India did the opposite of preparing for the second wave. It declared the war won and disengaged. But with the enemy still lurking around, complacency turned out to be an invitation to indiscriminate slaughter.
Indian Prime Minister Narendra Modi declared a decisive victory over the Covid-19 pandemic on January 22, 2021, at the 18th convocation of Tezpur University. He then declared the same to the world with another boastful sweep at the World Economic Forum’s Davos Summit on January 28, 2021. The prime minister said that India had taken “proactive decision to curb the fast-spreading virus”, and had “resisted the virus spread significantly and utilized the opportunity to improve our health infrastructure.”
On January 28, 2021, addressing the international community, the Prime Minister started by taking a dig at experts and institutions that had warned that with India’s dense population and hugely deficient health infrastructure, the Covid-19 pandemic could result in a large number of infections resulting in numerous deaths. The PM made light of the well-meaning warnings of disaster and basked in the fact that both the number of infections as well as Covid-19 related deaths had inexplicably dropped. India appeared to be faring better than many countries on that front.
Modi credited the “victory” to developing “Covid-specific health infrastructure”, “proactive, public participation approach”, “training human resources to rise to the challenge”, “using technology for testing and tracking”, “patient and dutiful conduct of the people”, and “turning the fight against Corona into a mass movement”. In short, the PM was congratulating himself for his phenomenal leadership. He also told the world that by controlling the spread of Covid-19, India had protected “the world and the humanity from a great tragedy.”
The fact is, none of it was true; not verifiably any way. In the absence of any plausible explanation for the decline in infections and death rate, there was no reason to think that the war against the pandemic had been won.
We did not know why the cases had declined; but the Prime Minister conveniently credited whoever and whatever suited him politically. There was no “proactive public participation”, for people had flouted social distancing norms routinely whenever there was an excuse. One such occasion was the taali-thali homework the Prime Minister had prescribed, and which was enthusiastically undertaken by the population as a pack activity to be performed in close proximity. It might be “dutiful conduct” because they had obediently done what the prime minister had asked, but it certainly couldn’t have helped India’s Covid-19 situation, and didn’t.
The only “mass movement” to speak of was the movement of the migrant laborers after the brutal national lockdown at a four-hour notice by the prime minister himself (on expert advice, they said), resulting in widespread misery and several senseless deaths. Thousands of poor workers found themselves on the road without food and shelter. The gut-churning human tragedy had exposed a complete lack of foresight, bordering on recklessness. The government had ordered a sudden lockdown without thinking about its possible consequences in a country as big, diverse and poor as India.
The Impact of the Lockdown
The lockdown was brutal and painful for migrant workers and the lower class in general. However, it was not the lockdown itself but the suddenness and ground-level unpreparedness that was the source of widespread misery.
The lockdown did help in arresting the upward trend of Covid-19 infections but it couldn’t have ended the pandemic A study, possibly the very first of its kind, published in the European Journal of Medical Research on November 10, 2020, “investigated the impact of a lockdown on epidemiological trends of prevalence and mortality of the COVID-19 pandemic.” Conducted with data from twenty-seven countries worldwide, the study found a noticeable decline in the growth rate “per day by the end of the lockdown period for both new daily cases and deaths.” But the findings failed to confirm the initial hypothesis that “that lockdown will significantly decrease the number of cases” because “the growth rate never fell to below 1.0 immediately following the lockdown. The study concluded that “the lockdown was beneficial in decreasing the rate of growth per day of infection”, but “was not sufficient to stop the pandemic.”
Pretty much in line with the study cited above, India’s lockdown did slow down the rate of infections and deaths but failed to bring the pandemic under control. Since the infections were dropping, the government got complacent.
Why India thought it had won the Covid battle?
The decline in the number of infections could be due to a relatively younger population assisted by the fact that over 65% of Indians live and work in the countryside. The virus is far more effective in closed surroundings compared to open areas. Also, the spread of the pandemic was uneven.
“My hunch is exposure to the infection is much higher than what the surveys indicate. Also we should not be taking India as one. In some cities like Delhi, Mumbai, Pune, and Bangalore, up to 60% of people have been found with antibodies to the virus. So it’s all very uneven,” Dr Shahid Jameel, a leading virologist had pointed out. A large number of cases could have gone unreported because people did not get themselves tested due to mildness of symptoms.
