VIDYA KRISHNAN AND AATHIRA KONIKKARA19 May 2020

For the third time since it began, the Indian government extended the nationwide lockdown without seeking scientific inputs from a national task force constituted to advise the central government on its pandemic response, according to multiple members of the team of scientists. HIMANSHU BHATT/NURPHOTO/GETTY IMAGES

On 17 May, for the third time since the COVID-19 pandemic began, the Narendra Modi administration extended India’s lockdown—one of the harshest across the world. For the third time, the Indian government did so without seeking scientific inputs from a national task force constituted to advise the central government on its pandemic response, according to multiple members of the team of scientists. There was a consensus among members we spoke to that the lockdown had failed to achieve its purpose due to the government’s failure to take crucial parallel measures, such as developing India’s testing capacity and medical infrastructure. Despite placing a 1.3 billion population under lockdown, India has recorded over a hundred thousand confirmed cases, crossing China’s COVID-19 numbers to become a new epicentre for the novel coronavirus in the Asia Pacific region.

“There is no doubt in my mind that the lockdown has failed,” an epidemiologist who is a member of the task force told us, speaking on the condition of anonymity. “Social distancing, wearing masks, and hand hygiene works. Together, these measures reduce the rate of transmission. However, till date, there is no evidence that lockdowns can cut down transmission.” Several public-health experts we spoke to said the government failed to use the time to conduct comprehensive contact tracing, scale up testing, and prepare India’s medical infrastructure for the pandemic. “The rationale for lockdown was to buy time to prepare ourselves in terms of logistics, preparing our hospitals, preparing our manpower, preparing guidelines, standard operating procedures,” an expert in community medicine, who is consulting with the government on its pandemic response, said.

“Biggest issue with lockdown is that many national responses think of it as a main or only measure of control—it is not,” Dr Salil Panakadan, a regional adviser with UNAIDS—a United Nations programme to combat HIV—said, referring to the response by different countries. Panakadan is looking after the organisation’s COVID-19 response in the Asia Pacific region. “It is a component of an overall comprehensive strategy, which must use the time to prepare health systems, populations, and supply chains.”

A second member of the task force, who also requested not to be identified, spelt out the different ways in which the central government’s response to the pandemic had made the situation worse. He said that the centre had failed “in containing spread to multiple sites in the country, failure on political and administrative front in providing social services to people under lockdown and migrants, failure of risk communication and countering stigma.” The second member also condemned the “police high-handedness” and the “delays in contact tracing, unlike Kerala.”

The epidemiologist on the task force shared the same concerns. “It does not add any extra value other than ensuring forcible social distancing,” he told us, discussing the lockdown. “That has shown results in the first world, where population density is far less than a country like ours. It is of no use to place blame people, especially in cities where so many are homeless—where were you going to lockdown the homeless families? Around 20 percent of population in any big city lives in slums.” The lockdown itself, without other measures and policies to fight the pandemic, “hardly achieves anything,” the epidemiologist added.

The task-force epidemiologist was also very critical of a mathematical model presented by Vinod Paul, the chairperson of the task force and a member of NITI Aayog, during a press briefing on 24 April. The model, represented on a graph in a presentation in Paul’s press briefing, had ambitiously claimed that the country would see no new COVID-19 cases from 16 May onwards. Predictably, the graph was completely false and India continues to see new infections every day, with the surging pandemic having recorded 101,139 confirmed cases and 3,163 deaths in India as of 19 May.

“Models are created based on some assumptions, and when the assumptions change—for example, with new evidence—the information you are acting on is useless, and outdated,” the epidemiologist said. “No one has looked at the math, which is the basis of their projection. No one has engaged with that. If you asked the government officials to explain that model, they won’t be able to. Yet, they have taken the model as a gold standard.”

According to two task-force members, and several other scientists we spoke with, the government has attempted to force India’s reality to fit the projections of that model by insisting that the lockdown is a success, based on nothing more than political reasons. While presenting this grossly inaccurate graph, Paul had said, “Today, we can say that the steps taken by this country to overcome this epidemic were timely, good and fulfilled, and with great strength, we are prepared to completely control and defeat this disease.”

