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Thread: Consolidating my criticisms for the health ministry's handling of COVID-19 with some examples here, because I think it's important for people not to dismiss these criticisms are not just a rant. (1)
First, please see this report on Article 14: https://www.article-14.com/post/govt-knew-lockdown-would-delay-not-control-pandemic, to be viewed in conjunction with my story here: https://science.thewire.in/health/coronavirus-testing-icmr-testing-strategy-covid-19-diagnostic-kits-community-transmission/ Both are snapshots of internal thinking by government scientists at various points during this outbreak (2)
Sharing these articles because of the consistent and dramatic differences between these internal govt. documents and public statements made by government officials. The difference is so stark that it amounts to lying/prevarication (3)
First, my story talks about ICMR model (published only in March), which suggested that due to presymptomatic transmission, airport screening alone would make no difference in delaying the outbreak's peak in India. The model suggested testing community-acquired cases of COVID(4)
Yet, ICMR began testing community-acquired SARI only on March 21 (testing only a tiny sample of SARI as part of sentinel surveillance until then). Not only that, ICMR's epi chief would keep talking about community transmission as a remote possibility. https://www.pscp.tv/w/1vAxRBzmBojxl (5)
This, when an internal model showed that given the current testing strategy (until March 21), there was *no way in hell* we could have avoided community transmission. Apart from the internal model, several ID experts/epidemiologists believed CT was very likely in India (6)
So the categorical statements made by ICMR, health ministry during March are really hard for people to understand. Why publicly deny what you privately suspect?(7)
Now for the Article 14 story, which talks about a presentation made by ICMR a week after the lockdown began. Here, the ICMR reportedly said, "Generalized large-scale transmission is inevitable with devastating numbers spaced by time and location." (8)
Now here is Lav Agarwal saying on 10th April that there is no community transmission, and no need to panic https://theprint.in/health/no-community-transmission-in-india-and-no-need-to-panic-health-ministry-says-again/399632/ (9)
Anyway, these statements were used to justify India's restrictive testing strategy, although the real reason likely was that we simply didn't have testing capacity. And yet, ICMR kept claiming that testing capacity *wasn't* the rate limiting factor. (10)
This public stance continues. A few days ago, NITI Aayog CEO Amitabh Kant defended testing strategy, citing a graph showing India's low test positivity. There are other problems with that argument, apart from the fact that it doesn't seem 2 reflect govt's internal thinking (11)
Now here is the funny thing. If ICMR/health ministry/NITI Aayog had said, at any point, that we are likely to be seeing community transmission, but we simply don't have testing capacity to look for it, no one would have been shocked (12)
Instead, there is this unstated assumption and rarely articulated assumption that India is poor, so we can't test more. If the government had framed this as a testing capacity problem, our entire discussion today would have been different (13)
Because I'm not sure poor countries necessarily need to test less. There might be ways for even us to innovate our way out of this. Case in point: the empowered committee's memorandum allowing institutes of national importance to chip in with testing https://bit.ly/3azVXmi(14)
But this discussion, of how to ramp up testing capacity, could never be had in public. Because we were all fighting the red herring of "no community transmission". The problem was something else all along (15)
And I don't fundamentally understand why governments feel the need to lie/prevaricate to this extent. It is an incredibly stupid policy, because journalists and external experts weren't born yesterday (16)
Everybody catches on. If not on day 1, they catch on on day 10. If not on day 10, they catch on after one year. The point is: everybody now knows that the government's claims are ridiculous and simplistic. And yet we spend an undue amount of time debunking them (17)
Meanwhile, these public lies allow the government to go slow and bungle on a thousand other things, like getting PPE stocks, ramping-up testing, preparing hospitals. Because by the time the public comes to know, it's too damn late (18)
So here we are, almost 3 months since the 1st Indian case: we lack reagents for PCR testing, have faulty antibody kits, and local companies cannot meet the PPE requirements. Dialysis centres are shutting down, and healthcare workers are getting COVID due to lack of PPE (19)
We are announcing measures today (like ensuring an adequate number of ventilated beds), which we could have done two months ago. All because nobody knew what the government was really thinking (20)
And nobody need say to the government "I told you so". Because the truth is that the government's own epidemiologists told them so. But they chose not to listen (21/21)
