With the increasing number of COVID positive cases, did the government manage the second wave well or was there any more scope for improvement? This article covers the answers to many questions or claims against the government, with reference to a recent article published in The Lancet.

For our comprehensive coverage and latest updates on COVID-19 click here.

---

Upfront, I want to laud the Central Government for some of the steps they took to control COVID during its first wave. But now is the time to introspect and see where we went wrong. Let alone indirectly, there isn’t a single household in India that hasn’t been affected by the virus directly. Let us not be oblivious to what we see around us (people desperately searching for supplies) and simply try to paint everything as 'positive'.

Some people couldn’t accept India’s genuine criticism in a 730-word editorial published in the most reputed medical journal The Lancet. Many attempted writing a rejoinder to it. A blog article was also tweeted by the Indian Health Minister. The two others include unpublished articles by Dr. Kapesh Gajiwala (Mumbai), and Dr. Vasantha Kamath (Karnataka). I will deconstruct their strongest arguments here.

---

---

Claim 1: India’s population is greater than the population of USA + Europe + Brazil + Argentina combined, still, the deaths per million of the population in India is less than 10% of that in USA, UK, Brazil, France, Spain and Italy

Reply

The COVID case and death data between India and western countries can’t be compared. Here’s why.

In India, there is underreporting of COVID cases due to 2 reasons; under testing due to lack of testing infrastructure and lapses at the government level. Similarly, we can’t compare the death rate due to two reasons. In developed nations, the proportion of people aged above 65 is more as compared to India (check the table above) due to better health/sanitation facilities. Citizens of developed nations also suffer from more comorbidities which could contribute to greater mortality (check the table above). The number of deaths reported in India may also seem to be lower due to underreporting for the reasons already highlighted. This underreporting had already been established by court observations and media reports.

The Patna HC, pointed out glaring discrepancies in the COVID data of the Bihar government. Hindustan Times reported, “Between 1st March 2021 and 10th May 2021, the Gujarat government has recorded only 4200 deaths from COVID, but about 1.20 lakh death certificates were issued in the state."

It is surprising that the rhetoric of India doing better than developed nations is only used when the developed nations have a poor statistical ranking. The comparison never draws to question the unimaginably low budget that India has dedicated to health in comparison with the USA and European nations (check the table above).

---

Claim 2: Farmer protests are equally responsible for the 2nd wave as compared to political rallies and Kumbh Mela

Reply

It’s inappropriate to compare them because the number of people attending the Kumbh was 91 lakhs versus a maximum of 1-2 lakh people at the protest. I feel the people opposing The Lancet article have ignored the crux of Lancet's case. Farmers' protests were a spontaneous agitation against the government's passing of new farm laws. But Kumbh Mela and political rallies were planned over months and were in government and Election Commission's own control. We can’t really blame the people who voluntarily attended the Kumbh and the India-England cricket matches as the government has far more responsibility and better decision-making capacity (owing to the presence of data, researchers, bureaucrats and advisors) to make sure such events were cancelled in the first place.

Had data on COVID cases and death not been hidden but rather used for decision making, it might have led to the government cancelling such “super spreader” events like the Kumbh and the cricket matches. Mr Prabhat Jha, Epidemiologist and Director of the Centre for Global Health Research in Toronto, highlighting the importance of data says, “Data actually offers a roadmap of the pandemic. When vaccine supply is limited in India, prioritising hotspots would be the best way to reduce the infection."

Even assuming the worst case, i.e all the three events are equally responsible for COVID spread, the question then becomes which ones could have been prevented. The Kumbh Mela could have been delayed to next year, when it actually was about to happen, 12 years after the last one in 2010.

