visited on 06.04.20
  8. Karl Marx views on religion
  9. https://www.pewresearch.org/fact-tank/2017/04/05/christians-remain-worlds-largest-religious-group-but-they-are-declining-in-europe/ visited on 06.04.20
  10. https://www.whyislam.org/on-faith/diseases/ visited on 06.04.20
  11. https://www.humanrights.com/course/lesson/articles-19-25/read-article-25.html visited on 06.04.20
  12. Consumer Education and Research centre and Ors. vs. Union of India (UOI) and Ors. (AIR 1995 SC 922)

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