The good, the bad, the ugly: What went wrong during India’s Covid-19 response

‘According to our village-level digital entrepreneurs in the SoochnaPreneur programme at Digital Empowerment Foundation (DEF), the four essential systems that were massively hit by the pandemic were education, healthcare, finance, and citizen entitlements. When the pandemic was raging, our SoochnaPreneurs reported that all people wanted was food and rations, a device to access online education for their children, the ability to talk to a doctor or health worker to learn how to keep themselves safe, and to make some money to meet their daily needs from the confines of their homes. Ironically, given the stringent nature of the lockdowns, all this needed access to the internet.

‘However, across the country, lack of access to resources, high levels of digital illiteracy, and the deepening digital divide exacerbated by the pandemic acted as major roadblocks in India’s COVID-19 response. Even as the government announced relief packages—food grains and cash payments—the mechanisms of delivery to beneficiaries at the last mile were unclear.’

Read here (IPS New, Nov 23 2021)

India may be reaching ‘endemicity’ after emerging from second COVID-19 wave

‘The number of new COVID-19 cases and deaths in India has dropped dramatically since a second wave of the virus peaked in May. First the Alpha and then the Delta variant — which was first detected in India and is now causing strife elsewhere in the world — ravaged the country. But the seven-day average of daily reported cases this week is just a tenth of the 400,000 recorded during the peak.

‘According to health authorities, more than 439,000 people in India have now died with the virus. The relatively stable numbers, which lasted throughout August, prompted the World Health Organization's chief scientist to suggest India may have reached a state of "endemicity". That is, it may be endemic or constantly present in a particular place. So how did they get there and is the worst of the pandemic over for India?’

Read here (ABC News, Sept 6, 2021)

India’s DNA Covid vaccine is a world first – more are coming

‘India has approved a new COVID-19 vaccine that uses circular strands of DNA to prime the immune system against the virus SARS-CoV-2. Researchers have welcomed news of the first DNA vaccine for people to receive approval anywhere in the world, and say many other DNA vaccines might soon be hot on its heels.

‘ZyCoV-D, which is administered into the skin without an injection, has been found to be 67% protective against symptomatic COVID-19 in clinical trials, and will probably start to be administered in India this month. Although the efficacy is not particularly high compared to that of many other COVID-19 vaccines, the fact that it is a DNA vaccine is significant, say researchers.

‘It is proof of the principle that DNA vaccines work and can help in controlling the pandemic, says Peter Richmond, a paediatric immunologist at the University of Western Australia in Perth. “This is a really important step forward in the fight to defeat COVID-19 globally, because it demonstrates that we have another class of vaccines that we can use.”

Read here (Nature, Sept 2, 2021)

Three new estimates of India’s all-cause excess mortality during the Covid-19 pandemic

‘India lacks an authoritative estimate of the death toll from the COVID-19 pandemic. We report excess mortality estimates from three different data sources from the pandemic’s start through June 2021. 

‘First, extrapolation of state-level civil registration from seven states suggests 3.4 million excess deaths. Second, applying international estimates of age-specific infection fatality rates (IFR) to Indian seroprevalence data implies a higher toll of around 4 million. Third, our analysis of the Consumer Pyramid Household Survey, a longitudinal panel of over 800,000 individuals across all states, yields an estimate of 4.9 million excess deaths. 

‘Each of these estimates has shortcomings and they also diverge in the pattern of deaths between the two waves of the pandemic. Estimating COVID-deaths with statistical confidence may prove elusive. But all estimates suggest that the death toll from the pandemic is likely to be an order of magnitude greater than the official count of 400,000; they also suggest that the first wave was more lethal than is believed. Understanding and engaging with the data-based estimates is necessary because in this horrific tragedy the counting—and the attendant accountability—will count for now but also the future.’

Read here (Centre for Global Development, Jul 20, 2021)

Indian Covid mutant more contagious, but not vaccine resistant: Top WHO scientist

“Surge in India increases chances of more dangerous variants emerging. Prelim data shows that Indian variant is more contagious. There is heterogeneity in India in terms of spread of Covid-19. WHO is concerned about number of cases and deaths in India. Globally, cases and deaths have plateaued, not in South Asia. South East Asia is seeing case rise owing to India. Overall numbers hide what is going on, need to go deeper in state, local level data,” she said.

