What's the meaning of epidemic?

The word ‘Epidemic' has come from Greek word epidemios means epi(on) and demos (people), the word epidemic already existed in ancient Greek around 430 BC (5th century BC).

After non-medical use of the term (epidemic) by Homer, Sophocles, Plato, and Xenophon(all were pre-eminent Greek philosopher), the word epidemic took its first medical meaning when used by the Hippocrates (who was a Greek physician often referred as the Father of Medicine) as the title of one of his famous treatise. Hippocrates used the adjective epidemios (on the people) to mean which circulates or propagates in a country.

At that time, epidemic was the name given to a collection of clinical syndromes, such as coughs or diarrhoeas, occurring and propagating in a given period at a given location. Civil wars and natural catastrophes are sometimes followed by epidemics. Over centuries form and meaning of the term has changed.

General
Epidemic is a term that is often broadly used to describe ‘that has grown out of control'. It occurs when an infectious disease spreads rapidly to several people within a country or a location and affects many individuals at the same time. Epidemic generally is a highly communicable disease that spreads through the population in a very short time. These diseases could be- viral, bacterial or other health events such as obesity.

Historical background of the Act:

It is a law which was first enacted to tackle Bubonic plague in Mumbai in former British occupied India. This plague struck the city in late 19th century thereby killing thousands of people. First case was detected in 1896. At that time, anti plague activities of Health Department included Police searches, isolation of sick, detention in camps of travellers and evacuation of residents. These measures were widely regarded as offensive and alarming Criticism to the said measures thereby led to an outrage, and further resulted in murder of British Chairmen W.C. Rand of Plague Committee. Mortality rate from plague was 22 per thousand at that time.

Fortunately, this Act, confined plague to Bombay by a series of tough measures which prevented throngs from gatherings.

The Act:

• This is a colonial Act.
• This Act strives to protect the common citizens in a particular area during the outbreak of an epidemic or a dangerous disease.
• The Act was enacted in 1897 and came into force on 4th Feb 1897, as a response to plague epidemic in Bombay, and came to be known as Epidemic Diseases Act.
• It extends to whole of India except the territories mentioned in part B States.
• It is the shortest Act as ever enacted by Indian Legislation comprising just 4 sections.

Power of Central Government under the Act:

It empowers the Central Government to take measures, if, it is satisfied that an outbreak or spread of any dangerous epidemic disease is visited by or threatened India or any part thereof and the ordinary provisions of law therein are scant to prevent aforesaid outbreak, and prescribe the following regulations:

1. To inspect any ship or vessel leaving or arriving at any port in the territories to the which the act extends and for the detention of the same.
2. To detain any person who is intending to sail or arriving on any such ship or vessel.

as the Central Government deems fit regards such epidemic.

Power of State Government under the Act:
It also empowers to State Government and Union territory to formulate necessary regulations to contain the outbreak or spread of any dangerous epidemic disease.

If the State government is satisfied that the State or any part thereof is visited by or threatened with an outbreak of any dangerous epidemic disease and it thinks that the ordinary provisions of the law in force for the time being are scant for the purpose of containment of such aforesaid epidemic, the State government may:
1. Take or require or empower any person to take such measures.
2. By public notice prescribe such temporary regulations to be observed by

• The public or
• By any person or
• By class of person

as the State government shall deem necessary to prevent the outbreak of such disease or the spread thereof and may determine in what manner and by whom any expenses incurred (including compensation if any) shall be defrayed.

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.

Which provides:

• If such disobedience causes or tends to cause obstruction, annoyance or injury, or risk of the same as aforesaid to any person lawfully employed, shall 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.
   
• If such disobedience causes or tends 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 which may extend to six months, or with fine which may extend to one thousand rupees, or with both.

Protection to persons acting under the Act:
This Act provides no suit or legal proceeding shall lie against any person for anything done or in good faith intended to be done under the Act.

Instances of Implementation of the Act:

This Act has also erstwhile been used for the containment of diseases:

• In 2009, to tackle Swine flue outbreak in Pune.
• In 2015, to deal with Malaria and Dengue in Chandigarh.
• In 2018, to deal with Cholera in Gujarat (Vadodara).
• Following the 2019-2020 Corona Virus pandemic the cabinet secretary of India on 11 March 2020 announced that all states and union territories should invoke the provisions of this Act.

Shortcomings of the Act:

The Act has major Limitation in current scenario:

• It is an archaic framework, 113 years old Act mere regulatory not the rights-based.
• It does not apply to the territories which immediately before the first November, 1956 were comprised in part B states. (45 of 1860) also warrants a revision.
• The punishment for violation of regulation under section 188 of Indian Penal Code
• It does not succinctly describe the duties of government in preventing and controlling epidemics.
• The Act emphasises the power of government, but is silent on the rights of citizens.
• This Act is also silent on the ethical aspects or human rights principles that comes into play during the response to an epidemic. For instance (People are facing hardship in having access to essential commodities and most vulnerable section is of daily wages workers).
• It contains clear executive instructions, it does not mention any scientific steps that the government needs to take to contain or prevent the spread of disease.

Future exhortation to revamp the Act:

1. It would have been good if the Act stated clearly the situations under which the authorities may curtail the autonomy, liberty and privacy should be respected to the greatest extent possible, even during the enforcement of law.
    
2. The Act says that State may empower any person to take some measures. Today we have a better structured public system, with specific people in charge of delivering primary care services thereby prescription that any person may empowered does not make any sense. The word any cannot can be accepted in current context, and who can do what needs to be specified.
    
3. There is a lack of uniformity between various acts followed in different States although India has number of legal mechanisms to support public health measures in an epidemic situation, they are not being addressed under a single legislation .There is a need for an integrated, comprehensive, actionable and relevant legal provisions for the control of disease outbreaks in India, so that implementation of responses to an epidemic can be effectively monitored.
    
4. Thus it is far beyond doubt that this century old Act needs a complete overhaul to cater the changing public health priorities so there should be a uniform and ample law which should be right based, people focused and public health oriented.