In an interview that will pierce the government’s claim that we are in control of the trajectory of COVID-19 and furthermore critical of ICMR Director General Balram Bhargava, India’s leading virologist has said: “Obviously the situation is alarming ”.
Dr. Shahid Jameel says there are two aspects of concern: first, the rate at which COVID-19 is growing, and second, the location where it is growing. Currently, two-thirds of the cases are in rural areas of India and in towns. He believes that we may already have more than 650 million undetected cases.
In a 42 minute interview with Karan Thapar for The wire, Jameel drew attention to the dramatic increase in cases and deaths in the last two months. He said the seven-day moving average of cases on Sept. 16 was 93,200. The seven-day average of deaths was 1,160. Two months earlier, the seven-day average of cases was 27,000 and deaths 540. He noted that this means that in just two months the burden of cases has increased by 230% while deaths have increased by 115%.
Jameel predicted that The wire that India would go from 5 million to 6 million in less than 10 days.
Asked by The wire If his figures meant that the spread of COVID-19 is accelerating in India, Dr. Jameel replied “absolutely”. He said this is “really worrisome” and we are seeing a significant escalation in both cases and deaths.
When asked if it can be extrapolated from the ICMR serosurvey conducted in May and June, which suggests that for every case detected there are likely to be between 82 and 130 undetected cases, to conclude that on that basis today, when we have 5 million recorded cases, we are likely to have between 410 million and 650 million unreported cases, said Jameel “yes indeed.”
However, Jaleel noted that the actual number is likely to be even higher because the COVID-19 outbreak has expanded considerably since mid-July. She said that logically speaking, we are likely to currently have between 700 and 800 million cases (both reported and unreported).
Jameel pointed out that the interview given to The wire on March 18 by Ramanan Laxminarayan, director of the Washington-based Center for Disease Dynamics, where, applying American estimates to India, he had predicted that in the worst case, India could end up with 60% of its population infected, is say, about 700 or 800 million people, you got it right.
He said Laxminarayan has been wrongly and foolishly criticized by both BJP spokesmen and some high-level journalists. Today that forecast has been vindicated.
Jameel, CEO of the Wellcome Trust DBT India Alliance and winner of the coveted Shanti Swarup Bhatnagar Award in 2000, compared the current situation in India to that of the United States. He said India was growing at an average of 7 days from 93,000 cases daily. For the United States, the figure is just 39,000 cases a day. He said that India will overtake America in 3-4 weeks, if not sooner.
However, Jameel criticized ICMR CEO Balram Bhargava, who on September 15 had said: “We distributed the curve in a way that … we didn’t have a huge peak.”
Jameel said, “How do you respond if you don’t feel sorry for those people? He (Balram Bhargava) is an important man and his words must be chosen carefully. People in important positions must choose their words carefully. “
Asked by The wire if he was disappointed by the ICMR and in particular by Dr. Bhargava, Dr. Jameel said, “He’s being very nice.” When asked to explain more clearly how he saw them, Jameel laughed politely but said no more.
Speaking about the statistics released by Health Secretary Rajesh Bhushan on Tuesday that only 3.6% of COVID-19 patients from India need oxygen, only 2.1% are in ICU and only 0.3% with ventilation, Jameel said that “the percentages don’t tell the picture.” The percentages are certainly small but, because the actual number of cases is large, in absolute terms the number of people who need oxygen, ICU treatment and fans will be very large.If you speak in percentages, it might provide comfort, but it hides or even disguises the reality of the actual numbers involved, he said.
Talking to The wire On the consolation the Indian government derives from India’s low mortality rate (60 per million as of September 17), Jameel noted that the mortality of all our neighbors is considerably lower. It is 29 per million for Pakistan, 29 per million for Bangladesh, 13 per million for Nepal, and 0.6 per million for Sri Lanka. He said that we continue to look to the West and therefore evaluate our performance as better than that of Europe and America. If we look to the East, what we will discover is that there are many countries whose performance is better than ours. What is also clear is that India’s low mortality is not unique. It does not place India in a special category.
However, Jameel does not believe there is a huge and worrying underestimation of COVID-19 deaths in India. First, he noted that deaths would not be accounted for in a worldwide pandemic. Second, because the majority of COVID-19 deaths so far have occurred in urban areas in India and are likely to have occurred in hospitals, the lower count will be lower. However, this leaves open the possibility that as the virus moves to rural areas of India, where there are few hospitals and no doctors, the underestimation of deaths from COVID-19 could increase considerably.
India’s top virologist said that it is not surprising that COVID-19 antibodies disappear in 4-5 months. He said that from then on T-cell immunity and memory response immunity will continue to protect. He noted that this may not protect against a second infection, but it will definitely protect against illness. He added that the infection is not what matters. It is disease that counts and T cell immunity and memory response immunity will protect against disease recurrence.
Speaking about Dr. Anthony Fauci’s claim that a COVID-19 vaccine is unlikely to be 100% effective, Jameel said that no vaccine in the world is 100% effective. Even the oral polio vaccine can cause the disease in one in a million cases.
Speaking specifically about the Russian Sputnik vaccine, Jameel said that he had read the report in the Lancet as well as criticism of the findings. He said he believes Sputnik is “underpowered.” He said that “only 40 volunteers had been evaluated in the phase 2 trials.” He added that the fact that there are identical data points “raises concerns.” He said this “needs clarification … it’s a credibility issue.”
Finally, Jameel spoke about a recent article published by The New England Journal of Medicine This raises the hypothesis that the use of masks could become a form of variolation that could reduce the severity of the virus and ensure that a greater proportion of infections are asymptomatic. He said he believes wearing masks will become common, but doubts it can reduce the virulence of the virus.
See the full interview here.
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