‘Speaking on efficacy of vaccines available in India, she assured, “There is no enough data to show that double mutant is vaccine resistant. All the available vaccines today in India and elsewhere prevent severe disease and death even if you get up the infection. You are not going to end up in the ICU critically ill. The message is take the vaccine whichever is available and you eligible for it. If your turn is there, please take it.”

Read here (Yahoo, May 10, 2021)

India's Covid-19 emergency: The Lancet proposes two strategies

‘India must now pursue a two-pronged strategy. First, the botched vaccination campaign must be rationalised and implemented with all due speed. There are two immediate bottlenecks to overcome: increasing vaccine supply (some of which should come from abroad) and setting up a distribution campaign that can cover not just urban but also rural and poorer citizens, who constitute more than 65% of the population (over 800 million people) but 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.

‘Second, India must reduce SARS-CoV-2 transmission as much as possible while the vaccine is rolled out. As cases continue to mount, 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. 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.’

Read here (The Lancet, May 8, 2021)

DCGI approves anti-Covid drug developed by DRDO for emergency use

‘The Drugs Controller General of India (DCGI) has granted permission for emergency use of anti-COVID-19 therapeutic application of the drug 2-deoxy-D-glucose (2-DG) developed by Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of Defence Research and Development Organisation (DRDO), in collaboration with Dr. Reddy’s Laboratories (DRL),Hyderabad. 

‘In a release issued on Saturday, the Ministry of Defence said that as per the order, emergency use of this drug as adjunct therapy in moderate to severe COVID-19 patients is permitted. It added that being a generic molecule and analogue of glucose, it can be easily produced and made available in plenty in the country. 

‘The drug comes in powder form in sachet, which is taken orally by dissolving it in water. It accumulates in the virus infected cells and prevents virus growth by stopping viral synthesis and energy production. Its selective accumulation in virally infected cells makes this drug unique.

‘Clinical trial results have shown that this molecule helps in faster recovery of hospitalised patients and reduces supplemental oxygen dependence, noted the release.’

Read here (The Hindu, May 8, 2021)

Covid in India: Missing facts, misdirected discourse

‘The current stentorian discourse sans facts, which shifts the blame on to the government for the supply chain failures of hospitals, misses a more critical fact. Anticipating a contingency like this, the Modi government had ordered 162 PSA plants at a cost of over Rs 200 crore in October last for government hospitals all over India. This could have produced 80,500 litres of medical oxygen per minute. This translates approximately to one ton of liquid oxygen per day per plant. 

‘But out of plants ordered for 162 hospitals, only 33 got installed. Why? Even state government hospitals thwarted the Centre’s plan for on-the-spot oxygen production facilities. The Print says, orders were placed in December but when vendors reached the hospitals for installation, many “faced resistance” from them, pretending “no space” — the real reason being vested interest to procure oxygen rather than generating the entire requirement onsite. This showed how advance planning for on-the-spot oxygen supply by the Centre was thwarted by even the state-run hospitals. In the contemporary shouting and counter shouting in the media and social media, has anyone heard about this farsighted move of the government, beyond the feeble voice of The Print?’

Read here (New Indian Express, Apr 27, 2021) 

India Covid crisis: Four reasons it will derail the world economy

It is clear that there is now a humanitarian crisis of significant proportions. India is a country of 1.4 billion people and makes up a sixth of the world’s population. Here are some ways in which it is also going to affect the world economy:

1. A lost year for India?
2. International restrictions
3. Pharma problems
4. Services not rendered

Read here (The Conversation, Apr 29, 2021)

‘We are witnessing a crime against humanity’: Arundhati Roy on India’s Covid catastrophe

‘As this epic catastrophe plays out on our Modi-aligned Indian television channels, you’ll notice how they all speak in one tutored voice. The “system” has collapsed, they say, again and again. The virus has overwhelmed India’s health care “system”.

