Acts Applicable
to COVID 19
Dr KK Aggarwal
President CMAAO,
HCFI and Past national President IMA
Indian Public Health
system
India has a constitutional
division of legislative responsibilities between the central government and the
states. Both the central government and the state governments are
constitutionally empowered to legislate on matters of public health.
Central Acts
1. Epidemic
Diseases Act 1897
The preamble states
that its objective is to provide for better prevention of the spread of
dangerous epidemic diseases.
It empowers
the state governments and the central government to take measures as may be
warranted or necessary to control the further spread of disease.
Thus, any
state government, when satisfied that any part of its territory is threatened
with an outbreak of a dangerous disease, may adopt or authorize all measures,
including quarantine, to prevent the outbreak of the disease.
Similarly, the
central government, when satisfied that there is an imminent threat of an
outbreak of an epidemic disease and that the provisions of the law at that time
are insufficient to prevent such an outbreak, may take measures and
prescribe regulations allowing for the inspection of any ship or vessel
leaving or arriving at any port and for the detention of any person arriving or
intending to sail.
Any person who
disobeys any regulation or order made under the 1897 Act may be charged with an
offense under section 188 of the Indian Penal Code.
188. Disobedience to
order duly promulgated by public servant.—Whoever, knowing that, by an order
promulgated by a public servant lawfully empowered to promulgate such order,
he is directed to abstain from a certain act, or to take certain order with
certain property in his possession or under his management, disobeys such
direction, shall, if such disobedience causes or tends to cause obstruction,
annoyance or injury, or risk of obstruction, annoyance or injury, to any person
lawfully employed, be punished with simple imprisonment for a term which may
extend to one month or with fine which may extend to two hundred rupees, or
with both; and if such disobedience causes or trends to cause danger to human
life, health or safety, or causes or tends to cause a riot or affray, shall be
punished with imprisonment of either description for a term which may extend to
six months, or with fine which may extend to one thousand rupees, or with both.
Explanation. —It is not necessary that the offender should intend to produce harm
or contemplate his disobedience as likely to produce harm. It is enough that he
knows of the order which he disobeys, and that his disobedience produces, or is
likely to produce, harm. Illustration An order is promulgated by a public
servant lawfully empowered to promulgate such order, directing that a religious
procession shall not pass down a certain street. A knowingly disobeys the
order, and thereby causes danger of riot. A has committed the offence defined
in this section.
Such offense,
at the discretion of the trial magistrate, may be tried summarily. No
suit or legal proceeding lies against any person or authority for anything
done, or in good faith intended to be done, under this Act.
Some of the
issues that require revisiting, the act is the “definition of epidemic disease,
territorial boundaries, ethics and human rights principles, empowerment of
officials, [and] punishment.” National Centre for
Disease Control is developing a “Public Health Emergencies Act,”.
3. MCI Ethics Regulations: 2.2 Patience,
Delicacy and Secrecy: Patience and delicacy should characterize the physician.
Confidences concerning individual or domestic life entrusted by patients to a
physician and defects in the disposition or character of patients observed
during medical attendance should never be revealed unless their revelation is
required by the laws of the State. Sometimes, however, a physician must
determine whether his duty to society requires him to employ knowledge,
obtained through confidence as a physician, to protect a healthy person against
a communicable disease to which he is about to be exposed. In such instance,
the physician should act as he would wish another to act toward one of his own
family in like circumstances.
4. MCI Ethics Regulation
7.14: The registered medical practitioner shall not
disclose the secrets of a patient that have been learnt in the exercise of his
/ her profession except – i) in a court of law under orders of the Presiding
Judge; ii) in circumstances where there is a serious and identified risk to a
specific person and / or community; and iii) notifiable diseases. In case of
communicable / notifiable diseases, concerned public health authorities should
be informed immediately.
5. Quarantine
of Visitors: For people entering India from abroad, a health
officer appointed by the central government is posted and empowered at the port
of entry.
The health
officer may demand to see the aircraft journey logbook, which shows the places
the aircraft visited. He may also inspect the aircraft,
its passengers, and its crew, and subject them to medical examinations after
their arrival.
The officer
must follow specific precautions about communicable diseases
that require a period of quarantine (such as yellow fever, plague, cholera,
smallpox, typhus, and relapsing fever) and other infectious diseases that do
not require a period of quarantine.
He may
prohibit the embarkation on any aircraft of any person showing symptoms of any
quarantinable disease and any person whom the health officer considers likely
to transmit infection.
