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Last week, The new Indian express, one of India’s leading English newspapers, published an article that was highly critical of the Center’s response to the COVID-19 outbreak. The article, titled “The Center’s COVID-19 Communication Plan: Contain Data, Gag Agencies, and Scientists,” discussed the government’s reluctance to share data related to outbreaks and attempts to silence scientists.
He noted how scientists at India’s medical research agency, the Indian Council for Medical Research (ICMR), have suddenly and inexplicably disappeared from the daily health ministry COVID-19 press briefings. He also claimed that ICMR had dissolved a panel of experts it had previously established to study the COVID-19 drugs and vaccines because members of the group had criticized the government’s actions.
The article was published in The new Indian expressTheir website at 7:09 pm on May 8, and disappeared from their link in one day without explanation. The page at the same link now has a short message: “Wow! It appears you are looking for a page that does not exist or has been moved. “
Journalists speculated that the Center may have pressured the newspaper to download the article and that the newspaper complied. However, The Wire ScienceQuestions to the editor-in-chief of the newspaper G.S. Vasu, asking if this was the reason, were not answered. The author of the piece, health journalist Sumi Sukanya Dutta, also did not respond to questions.
In India, news reports often disappear. The new Indian expressThe report did. On May 27, 2019 The caravan He listed 10 of those articles that the newspapers had withdrawn during Prime Minister Narendra Modi’s first term, probably because they were unfavorable to his administration. One of them was an article published by The new Indian express; withdrew after raising issues with an Ahmedabad-based bank headed by Interior Minister Amit Shah as The wire reported.
Now, it appears that this phenomenon has also affected public health journalism, in the midst of an epidemic that has claimed at least 2,415 lives in the country so far. The terrible irony is that the government, and probably also the editors of a newspaper, gagged a journalist for criticizing the scientists’ jokes. One cannot invent this.
Transparency helps fight outbreaks
Refusing to share data during an outbreak is immoral because it costs lives. This argument underlies journalistic coverage of the lack of transparency during an outbreak. It’s also why The new Indian express The article was important. A copy archived by Wayback Machine is available to read here.
One issue Dutta reported was that the government had not yet released the list of hospitals dedicated to treating patients with COVID-19; a distribution of patients by gender and age; and the statewide distribution of oxygen beds and ventilators 1. Pointing out this lack of information is not an inactive tent. During an outbreak, a central government can and should assess where resources are available, if only to help decide how to improve infrastructure in vulnerable regions.
Stakeholders outside of government, such as doctors, epidemiologists, state administrators, and public health researchers, should also have access to this information because it helps them analyze government policy, propose alternatives, and prepare. After all, the government is not the exclusive repository of public health expertise for decision-making, and they may also be wrong. There is also nothing wrong with a reporter demanding this data: data collection is financed by taxpayers, so this information belongs to taxpayers.
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ICMR must speak
The second problem Dutta raised was the notable absence of ICMR scientists in the daily press sessions of the health ministry. Until April 23, when journalists began to highlight the poor accuracy of the rapid diagnostic tests that the ICMR had obtained from China, the agency’s chief epidemiologist Raman Gangakhedkar or CEO Balram Bhargava were present at all the meetings. informative. But as ICMR’s role in the test kit fiasco became more apparent, agency representatives stopped attending the briefings, leaving no medical expert there.
At the same time, several journalists noted that ICMR scientists had been asked not to speak to journalists. For example, on April 28, health journalist Anoo Bhuyan tweeted an ICMR official’s statement to her that the agency’s headquarters had ordered them to refrain from interacting with the media. When asked if this was true, Balram Bhargava replied on WhatsApp: “There are no such instructions. All the scientists are busy working. “He did not respond to a follow-up question about why ICMR representatives had stopped attending the press sessions.
Again, the absence of ICMR representatives in interactions with the media is a crucial issue. The agency is behind most of India’s COVID-19 policies on drugs, vaccines, treatments and tests. Clearly, these policies have a tremendous impact, and any flaw or oversight, however slight, in their design can have a snowball effect across the country. How The Wire Science Recently reported, ICMR’s failure to follow its own ethical protocols in recommending the use of hydroxychloroquine as prophylaxis and treatment for COVID-19 has encouraged thousands of people to take the drug indiscriminately.
Also read: India established a code to use experimental drugs in an outbreak, then ignored it
The questions accumulate
Therefore, ICMR is responsible to the country, and its representation in daily press sessions is not negotiable. However, the agency’s demise trick means that unanswered questions from journalists and outside experts are only piling up. Here are three.