‘The system has not collapsed. The “system” barely existed. The government – this one, as well as the Congress government that preceded it – deliberately dismantled what little medical infrastructure there was. This is what happens when a pandemic hits a country with an almost nonexistent public healthcare system. India spends about 1.25% of its gross domestic product on health, far lower than most countries in the world, even the poorest ones. Even that figure is thought to be inflated, because things that are important but do not strictly qualify as healthcare have been slipped into it. So the real figure is estimated to be more like 0.34%. The tragedy is that in this devastatingly poor country, as a 2016 Lancet study shows, 78% of the healthcare in urban areas and 71% in rural areas is now handled by the private sector. The resources that remain in the public sector are systematically siphoned into the private sector by a nexus of corrupt administrators and medical practitioners, corrupt referrals and insurance rackets.

‘Healthcare is a fundamental right. The private sector will not cater to starving, sick, dying people who don’t have money. This massive privatisation of India’s healthcare is a crime.’ 

Read here (The Guardian, Apr 28, 2021)

As Covid sweeps India, experts say cases and deaths are going unreported

‘India, home to the world's worst ongoing coronavirus outbreak, has reported more than 17.6 million cases since the pandemic began last year. But the real number, experts fear, could be up to 30 times higher -- meaning more than half a billion cases. Health workers and scientists in India have long warned that Covid-19 infections and related deaths are significantly underreported for several reasons, including poor infrastructure, human error, and low testing levels.’

Read here (CNN, Apr 28, 2021)

Covid-19 in India—profits before people

...‘In the interim, in a uniquely cynical strategy, the Modi government has passed the buck on vaccination to the states, without providing any funding—indeed making them pay higher prices. It has agreed with the private producers a pricing system whereby state governments already desperately short of finances and facing hard budget constraints will have to pay up to four times what the central government pays for the same vaccines...

Disaster capitalism: ‘The latest sign of this active encouragement of disaster capitalism by the Indian state is even more egregious. In the proposed opening up of vaccination to the 18-45 age group from May 1st, access is to be limited to private hospitals and clinics, and only on payment—with prices ranging from ₹1,200 to ₹2,400 (€13.25-€26.5) per dose! Obviously, the poor will be unable to afford the vaccines, and so the pandemic will rage on, the massive human suffering will continue and countless lives will be lost.’

Read here (Social Europe, Apr 27, 2021)

Why the world should worry about India

‘The world’s largest vaccine producer is struggling to overcome its latest COVID-19 surge—and that’s everyone’s problem...

‘None of the Indian government’s missteps absolve the world from caring about what happens to the country, nor should they. Beyond the obvious moral reasons are practical ones too. As I have repeatedly written before, uncontrolled outbreaks anywhere pose a threat everywhere, including vaccine-rich countries such as the United States. Perhaps the biggest concern right now, in India and elsewhere, is the threat posed by more transmissible variants and their potential ability to overcome vaccine immunity. Though virtually every known variant, including those from Britain, Brazil, and South Africa, has been identified in India, in some states the Indian strain has become the most prevalent.

“It’s very similar to what we saw in Manaus,” Christina Pagel, the director of clinical operational research at University College London, told me, referring to the badly hit Brazilian city. She noted that “it’s not a coincidence that these variants are arising in populations that have developed immunity through infection.”

Read here (The Atlantic, Apr 26, 2021)

Right to life: Dead in India?

‘Constitution and national health policies should have been the guiding philosophy for leaders and planners. But did we even read them?... The deadly combination of uneducated leaders, greedy corporates, ignorant public, and the contemptuous disregard for science has wreaked havoc. Our priorities are misaligned and actions ill-intentioned.’

Read here (Outlook India, Apr 25, 2021)

India’s health system has collapsed

‘As human tragedy unfolds, there is a shortage of everything — oxygen, drugs, beds, vaccines, even cremation space...

“We have collapsed, Maharashtra is sinking and other states will follow.” The starkness of these words from Dr Jalil Parkar, a top pulmonologist in Mumbai’s Lilavati Hospital, silenced me in a way that little has through 2020 and 2021, when most of my journalistic energy has been spent on reporting the Covid crisis on the ground. “This is worse than World War Two,” Parkar said, lashing out in rage and hurt at how doctors and health workers are still targeted by angry and distraught families as well as armchair commentators “who sit behind their laptops and in their ivory towers”.

