Science Another Casualty of COVID-19

The New York Times has recently published an article detailing how politics overrode science in India's deadly second wave. It is based on the struggle of a young scientist, Dr Anup Agarwal, who sought to warn the top scientific and health agency, Indian Council of Medical Research, of a second wave and that a policy based on the so-called Super Model would be disastrous for the country. Dr Agarwal has since then left the country.

Dr Agarwal was not the only one who had warned the government. Many other scientists and scientific bodies had warned that a second wave was very likely, and the so-called Super Model was mathematically and epidemiologically bogus. But this is not what the government wanted to hear. They had set their sights on the state elections in Tamil Nadu, Kerala, Assam and West Bengal. After Narendra Modi proclaimed "victory" in Davos, the World Economic Forum's Summit in January 2021, any message to the contrary was simply not going to be heard. And of course, there was the Kumbh Mela in Haridwar, which had to be allowed despite the risks of spreading the epidemic.

Even when the second wave was killing large numbers in April 2021 and hospitals were facing a dire shortage of beds and medical oxygen, Modi and Home Minister Amit Shah were still on their campaign trail in Bengal. Modi only stopped his public rallies almost two weeks after the Left and other parties had called off their public campaign in Bengal. Of course, the pandemic spread in Bengal was compounded by the Election Commission's unprecedented decision to hold the longest ever election in any state in the country. Completely missing in the second wave was the voice of science and sanity in the decision-making on how to handle a pandemic.

NYT story has made public how science in India's major science institutions became a hand-maiden to immediate politics. It has brought an insider's account of how ICMR discouraged any questioning of the "official narrative", including disciplinary measures to silence scientific voices. It details how papers that did not support the official narrative were not allowed to be published or withdrawn. This makes world news, and therefore news in India as well. But scientists and health experts—braving the government's displeasure—have been speaking up in public throughout the epidemic. Indian news organisations—traditional and digital platforms—have carried critical opinions on the Modi government's failure in handling the COVID-19 pandemic and reported these views despite the government's hostility. This also includes our columns and our video discussions in Newsclick. The All India Peoples Science Network and Jan Swasthya Abhiyan have issued a number of statements in this period articulating most of the concerns that NYT has now reiterated. We should not think that Dr Agarwal is or was the only lone voice within the Indian scientific community.

Let us start first with the interventions of the public health and scientific bodies. Three leading public health bodies—Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) & Indian Association of Epidemiologists (IAE)—issued a series of statements, bringing out the failures in government's handling of the pandemic. The key failure was not handling it as a public health and epidemiological challenge but as an "administrative" one. It was this failure that was reflected in the failure of the draconian lockdown to contain the First wave. On May 25, 2020, they wrote, "India's nationwide "lockdown" from March 25, 2020, till May 31, 2020, has been one of the most stringent; and yet COVID cases have increased exponentially through this phase, from 606 cases on March 25 to 138,845 on May 24." Further, they stated, "The incoherent and often rapidly shifting strategies and policies, especially at the national level, are more a reflection of "afterthought" and "catching up" phenomenon on the part of the policymakers rather than a well thought cogent strategy with an epidemiological basis." Simply put, in the government's handling of the epidemic, a scientific understanding of the epidemic was missing.

The other continuing mishandling of the COVID-19 epidemic is the ICMR recommendations on medicines. Extensive trials with hydroxychloroquine and ivermectin, have shown that they have no efficacy, yet they were still being promoted. ICMR's COVID-19 Guidelines dated May 17, 2021, issued by ICMR and the Ministry of Health and Family Welfare continued to recommend these two medicines for COVID-19 treatment, taking them off only on September 23, 2021. NYT claims that this is the Trump-Bolsonaro influence on Modi. Instead, it may be simply the unwillingness to confront the anti-vaccination and anti-science campaign that has taken over major parts of social media, even in India.

This disregard of science continues throughout the Modi Government's handling of the COVID-19 pandemic. But it was most blatant in the period between the First and the Second Wave. There were two key features in how the Modi government dealt with science in this period. The first was to proclaim complete victory over COVID-19 using a deeply flawed "Super Model". The second was to completely disregard all scientific data early this year that showed that there was a new, much more transmissible variant emerging in India and, therefore, the imminent threat of a Second Wave.

The Modi Government collected a set of modellers whose task was to proclaim victory over the pandemic. A paper authored by three persons who led the DST's Super Model was published in Indian Journal Medical Research, which made astounding claims:

• There were two kinds of people, some who remain symptomatic and somebody who fell seriously ill
• The COVID-19 pandemic was waning in late 2019, and by February 2021 would disappear from India
• India had 380 million already infected and could be moving towards "herd immunity."

The criticism of this approach to modelling was sharp. Professor Gautam Menon, who is a modeller and an epidemiologist, pointed out that nothing in the COVID-19 pandemic showed that people who have different levels of infection are different. They only have different levels of exposure and levels of immunity. He also explained that the DST Super Model had not simply added an extra parameter but also changed the parameters continuously, making it from a 3 parameter to a 24 parameter model. This was robbing it of any worthwhile predictive value. Speaking to the leading publication Science, T Jacob John, former head of the department of virology at Christian Medical College, explained why models of a national epidemic did not work. "The national epidemic is a "figment of statistical imagination. Instead, there are 100 or more small epidemics in different states and cities, rising and falling at different times." There were enough scientific voices within and outside the governmental agencies that privileging a so-called Super Model simply to propagate what the government wanted to hear, or wanted people to hear, could have dangerous consequences.

On the rise of a more infectious variant of SARS-CoV-2 or what we now call Delta variant, again, the Modi government had advance warning as early as March 2021. Reuters had reported on May 1, 2021, that the Indian SARS-CoV-2 Genetics Consortium, or INSACOG, had warned about a new, much more infectious variant in early March. This was conveyed to a top official who reports directly to the prime minister, presumably either the head of ICMR or the Scientific Advisor to the PM. Why then was no measure taken to strengthen the public health systems and the increase in the supply of medical oxygen, the most important "medicine" for serious cases of COVID-19? Instead, we saw public rallies, lengthening of elections to allow the national BJP leaders to visit more states and address more rallies and complete COVID-19 inappropriate behaviour on the dais and in rallies.

The NYT reports again confirm what we knew about this government's disregard for science. I am going to end with what two scientific voices said to Reuters (May 1, 2021). Shahid Jameel, chair of the scientific advisory group of INSACOG said, "I am worried that science was not taken into account to drive policy." Rakesh Mishra, director of the Centre for Cellular and Molecular Biology, which is part of INSACOG, said the country's scientific community was dejected. "We could have done better, our science could have been given more significance,...what we observed in whatever little way, that should have been used better." Science was among the many casualties in the Modi Government's handling of the COVID-19 pandemic.