---

Claim 3: Showing the full wrath of COVID by journalists causes fear in the minds of people

Reply

This leads to:

1. Black marketing, hoarding of oxygen cylinders and medicines: But, black marketing is done for profit and not out of fear. If fear would have been the motivating factor, then the police wouldn’t have found thousands of oxygen concentrators in possession of a single person. Moreover, people under fear will hoard fewer supplies that will never be brought to light as it wouldn’t arouse suspicion.
2. People crowding hospital facilities for the mildest of symptoms: This seems unbelievable as an average citizen doesn’t get himself admitted without a doctor’s opinion. The doctors act in good faith and will usually recommend people with mild symptoms to home quarantine. In a few cases, speculating a shortage of beds, the doctor might tell the patient to get himself admitted.
3. Harming people’s mental health: This argument assumes that people can’t opt out of social media and are forced to see such stories. This is not true. Most social media users opt into what pages they follow and engage with. Instagram and Facebook have options of muting posts and stories of pages. Media outlets have now also started to put a trigger warning on their Instagram posts thus allowing people to make an informed choice.

---

Claim 4: Western media houses did not show horrifying images from hospitals in the USA or UK, even with COVID-19 in their home country

Reply

This is completely untrue. As deaths from COVID surged in New York last year, Reuters, Washington Post, CNN, New York Times, BBC, Telegraph showed drone footage of caskets being buried in mass graves. There were similar reports from graveyards in Brazil, Italy and the United Kingdom. Journalists are thus playing an important role to expose the discrepancies between reality and government data.

---

Claim 5: It's unethical and immoral to show triggering images of people who died of COVID- If it's illegal in the USA (due to the presence of the HIPPA Act) to show images of dead people without consent, the same moral standard must apply to India as well

Reply

Journalists are bound to follow the law of the land and nothing more. For example, in France there is no law to punish people criticising religious sentiments, thus newspapers like Charlie Hebdo have published cartoons criticising religions without any repercussions. However, when they want to publish the same cartoon in India, they can be booked under the Indian Penal Code. Such dichotomy exists in healthcare law as well. If there is no law preventing the displaying of dead bodies, it's legal for the journalists to do it. At best it can be called an immoral act to do such a thing. However, showing the full wrath of the COVID sparks fear in the minds of the general population. As fear is the strongest motivating factor for people to act, people can be compelled to act in a better way by showing such devastating images.

---

Claim 6: The Lancet paper ignored India’s generous humanitarian initiative of exporting 66 million doses of vaccine

Reply

I don’t think it's humanitarian to let vaccine shortages affect the country’s own citizens. Given India’s huge population, it's reasonable to expect from the government that it should have preempted a shortage. The exports on humanitarian grounds should have been delayed until a large chunk of 18 to 45 years people were inoculated. The government could also have incentivised other vaccine creators like Pfizer and Moderna to apply to CDSCO for emergency use authorisation. This would have allowed multiple players in the Indian vaccine market and could have prevented a shortage as we see now. Such proactive steps could only be possible if we did not claim victory too soon and didn’t become complacent.

---

Claim 7: The Lancet paper only criticised India’s response because of a hidden agenda and did not do so for other countries; it has ignored China’s Human rights violation and its potential role in weaponising SARS-CoV-2

Reply

The Lancet Commission on Public Policy and Health assessed the repercussions of the US President's health-related policies and examined the failures and social schisms that enabled his election. Especially in the COVID era, the Lancet criticised the US Predient's COVID response and blamed the USA’s poor response on the “absence of a cohesive national strategy, and volatile, incompetent leadership”. The Lancet has also published a news article in 2004 that discusses the USA action of filing a resolution at a UN conference condemning China's human rights record. Expecting The Lancet to publish conspiracy theories like the potential use of SARS-CoV-2 as a bioweapon is a step too far because no reputed medical journal would indulge in a practice like this.

---

Claim 8: We are able to criticise the government only because we have the benefit of hindsight

Reply

This is a blatant lie. Second waves in pandemics are not a new sight. Allowing the Kumbh Mela to continue led to most devotees attending it in the month of April even though a warning of a more contagious variant by a forum of scientific advisers (set up by the Indian government themselves) was issued in early March. The shortage of oxygen was predicted by the national task force as early as April and November 2020. All this proves that the government had the opportunity to act but failed to respond adequately.

---

Click here to see references