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Lancet Editorial Slams Modi Government for Ignoring Second Wave Warnings
In an editorial that minced no words, the medical journal The Lancet severely criticised the Narendra Modi government for its handling of the COVID-19 crisis in India, saying it has given the impression of being more occupied with “removing criticism on Twitter than trying to control the pandemic”.
The editorial says top government officials prematurely declared victory over the pandemic – highlighting health minister Harsh Vardhan’s comment that India is in the ‘endgame‘, leading to complacency and insufficient preparation. While pointing out the shortcomings of the government’s response, The Lancet also suggested a two-pronged strategy to control the outbreak.
“The impression from the government was that India had beaten COVID-19 after several months of low case counts, despite repeated warnings of the dangers of a second wave and the emergence of new strains. Modelling suggested falsely that India had reached herd immunity, encouraging complacency and insufficient preparation, but a serosurvey by the Indian Council of Medical Research in January suggested that only 21% of the population had antibodies against SARS-CoV-2,” the editorial says.
The journal also criticised the government’s decision – despite warnings – to allow religious and political congregations These events are “conspicuous for their lack of COVID-19 mitigation measures”, the editorial said.
“The message that COVID-19 was essentially over also slowed the start of India’s COVID-19 vaccination campaign, which has vaccinated less than 2% of the population. At the federal level, India’s vaccination plan soon fell apart. The government abruptly shifted course without discussing the change in policy with states, expanding vaccination to everyone older than 18 years, draining supplies, and creating mass confusion and a market for vaccine doses in which states and hospital systems competed,” The Lancet said.
The journal said that the country’s “botched” vaccination campaign must immediately be rationalised and implemented with all due speed. It saw two immediate bottlenecks: increasing vaccine supply (some of which should come from abroad) and setting up a distribution campaign that will also cover rural and poorer citizens, who “face a desperate scarcity of public health and primary care facilities”. “The government must work with local and primary health-care centres that know their communities and create an equitable distribution system for the vaccine,” it suggested.
Transmission of the virus should also be reduced as much as possible while the vaccine is rolled out, The Lancet said, asking the government to 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. The editorial says the government must also consider the possibility of a new federal lockdown.
“Genome sequencing needs to be expanded to better track, understand, and control emerging and more transmissible SARS-CoV-2 variants. Local governments have begun taking disease-containment measures, but 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. Modi’s actions in attempting to stifle criticism and open discussion during the crisis are inexcusable,” it said.
Citing estimates made by the Institute for Health Metrics and Evaluation, The Lancet said India could see 1 million deaths from COVID-19 by August 1. “If that outcome were to happen, Modi’s Government would be responsible for presiding over a self-inflicted national catastrophe. India squandered its early successes in controlling COVID-19. Until April, the government’s COVID-19 taskforce had not met in months. The consequences of that decision are clear before us, and India must now restructure its response while the crisis rages,” the editorial says.
The success of this restructured response 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”, it concluded.
The editorial comes at a time when many Indians are struggling to find hospital beds and oxygen cylinders for COVID-19 patients who require critical care. On Saturday, India reported its highest death toll yet due to COVID-19, recording 4,187 fatalities. The country also reported 4,01,078 new infection, the third consecutive day with more than 4 lakh new cases.
(Courtesy: The Wire.)
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COVID-19: Maha Kumbh ‘Single Largest Super Spreader Event’ Raising Virus Footprint Across India
Rashme Sehgal
The Mahakumbh Mela’s gift to the host state of Uttarakhand – the number of COVID-19 cases in this hilly state have doubled in one month’s time. On March 29, the number of recorded cases in Uttarakhand was approximately 90 ,000. On May 3, the figure had jumped to 2.11 lakh. On May 6, Uttarakhand recorded 8517 active cases in one day.
