A self-inflicted national catastrophe

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Lancet, the world’s leading medical journal, holds government responsible for the spread of coronavirus in India and makes some important suggestions

This is a tough time for the Modi Government and Prime Minister Narendra Modi has been made the face of failure in India’s battle against the pandemic—which nearly accounts for half of the Covid-19 cases all over the world. All the leading publications of the world, including New York Times to the Guardian, have been carrying lead stories about the corona debacle in India. So much so, that Foreign Minister Jaishankar —a career diplomat—asked the heads of Indian missions abroad to counter ‘one sided’ world media narrative on the government’s failure to deal with the second wave of coronavirus.  

While this was on, in a rare move, Lancet, one of the world’s oldest and best-known weekly peer-reviewed general medical journals, in an editorial, described the state of affairs in India—it was not  a rosy picture, and held the leadership responsible by name. “(Prime Minister Narendra) Modi’s actions in attempting to stifle criticism and open discussion during the crisis are inexcusable,” the editorial said.

Lancet editorial started by saying, “The scenes of suffering in India are hard to comprehend,” hinting that a huge part of it was avoidable. Describing the situation, “Hospitals are overwhelmed, and health workers are exhausted and becoming infected. Social media is full of desperate people (doctors and the public) seeking medical oxygen, hospital beds, and other necessities” it was not that the establishment was taken by surprise, perhaps denial. When the second wave of cases of Covid-19 began to mount in early March, “Indian Minister of Health Harsh Vardhan had declared “that India was in the ‘endgame’ of the epidemic,” Lancetwrites. Despite “repeated warnings of the dangers of a second wave and the emergence of new strains” Lancet points out “Modelling suggested falsely that India had reached herd immunity, encouraging complacency and insufficient preparation.” 

At times, Prime Minister Narendra Modi’s Government has seemed more intent on “removing criticism on Twitter than trying to control the pandemic,” further, “despite warnings about the risks of superspreader events, the government allowed religious festivals to go ahead, drawing millions of people from around the country, along with huge political rallies—conspicuous for their lack of Covid-19 mitigation measures.” Also at the federal level, “India’s vaccination plan soon fell apart.” 

The editorial mentions the states of Uttar Pradesh and Maharashtra as an example “unprepared for the sudden spike in cases, quickly running out of medical oxygen, hospital space, and overwhelming the capacity of cremation sites, and with some state governments (there were reported cases from Uttar Pradesh) threatening those asking for oxygen or a hospital bed with national security laws.” 

The timely government interventions do matter, as Lancet gives the example of Kerala and Odisha “were better prepared, and have been able to produce enough medical oxygen in this second wave to export it to other states.”

Suggestions: Lancet suggested India pursue a “two-pronged strategy.”  The first being what they call the “botched vaccination campaign” be “rationalised and implemented with all due speed” and to be able to do that remove “two immediate bottlenecks”  that being “increasing vaccine supply and setting up a distribution campaign that can cover not just urban but also rural and poorer citizens” Also, the government must work with “local and primary health-care centres” that know their communities and create an equitable distribution system for the vaccine.

Second, to reduce SARS-CoV-2 transmission as much as possible while the vaccine is rolled out. For that it’s important “the government must publish accurate data in a timely manner, and forthrightly explain to the public what is happening and what is needed to bend the epidemic curve, including the possibility of a new federal lockdown.”There has been reluctance on the part of the government to impose a nation-wide lockdown due to adverse economic consequences. 

Further, “genome sequencing needs to be expanded to better track, understand, and control emerging and more transmissible SARS-CoV-2 variants,” points out Lancet as “the federal government has an essential role in explaining to the public the necessity of masking, social distancing, halting mass gatherings, voluntary quarantine, and testing.”

The Institute for Health Metrics and Evaluation estimates that India will see a staggering one million deaths from Covid-19 by Aug 1. “If that outcome was to happen, Modi’s Government would be responsible for presiding over a self-inflicted national catastrophe,” the Lancet editorial didn’t mince words. And to change that, or prevent it from happening, “India must now restructure its response while the crisis rages. The success of that effort will depend on the government owning up to its mistakes, providing responsible leadership and transparency, and implementing a public health response that has science at its heart.”

 

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