The community-medicine expert who is consulting with the government said that the centre was devising a theory to justify lifting the restrictions because there was no evidence to show that the lockdown had been successful. “The withdrawal of lockdown would be a political decision, which would be justified with pseudo-science or semi-scientific information,” he said.

While they criticised its implementation, there was a clear consensus among the scientists we spoke with that the first phase of the lockdown was necessary to acquire data about the spread of the virus and to take measures to protect India’s health systems. “To flatten the curve, that was necessary,” the epidemiologist who is on the task-force said. “But three–four weeks is more than enough, even in a country like ours. We generate enough data to inform decisions.” But the Indian government, after taking decisions without consulting the experts, has failed to allow the newly gathered evidence to inform their decisions.  

“Lockdown as a tool only makes sense if you have the back up of laboratories, and shore up testing,” the epidemiologist said. “Without testing, it is like having a revolver, but with no bullet in it. Any sensible policymaker, would have looked at the data, take some time to think about it, plan effectively what we should do, why, and how before implementing the first lockdown.”

In an interview with Science magazine, Marc Lipsitch, an epidemiologist and professor at Harvard University’s TH Chan School of Public Health, compared lockdowns as a pandemic response to getting to a “life raft” without solving the bigger problem: how to get to the shore? According to Panakandan, while there was no single formula to resolve the crisis, a lockdown that focused on public health, and not law and order, was more likely to take a country to the shore. “We cannot have the same one-size-fits-all lockdown measure,” he said. “There are versions of lockdowns—total lockdowns like in South Asia, and partial lockdowns, like in South East Asia. The difference is often in how the lockdown is enforced—as a public health measure or as a law and order issue. And countries that approached this as a public health measure have done well.”

In Asia Pacific region, Vietnam and Thailand have been largely successful in flattening the COVID-19 infection’s curve. On 17 May, Thailand opened malls and department stores after over two months, while Vietnam has not reported a single death from COVID-19 due to the success of the nation’s strict contact-tracing measures. New Zealand also witnessed an efficient use of a lockdown, during which time the prime minister, Jacinda Ardern, developed a strategy in consultation with the nation’s health experts, and used the time to massively scale up its testing capacity.

Meanwhile in India, the government has allowed the COVID-19 infections to surge as it failed, time after time, to consult epidemiologists about the remedial measures that had to be taken during the lockdown. Addressing his constituents in Varanasi on the first day of the lockdown, on 25 March, Modi had stated, “Mahabharata war was won in 18 days. The war that the whole country is now fighting against Corona will take 21 days. Our aim is to win this war in 21 days.” Days after that failed to come true, the central government made the next false claim that India would see no new infections by 16 May.

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During this period, in addition to over three thousand COVID-19 deaths, at least 134 workers have reportedly been killed in road accidents amid the migration crisis triggered by the lockdown. Over fifty days into the lockdown, thousands more are still walking hundreds of kilometres to their homes in different cities. “Why are they extending it further?” the epidemiologist asked. “I cannot imagine how these decisions are being taken. There is no science in it.” 

The epidemiologist answered his own question. “They are paralysed,” he said. “There is no question that the lockdown is being extended out of desperation. First time in my life as an epidemiologist, I have seen a government this myopic. They are only thinking of what will happen two weeks later. This is problematic for a country like ours.” According to him, it was futile to plan for just two weeks because the novel coronavirus could remain for as long as three years.

We wrote to the official email address of the home ministry; Balram Bhargava, the director general of the Indian Council of Medical Research; Preeti Sudan, the health secretary; and Paul, the chairperson of the national task force for their comments on the accusations raised by the task-force members about the failure of India’s lockdown. By the time this story was published, we had not received any response. This story will be updated as and when a response is received.

Many among India’s scientific community said they were increasingly concerned about the lack of a long-term plan to address the future trajectory of the pandemic. “We need to learn better, comprehensive, and long-term interventions,” the epidemiologist said. “We learnt from the HIV epidemic that we need a national plan on how to adopt and change behaviour so that we slowly get accustomed to this new normal. It is not an easy task. We saw with HIV, we need to adopt same behaviour-change strategy, which should involve people from all walks of life.  It cannot be implemented by police.”

https://caravanmagazine.in/health/members-pm-covid-19-task-force-say-lockdown-failed-due-to-unscientific-implementation

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