New Delhi: India is in the middle of general elections. Spread over seven weeks, this is the first election for the Lok Sabha post the biggest human misery recorded in history after 1918; the COVID-19 pandemic. Prime Minister Narendra Modi has made several references to it, making tall claims about its ‘management’.
As recently as on April 19, Modi said his government had ensured the ‘well-being of all and worked with the Spirit of nation-first’ in a rally at Madhya Pradesh’s Damoh district.
Illustration: Pariplab Chakraborty
These elections are taking place three years after the deadly second wave of the pandemic.
Here is a reality-check on India’s COVID-19 crisis in five points.
A deadly second wave
People dying on roads literally for want of oxygen and family members scrambling even for a hospital bed for their loved ones were the images that sent shock waves across the world, and not just in India. The pandemic roiled people in every country but from nowhere else did such distressing scenes surface.
The dead bodies lying on the banks of the Ganga and people queuing up outside the burial grounds for the last rites seem to have been either forgotten by the PM when he makes tall claims regarding the pandemic management, or it is a deliberate attempt to manipulate the memory of the common people.
Medicine availability also became difficult for people. They purchased them at exorbitant prices. The government could hardly do anything to prevent the black market of drugs – something that even a high court recorded.
When social media became the go-to platform for people to seek; and offer help – a job that the government was supposed to do – the hand of the government went just completely missing.
Before the second wave emerged, the officials of the Indian health ministry used to hold regular press conferences. Even the prime minister used to, at least, address people through his TV appearances. All of this disappeared during the second wave and the government didn’t even deem it necessary to communicate with its people in the middle of the worst ever crisis.
The situation took such a turn that the Supreme Court of India had to take suo motu cognisance of ‘issues related to oxygen supply, drug supply, vaccine policy’ during the middle of this wave. It went on to form a 12 member task-force comprising independent scientists and officials to manage these issues, taking reins in its own hands.
But was it impossible to project such deadly misery before it became what it became? No. The scientists of a group – INSACOG – set up by the government itself had been warning it since March itself – at least a month before the second wave became what it became, Reuters had reported.
Yet the Narendra Modi-led government ignored all these warnings.
The PM continued with his political rallies in the state assembly elections for West Bengal and Kerala, and people were allowed to throng large religious and other gatherings.
This phase also led to the resignation of the top scientist, Shaid Jameel – as head of INSACOG – the genome sequencing consortium of India. Although Jameel attributed resignation to personal reasons, he did so in the middle of the second wave when the government didn’t pay heed to his group’s projections of a new variant of novel coronavirus – delta – emerging from India that eventually spread across the world.
The INSACOG was not the only warning.
This reporter had quoted Sitabhra Sinha, a professor at the Institute of Mathematical Sciences, in February (two months before April), who had said that the reproductive number or R0 had been rising in a few states – much against the slowing trend of virus transmission in the previous months. (Reproductive number tells how many people were getting infected from one infected person). This was clearly an indication of ‘things not being good’, Sinha had said at that time.
The government ignored Sinha and threw caution to the winds.
Also read: The Pandemic Has Yet Again Exposed Modi’s Insidious Politics of ‘Narrative Control’
2. The highest death toll
No wonder the second wave led to a storm that had no precedent. India had the highest death toll of the pandemic across the world. According to the World Health Organisation (WHO) excessive death estimates, as many as 47 lakh people in India died till the second wave. This is equal to a little less than the entire population of Maldives.
It must be noted that according to the Indian government, only 4.8 lakh people died in India – 10 times less than the WHO estimates. Incidentally, this was the highest number of the deaths that a country missed counting.
India had rejected the WHO report vehemently. In fact, India was the only country to have rejected the WHO report.
The government officials cast aspersions over the WHO’s methodology to arrive at these estimates. However, when the WHO’s estimates were compared with the Indian government’s own all-cause mortality deaths recorded by the Civil Registration System (CRS) for the first wave of 2020, they almost completely matched with the WHO’s figures, as The Wire reported.