This quantum jump, doctors believe, along with the new mutant strains, must be directly linked to the holding of the Maha Kumbh Mela in Haridwar in the month of April which was attended by over 91 lakh pilgrims. An explosive 1800% spike in active cases in Uttarakhand took place between March 31 and April 24, coinciding with the large congregations that had gathered in this holy town.
More than 1,000 people had tested positive in just 48 hours in Haridwar between April 12-13. The numbers have only kept rising since. The key question being asked is why these pilgrims were not quarantined for a fortnight in Haridwar itself before being allowed to spread the virus in their homes scattered across the country?
Uttarakhand, unfortunately, had not made any provision for large scale quarantining. Despite making an allocation of Rs 2,000 crore to upgrade services for the Kumbh Mela that also included large scale testing and quarantining facilities, the newly elected Uttarakhand Chief Minister Tirath Singh Rawat stated that no devotee would be “unnecessarily harassed in the name of COVID-19 restrictions”. He even went on to say that, “Ma Ganga’s blessings are there in the flow of the river so there will be no coronavirus,” and a signal was sent out to the health workers on duty not to push for the implementation of basic COVID-19 protocols including masking and testing. The tweet by the Union Health Ministry on April 6, denying that the Kumbh Mela could become a serious health emergency only added to create a sense of fake assurance.
Not quarantining pilgrims in Haridwar and allowing them to return home using different modes of transport has accelerated the spread of the virus.
Rise in Cases Across States
The result of this criminal mistake is that these infected carriers have spread the virus to every corner of the country. Confirming the surge of COVID-19 cases across its five districts of Dehradun, Tehri, Haridwar, Nainital and Udham Nagar, Uttarakhand’s Director of State Medical and Health Department, Dr. SK Gupta, pointed out, “Several check points had been put up where visitors attending the Kumbh Mela were tested. Those who tested positive were sent back to their homes.”
When asked what was the line of treatment for those who tested positive during the mela, Dr Gupta said, “We had set up a 650- bed facility for COVID-19 positive patients who were being treated there.”
Obviously these measures were not adequate as the fallout is being felt across states.
Take the case of the small town of Mendhar in Jammu and Kashmir’s Poonch district. On Tuesday, May 4, a middle- aged woman, Kanchan, was cremated by the district authorities. She was suffering from COVID-19 as confirmed by the district collector of Poonch, Inder Jeet.
She had made the mistake of going to meet her parents in the nearby town of Adhi, also in Poonch district, after they returned from the Kumbh Mela. Four days later, the woman was dead and was cremated according to COVID-19 protocols by personnel of the district authorities.
Three other pilgrims, who had travelled to Haridwar for the Kumbh Mela from Mendhar, have also reportedly succumbed to the virus in late April.
In the neighbouring Rajouri district, BJP leader and former legislator Thakur Puran Singh, a resident of Koterkanka, died of COVID-19 after attending the Kumbh Mela. He too was cremated following all COVID-19 protocols, as per the authorities.
J&K has witnessed a sharp rise in COVID-19 cases, reportedly from which almost half belong to the highly infectious UK strain and are from the Jammu division. On May 6, J&K recorded 4,926 new cases from which 1,685 were from the Jammu division.
In fact, there is no corner of India which did not see infected pilgrims leave their deathly imprint and the steps being taken by the state governments is a case of too little too late.
Madhya Pradesh mandated that the Kumbh Mela returnees should quarantine themselves but did not make the COVID-19 test compulsory. Leaving it to pilgrims to self- quarantine does not always work.
Take the example of 83 people who returned to Gyaraspur in Vidisha district on April 25. Unwilling to be tested, 22 of these visitors went underground while 60 out of the rest 61 tested positive. They were told to stay in home isolation. Five went on to develop complications and were moved to COVID-19 care centres.
In Odisha, the state claimed that around 400 people of 150 families had attended the Mela, though this information is suspect because several people may have used circuitous routes via Delhi and other cities to return to their home state. Special relief commissioner P.K. Jena was quoted saying that all district administrations have been told to trace the people who had gone to the Kumbh and were in touch with the Uttarakhand government. The state has made a 14-day quarantine mandatory for all those returning from the Mela. Odisha registered a spike in cases following the return of pilgrims, recording 9,889 new cases on May 6 with a concomitant rise in death cases.