Regulations require that airline staff report any
suspected cases or passengers who in their opinion, from observations made in
flight, may be suffering from symptoms of a quarantinable disease.
With respect
to Ebola, in early August 2014, the Health Ministry announced that “mandatory
self-reporting is required at immigration.”
6. Right to
move free
Quarantine affects the fundamental right “to move
freely throughout the territory of India.” However, this right is subject to
reasonable restrictions that the state may impose in the interest of public
health.
The Supreme Court of India has found that the right
of privacy is an essential component of the right to life, but that it is not
absolute and may be restricted to prevent crime or disorder, or to protect
health, morals, or the rights and freedom of others.
State acts
Punjab
Vaccination Act makes primary vaccination and revaccination of children
compulsory throughout the state.
The states, in
such emergencies, delegate some of these powers to the deputy commissioners in
the districts typically through state health acts or municipal corporation
acts.
State and
Municipal Governments
A state
government may also take measures and prescribe regulations for the inspection,
vaccination, and inoculation of persons traveling by road or rail, including
their segregation in a hospital, temporary accommodation, or otherwise, if such
persons are suspected by the inspecting officer of being infected with any such
disease.
A state
government, by general or special order, may also empower a deputy commissioner
to exercise, in relation to his district, all the powers under section 2 of the
1897 Act that are exercisable by the state government in relation to the state,
other than to determine the manner in which and by whom any expenses are to be
defrayed.
Many of these
powers are prescribed in Municipal Corporation Acts governing “major
municipal areas,” or Public Health Acts that also
provide municipal-level commissioners or collectors with quarantine or other
powers. These can be in relation to removal of a person to separate
premises for medical treatment, Cleansing or disinfecting any building or part
of any building or any articles, taking special measures in case
of the outbreak of dangerous or epidemic diseases.
Civil
Rights
The ambit of
section 2 of the Epidemic Diseases Act is wide enough to allow a state or a
lower functionary in the administration, in dealing with an emergency caused by
the outbreak of a dangerous disease, to seek or require the cooperation of the
public or corporate bodies in the public or private sectors. If the desired
cooperation is not forthcoming, a regulation may be imposed. Failure to
obey or comply with restrictions imposed by such a regulation constitutes a
punishable violation.
Judiciary
The judiciary
in India ensures transparency in government actions and executive orders.
One can seek judicial review of executive orders and regulations. The
Parliament of India has also enacted a Freedom of Information Act, requiring
transparency in government actions.
International
Regulations
PHEIC:
mandates reporting to WHO about disease in question
The
epidemic Act
2. Power to take special measures and prescribe
regulations as to dangerous epidemic disease] is satisfied that [the State] or
any part thereof is visited by, or threatened with, an outbreak of any
dangerous epidemic disease, the [State
Government], if [it] thinks that the ordinary provisions of the law for the
time being in force are insufficient for the purpose, may take, or require or
empower any person to take, such measures and, by public notice, prescribe such
temporary regulations to be observed by the public or by any person or class of
persons as [it] shall deem necessary to
prevent the outbreak of such disease or the spread thereof, .
(1) When at any time the [State Government and may
determine in what manner and by whom any expenses incurred (including
compensation if any) shall be defrayed.
(2) In
particular and without prejudice to the generality of the foregoing provisions,
the [State Government] may take measures
and prescribe regulations for— (b) the inspection of persons travelling by
railway or otherwise, and the segregation, in hospital, temporary accommodation
or otherwise, of persons suspected by the inspecting officer of being infected
with any such disease.
[2A. Powers of Central Government.—When the Central
Government is satisfied that India or any part thereof is visited by, or
threatened with, an outbreak of any dangerous epidemic disease and that the
ordinary provisions of the law for the time being in force are insufficient to
prevent the outbreak of such disease or the spread thereof, the Central
Government may take measures and prescribe regulations for the inspection of
any ship or vessel leaving or arriving at any port in [the territories to which
this Act extends] and for such detention thereof, or of any person intending to
sail therein, or arriving thereby, as may be necessary.]
3. Penalty. —Any person disobeying any regulation or
order made under this Act shall be deemed to have committed an offence
punishable under section 188 of the Indian Penal Code (45 of 1860).
4. Protection to persons acting under Act. —No suit or
other legal proceeding shall lie against any person for anything done or in
good faith intended to be done under this Act.
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