The government has withheld the CRS estimates of 2021 in which the maximum deaths happened. Had that CRS numbers for 2021 been released, it might have confirmed the WHO death estimates for 2021 also. And, it might have proven all arguments of India questioning the WHO’s estimates itself questionable.
Photo: Trinity Care Foundation/Flickr (CC BY-NC-ND 2.0 DEED)
Moreover, before the WHO’s numbers came out, many independent scientific studies like this, this and this had reported that India had undercounted COVID-19 deaths; the government rubbished all these papers.
3. First wave hangover
If the second wave was all about the absence of government, the first wave would be remembered for the long march of the migrant workers due to a lockdown that PM Modi announced while giving a window of just four hours on March 24, 2020.
By the time the PM announced lockdown in India, many countries were shutting down; but in a calibrated manner. It is hard to find a parallel when a Prime Minister announced a lockdown at 8pm to be effective by 12 am, midnight, the same night.
People went into a frenzy with panic buying taking place and migrant workers set out to cover thousands of miles by foot, often for days and weeks together, without food and water. It was dubbed as the biggest march after the partition.
Migrants on the open road in Ghaziabad. Photo: PTI/File
A few workers died on the road; others were lathi-charged by police for breaking the ‘lockdown rules’. They started going towards their home-towns when they were shooed away by employers, who, in turn, claimed that they would not have any money to pay salary due to a sudden shutdown.
The government failed in anticipating this one-of-its-kind catastrophe.
The lack of any planning could be gauged by the extent that when the airlines offered to ferry the workers for free, the government didn’t permit them. It said the lockdown meant ‘staying where one was’ – a principle that stood violated had the airlines did what they wanted to.
But was the government able to slow down the virus spread after the sudden announcement 21-day lockdown, which was eventually extended? A detailed assessment by this reporter in May – two months after the lockdown was announced – using various datasets and analysis of various indicators suggested otherwise.
The number of days between which new 5,000 cases were getting added to the tally reduced. In other words, new cases were getting added faster to the tally as compared to before the lockdown. This indicated that the virus was spreading faster.
Thus, there were hardly any visible gains of the lockdown.
However, one thing was clearly visible. The vilification of Muslims by the government. The officials like the then joint secretary in the health ministry, Lav Agarwal, in a press conference on April 5, 2020, claimed that the virus would have spread much less had an Islamic sect, Tablighi Jamaat, not organised a congregation in Delhi.
The government officials often repeated this claim subsequently in press conferences. This happened despite the Supreme Court striking down all attempts to paint followers as spreading COVID by design.
Representative image. Indonesians who were stranded in India, including members of the Tablighi Jamaat, boarding repatriation flights in New Delhi, July 29. Photo: Twitter/@KBRI_NewDelhi
A large section of the media amplified the government’s message of singling out the Islamic sect; which had no scientific basis because the cases were increasing otherwise too. The WHO expressed explicit disappointment with this development without naming India but added the religious categorisation of the cases helped no cause at all.
4. Science took a back seat
As the first wave surged, India was under the pressure of making a vaccine, more importantly a ‘Bhartiya vaccine’, Covaxin. The Indian Council of Medical Research (ICMR) isolated the virus for vaccine development. Following this, a private firm was handed over the virus for vaccine development and clinical trials were set up at multiple sites across the hospitals in the country. But the then ICMR head, Dr Balram Bhargava, came out with a quirky target.
Bhargava wrote to the principal investigators on July 3, 2020, that the vaccine should be available for public use by August 15, 2020 – a timeline that was impossible, those conducting the trial told this reporter. It was perhaps one of the most telling examples of the worst kind of science. The letter warned of consequences if the deadline was not met.
It led The Lancet, one of the oldest medical journals, to come down heavily on ICMR – India’s premier medical research agency – perhaps for the first time in history, in a scathing editorial in September 2020 titled: ‘COVID-19 in India: The Dangers of False Optimism’.
“The Indian Council of Medical Research (ICMR) has been singled out by experts for straying from scientific evidence, appearing at worst politically motivated and at best overly optimistic,” The Lancet said.