Likewise, the low death rate could be due to a number of reasons, and one of them could easily be underreporting of deaths. India has not been particularly diligent in keeping the count, then as now. So many more died than reported dead.
In fact, even in August 2020, doubts about the low death rate were raised despite the Indian government frequently highlighting low mortality rates of Covid-19 patients compared to other countries. Modi singled it out as the indicator of India’s success in arresting the march of the pandemic.You will find more infographics at Statista
The claim was based on the Case Fatality Rate (CFR), which is not a particularly robust measure. CFR applied to a nation fails to take into account a number of relevant factors, among the most crucial of which is age. During the first wave, the virus affected the elderly disproportionately. A number of studies also indicated that age-adjusted CFR for India was not particularly low.
A study published in the Journal of Human Development and Capabilities on December 30, 2020, said that their “evaluation of India’s experience suggests that the country’s record is a good deal less flattering than a reliance solely on a measure of central tendency such as the case fatality rate would indicate.” The study further said that age-adjusted CFR “predictions are lower than India’s actual performance, suggesting that India’s CFR is, if anything, too high rather than too low.” In view of the findings the study warned against “misplaced complaisance”.
While the government and its agencies evaluating the situation went into congratulatory overdrive over successful measures, the authors of the study had said, “India’s Covid-19 experience does not imply successful management from the points of view of human development and capability achievement. At the very least, there is reason to believe that an undiscriminating employment of the raw CFR as an indicator of success deserves to be treated with some skepticism.”
The authors did not fail to point out that such “summary indicators of performance” are “inadequate or misleading” and threaten “both objective appraisal and fair accountability”, particularly when they “are employed to their advantage by politicians and policy-makers.”
It is safe to say that there was considerable doubt in the scientific community regarding the factors responsible for the drop in infections and deaths, but no credible scientific expert thought it was over. And none of them had ruled out the second wave.
Reckless and Dangerous Declaration
In fact, the possibility of a second wave was raised in April 2020 itself. It was based upon the understanding that pandemics come in multiple waves. The 5th century BC outbreak of plague in Athens hit repeatedly in 430BC, 429BC, and then between 427BC to 426BC. Black Death also made a comeback in 14th century Europe, and so did smallpox in the 18th century. And just a century ago, the Spanish Flu assailed much of Europe in the spring of 1918, and then returned later the same year, and then again in 1919.
A study published on April 30, 2020 by The Center for Evidence-Based Medicine (CEBM) analyzed and tabulated ten outbreaks starting from the 1889-1991 pandemic and ending with the current pandemic. It reflected that most of the pandemics came in multiple phases. The study noted that the second-wave theory for Covid-19 pandemic was largely based on the experience of the Spanish Flu of 1918-20, which “infected 500 million people worldwide and reportedly killed an estimated 20 million to 50 million.” After the initial outbreak, the flu returned with “a deadlier strain” in August 1918.
The 2009 H1N1 influenza pandemic came in two waves as well. A study of the seroprevalence after the second wave had “found high anti-2009 H1N1seroprevalences among school children and high anti-1918 H1N1 seroprevalences among the elderly”, making “further sustained viral transmission” unlikely. Relatively low transmissibility of the novel 2009 H1N1 influenza strain and the vaccination had helped the situation. But the study cautioned that there was a possibility “that geographical pockets of limited immunity may be present in which a third wave may yet occur”, making it imperative that “ongoing viral and serosurveillance efforts” were maintained for informed “decisions around vaccination and other disease mitigating strategies.”
In the same breadth, regarding the current pandemic, the CEBM study of April 2020 had noted that although “absolute statements of certainty about ‘second wave’ is unwise”, “preparedness planning should be inspired by robust surveillance, the flexibility of response and rigid separation of suspected or confirmed cases.”
India did the opposite of preparing for the second wave. It declared the war won and disengaged. But with the enemy still lurking around, complacency could only be an invitation to indiscriminate slaughter, the kind of which we are witnessing now with almost a quarter of a million falling every day.
Prime Minister’s self-congratulatory trumpet of victory at the Davos Summit was not only an ugly display of vainglorious hubris but also reflected a reckless disregard of science, expertise, and even reason with callous indifference to public health and safety.