Read here (Hindustan Times, Apr 17, 2021)

India: ’A coronavirus tsunami we have not seen before’

‘India's Covid caseload has risen sharply in the past few weeks. The country's been reporting more than 150,000 cases a day. In January and February daily cases fell below 20,000.

‘So, how did India get from relative calm to its new crisis? Workplaces, markets and malls have reopened, and transport is operating at full capacity. Big weddings, festivals and election rallies are also being held. The result: a situation that one doctor described as a "Covid tsunami".’

View here (BBC, Apr 15, 2021)

‘A tsunami of cases’: Desperation as Covid second wave batters India

‘Dr K Senthil had feared it was coming. He had feared it as he saw the reckless crush of hundreds of people taking part in large wedding parties over the past months, feared it as he saw the maskless faces of shoppers at the market, feared it as he witnessed thousands come together for political rallies in the ongoing elections in the Indian state of Tamil Nadu, where he is the president of the state medical council.

‘But despite his growing sense of foreboding, the second wave of coronavirus that began to engulf India last month has confounded even Senthil’s worst expectations.’

Read here (The Guardian, Apr 14, 2021)

Vaccinating Asia: How does world's largest continent immunise 4.5 billion people in shortest time possible?

‘It is a critical issue as the world rushes to achieve herd immunity against the coronavirus. How does the largest continent in the world immunise 4.5 billion people in the shortest time possible? The Straits Times bureaus find out in this special report.’

• Grappling with myriad challenges on path towards Covid-19 immunity
• Midwives and soldiers in Indonesia mobilised to support country's inoculation drive
• Millions of undocumented migrants in Malaysia keen on Covid-19 jab but wary of arrest
• Filipinos in search of coveted 'Covid-19 passport'
• India's greatest challenge lies in vaccinating rural villages
• Quality and quantity of Covid-19 vaccines in China hamper inoculation drive
• Hong Kong's Covid-19 vaccination drive zips ahead despite woes
• South Korean govt draws flak for not mandating Covid-19 vaccine holiday after roll-out delay
• South Korean man, Singaporean fiancee inoculated ahead of May wedding
• Japan's chequered past with vaccines raises fresh fears
• No rush for Covid-19 jab in Taiwan, given fears over side effects
• Religious, community groups, experts clear doubts about Covid-19 jabs in Singapore
• Church webinar in S'pore convinces senior to take Covid-19 jab
• Tapping TikTok videos and social media influencers to spread information on vaccines in Singapore
• MCI officers create skits, dances on TikTok to debunk Covid-19 myths
• Foodcourt chat to allay fears about Covid-19 shots among Singaporeans

Read here (Straits Times, Apr 2, 2021) 

US and allies (India, Australia and Japan) promise one billion jabs for South East Asia

‘The leaders of the US, Australia, India and Japan have agreed to deliver one billion doses of coronavirus vaccine to much of Asia by the end of 2022. The joint commitment was made following the first leaders' meeting of the so-called Quad - a group formed in 2007. The vaccines - expected to be the single-dose Johnson & Johnson product - are set to be manufactured in India.’

Read here (BBC, Mar 13, 2021)

India’s Covid vaccine rollout ‘rescued the world’: Top US scientist

‘Dr Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine (BCM) in Houston during a recent webinar said that the two mRNA vaccines may not impact the world's low- and middle-income countries, but India's vaccines, made in collaboration with universities across the world such as BCM and the Oxford University, have "rescued the world" and its contributions must not be underestimated.

‘During the webinar, "Covid-19: Vaccination and Potential Return to Normalcy - If and When", Dr Hotez, an internationally-recognised physician-scientist in neglected tropical diseases and vaccine development, said that the Covid-19 vaccine rollout is "India's gift'' to the world in combating the virus.

‘India's drugs regulator gave emergency use authorisation to Covishield, produced by Pune-based Serum Institute of India after securing licence from British pharma company AstraZeneca, and Covaxin, indigenously developed jointly by Hyderabad-based Bharat Biotech and Indian Council of Medical Research scientists.’

Read here (India Today, Mar 7, 2021)