The Delhi Disaster Management Authority issued an order making it compulsory for all pilgrims who had visited the Kumbh Mela to upload their personal details, ID proof, and dates of departure and arrival back to Delhi at their official website as also undergo a fortnight’s compulsory home quarantine.
“But which is the body which is going to oversee and ensure that this diktat is practised?,” asked Jammu-based activist Sukesh Khajuria.
Gujarat CM Vijay Rupani issued a similar diktat, ordering all collectors to keep watch on the Kumbh Mela returnees and enforce a nakabandi (security checking) to prevent their entry in their hometowns without undergoing an RT-PCR test.
According to official data, 533 Kumbh returnees were tested for the virus at Sabarmati Railway Station in Ahmedabad on April 15 and 16. Rapid antigen tests were conducted by the civic health teams and those who tested positive were shifted to COVID-19 care centres in the city, the Ahmedabad Municipal Corporation said in a statement. From one lot of 313 people, 34 were found to be posiive.
The following day, out of 220 Kumbh returnees, 15 were found to be infected with the virus. Government statistics indicate that as per the data available, one out of every 10 returnees has tested positive in Gujarat, stoking fear that Kumbh returnees are super-spreaders.
Gujarat is among the 10 worst hit states in India as of today. Maharashtra has the highest 6.72 Lakh active cases followed by Uttar Pradesh (1.91 lakh) and Karnataka (1.33 lakh).
The Maharashtra government had also ordered that all Kumbh returnees must undergo a 10-day home quarantine. Mumbai city Mayor Kishori Pednekar had ordered that all those returning from the Kumbh Mela should be quarantined for 10 days in hotels and allowed to return to their homes only if they test negative. But cases continue to rise dramatically in this state and on May 6 the state recorded 62,194 active cases.
COVID-19 test would be mandatory for all Karnataka pilgrims returning from Kumbh Mela at Haridwar, state Health Minister K. Sudhakar announced on Thursday, May 6. “Pilgrims returning to the state after taking part in the holy Kumbh Mela at Haridwar must self-isolate at their home for a week and take an RT-PCR test,” said Sudhakar in a tweet in Kannada, tagging an order from the state Health Department.
States Didn’t Heed Health Experts’ Warnings
Health experts including Dr K Srinath Reddy, president of the Public Health Foundation of India, and Dr Sundarraman, Global Coordinator of the People’s Health Movement, had warned that the Kumbh returnees could be a source of creating new COVID-19 clusters. In places where the pandemic has not reached, these people would contribute significantly in spreading the disease these experts added.
Similar curbs have been put in place in other states. The problem is that each state has been so consumed with dealing with rising COVID-19 cases that they have not been able to create mechanisms to keep a tab on the exact numbers of Kumbh Mela returnees.
Uttar Pradesh, the neighbouring state to Uttarakhand is also reeling under the pandemic. Former Uttarakhand CM Trivendra Singh Rawat was in so much awe of Yogi Adityanath that his decision to hold a huge gathering at Haridwar had been directly inspired by the popularity of the 2019 Ardh Kumbh held in Allahabad and Rawat was determined to outdo that event in pomp and splendour.
Over 20 seers tested positive in Haridwar and Kapil Dev Das, head of an akhada, succumbed to COVID-19 in mid-April while Narendra Giri, president of 14 leading akhadas, ended up being infected with the virus. The money wasted on the Kumbh could have been spent on setting up oxygen plants for every hospital in the country.
Instead, we have been left decrying an event that that Dr Ashish Jha, Dean of the Brown University School of Public Health denounced as being the “single largest super spreader event of the entire pandemic”.
(The author is an independent journalist. Article courtesy: Newsclick.)
