Amid the coronavirus pandemic, the central Indian state of Madhya Pradesh does not have a health minister or, for that matter, a Cabinet.
Three of its most senior bureaucrats dealing with health issues have tested positive for the virus.
More than 50 workers at the state's health department have tested positive and scores of others are in quarantine.
Madhya Pradesh, which saw political turmoil leading to a change of government as the pandemic was taking root in India, is among the worst-affected states.
It recorded 361 new cases on Thursday, the highest increase among states in India, taking the total to 1,299, behind only Maharashtra, Delhi and Tamil Nadu.
Indore, the state's industrial hub and India's cleanest city, has emerged as one of the country's epicentres, with 544 cases in a population of 1.9 million residents.
"It's a fact Madhya Pradesh has not handled it as it should have. This is due to the battle for power when the problem was blowing up, our political leaders were busy with political wrestling," said social activist and food rights activist Sachin Jain.
"They (government) haven't involved civil society organisations. We are struggling to get passes for food distribution (for the poor). The police (instead of healthcare workers, in many instances) are going to pick up coronavirus cases. There is a total disconnect."
Madhya Pradesh was hit by political turbulence after Indian National Congress' Jyotiraditya Scindia and 22 Congress legislators defected to the Bharatiya Janata Party (BJP), which was then in opposition.
Congress Chief Minister Kamal Nath resigned, leading to the swearing in of BJP Chief Minister Shivraj Singh Chouhan on March 23, two days before Prime Minister Narendra Modi announced a lockdown.
Mr Chouhan had no time to choose his Cabinet, usually a lengthy process in India involving multiple negotiations to ensure representation of different castes and power blocs.
And the fact that the state has a weaker health infrastructure than other states such as Kerala and Tamil Nadu has not helped the situation.
India's response to the coronavirus has also been dependent on state leadership, with public health being a state issue in the country's federal system.
"Madhya Pradesh is a backward state. State health services have been very bad. Successive governments have not been making any effort to put strategy in place to deal with health services," said Bhopal-based political analyst Rasheed Kidwai.
The state has been sending samples for testing to Delhi, though it has nine designated labs to test for the coronavirus.
Still, government officials and BJP leaders have denied lack of planning or strategy.
A Covid-19 task force, involving political leaders but no health experts, was set up on Monday to coordinate the response.
BJP president V. D. Sharma, who heads the task force with the state's chief minister, blamed the initial poor response on the Congress, which in turn blamed the BJP.
"The BJP set-up is working with strength. The chief minister is working day and night. He has taken it (the situation) in hand from the first day," Mr Sharma told The Straits Times