File photo of Prime Minister Narendra Modi at the Bharat Biotech plant in November 2020. “At the Bharat Biotech facility in Hyderabad, was briefed about their indigenous COVID-19 vaccine. Congratulated the scientists for their progress in the trials so far. Their team is closely working with ICMR to facilitate speedy progress,” Modi had tweeted at the time.
The ‘deadline’ was issued just to clear the red tape, the ICMR later clarified, after the backlash. The vaccine was rolled out in January 2021, eventually.
Although the roll-out was also far from controversial. India’s then drug controller of India, V G Somani, approved the vaccine in what he termed as ‘clinical trial mode’, a term that found no mention in any scientific literature before, and a move that led vaccine scientists flummoxed. It essentially meant the vaccine was released when the trial was still not complete and something like everyone who took the vaccine was a trial participant.
There were no interim results available at the time it was made available for public use. It must be clarified here that eventually the vaccine did complete the trial, after the rollout.
Another aspect in which India was found wanting was inadequate genome sequencing during the second wave. It reveals what particular variant is circulating at a given time; and also at times help project what variant may become dominant in the near future. Without it, pandemic planning is an exercise done blindly. Even after the second wave, the genome sequencing faded, this reporter filed using reply that the government gave her to an RTI application.
5. Solution? Worse than the problem
Two agencies of the government came out with such treatments for which the scientific rationale was hard to find. One was the Drug Controller General of India’s (DCGI) approval of certain drugs for COVID-19 use. Despite the WHO strictly advising against use of remdesivir for treatment of COVID-19 after the large scale ‘Solidarity Trials’ were completed in May 2020 showed no relevance of the drug, the DCGI approved its use a month later.
People, who were already desperately looking for any and every treatment, didn’t hesitate travelling to different cities for arranging one dose of the injection
Another such instance was approval of 2-deoxy-D-glucose for COVID-19 developed by India’s Defence Research and Development Organisation (DRDO) and Dr Reddy’s. The DCGI had approved it with little to no evidence.
The DCGI also approved the use of the tocilizumab drug for preventing what is called ‘cytokine storm’ in COVID-19. Cytokine storm refers to excessive release of cytokines in the body as part of the immune response against the virus. The storm could cause severe effects. But the DCGI approved use of tocilizumab by waiving the final, phase III trial. It relied merely on the basis of the second phase results in which it was impossible to understand the efficacy of the drug on a large scale.
India’s Ayush ministry was at front to issue such preventive protocols for COVID-19 for which trials were either not conducted or the trials were questionable. For example, it suggested that people should use Giloy to prevent the COVID-19 infection when no trial had suggested so. Moreover, later the evidence emerged that in the case of those people, especially, those who had diseases like diabetes, the herbal drug ended up damaging their liver. This either led to death or liver failure – as documented in two papers – this and this.
The Ayush ministry also advised people to take chyawanprash in post-recovery because it merely ‘believed’ that it was effective. It was one of those instances when a ministry asked people to consume a product without any evidence.
Patanjali could roll out use of ‘Coronil’ for Covid-19 even when trials were incomplete; and even confusion prevailed over the fact whether it was for prevention of the disease or treatment. The pictures of two Union ministers – Harsh Vardhan and Nitin Gadkari alongside Ramdev – during the release of the drug showed how little science mattered for the government.
Ramdev releases Coronil with Nitin Gadkari and Harsh Vardhan in attendance. Photo: Video screengrab.
Among these many flip-flops of the government, there were other embarrassing optics. PM Modi’s declaration of victory in the war against COVID-19 at the World Economic Forum in January 2021, the promotion of use of taali, thali and diya and Corona’s Bhabiji papad patronised by a minister in Modi’s cabinet who is now law minister, are just a few instances of the same.
The delivery of COVID-19 vaccines almost till the last mile eventually, ensuring more than 90% coverage of the two doses stands as one shining example of India’s one effort during the pandemic, for a country of India’s size.
But is the country ready to learn from its other mistakes for better future preparedness? The hint to the answer lies in the political speeches.