Question 1 – In a press release dated May 10, ICMR said it had developed a COVID-19 antibody test kit that would be mass-produced by Gujarat-based company Zydus Cadila. Why was Zydus Cadila chosen for this task over other medical diagnostic companies?
Why is this question important? By now, it is widely clear that ICMR failed to acquire rapid antibody kits from China. He placed orders with companies without import licenses, sending his own purchase price through the roof. It’s also strange that ICMR discovered how inaccurate these kits were only after they had been shipped to various states and used in the field.
Many countries have already stumbled upon rapid antibody kits. As early as April 5, scientists in the UK had evaluated quick kits from China, including from a company that ICMR had also purchased, and found them inappropriate. Why did this event not raise ICMR antennas considering it received its first shipment of kits, even from that company, only after April 16?
The agency also claims to have verified the quality of the kits before approving them for field use in the states. How did this QA step miss the top precision issues, all known since the UK had caught them a week earlier?
This story with quick test kits suggests that ICMR needs to be more transparent with both its acquisition and quality control, and explain how it did both. And this is why journalists and outside experts demand to know more details about how the new kits were tested for quality, and why Zydus Cadila was chosen among other companies for mass production.
It is not unusual to share such details. When researchers at the Mount Sinai Laboratory in New York developed an antibody test kit, they loaded a preprint paper explaining their methods. But when a journalist asked during the May 11 press conference why Zydus Cadila was chosen as an ICMR partner, the joint secretary of the health ministry, Lav Agarwal, said that only the ICMR could answer that question, before sharing some vague details about the acquisition process.
Question 2 – Why has ICMR not attempted to alter its flawed March 22 notice suggesting hydroxychloroquine as prophylaxis for COVID-19, given that the latest evidence has shown the drug to be ineffective?
Why is this question important? The ICMR notice on hydroxychloroquine violated its own ethical guidelines, such as The Wire Science Now, it appears that the worst case scenario, that the guidelines were designed to prevent, has been met. Even as new evidence accumulates of the drug’s ineffectiveness against COVID-19, states like Maharashtra are ignoring ICMR’s guidelines for crafting their own absurdities.
For example, the state Department of Medical Education and Research has begun prescribing hydroxychloroquine for children, contrary to the ICMR notice, which clearly states that pediatric use of the drug is not recommended.
However, there are good reasons why ICMR has expected its advice to trigger indiscriminate use. Historically, India has seen extensive irrational use of off-label drugs by physicians. But if ICMR didn’t anticipate this, why isn’t it making a course correction now, given the damage already done?
Question 3: How many cases of influenza-like illness (ILI) have there been in India in recent years, and is this number atypically increasing in some districts this year?
Why is this question important? The National Centers for Disease Control in India (NCDC) keep track of the number of ILI cases each year as part of their influenza surveillance program. These data could be an excellent indicator of how widespread COVID-19 is in India, given India’s testing strategy is not enough to determine this.
For example, if any district is seeing an increase in ILI cases compared to the historical average during that month, it could signal the presence of COVID-19 there. So journalists have asked ICMR and the NCDC to share ILI numbers multiple times, but neither agency has done so.
It is quite strange that the two agencies do not extract this data or do not share the results if they do. On the one hand, such data could indicate how many cases of severe acute respiratory illness (SARI) occur in India at any time of the year. Part of ICMR’s COVID-19 test strategy is to search for the new coronavirus in samples from all SARI patients in India; SARI is simply ILI severe enough to require hospitalization. So if we could estimate the number of SARI cases from ILI data, we could get an idea of how many tests India should perform overall.
Also read: Four reasons why it is hard to believe that India does not have community transmission
But it is worrying that while this important data set remains unpublished, government officials have been selecting unrepresentative data to claim that India is not seriously affected by COVID-19 at all. For example, NITI member Aayog Vinod K. Paul recently cited the number of SARI cases hospitalized under the Ayushman Bharat insurance scheme to state that India does not have community transmission. These daily cases had decreased between February and April 2020, contrary to what would be expected during an epidemic of respiratory diseases.
The problem with Paul’s claim was that only a small percentage of all SARI cases in India are treated under the Ayushman Bharat scheme. It is also impossible to say if the decline from February to April is unusual unless compared to data from previous years. And ultimately, it is strange that government officials do not share the comprehensive ILI data they have access to, but instead resort to limited data sets that may be painting a distorted view of reality.
Non-scientists replace scientists
Now that ICMR has disappeared from press conferences, government officials without medical training answer questions like the ones above, aimed at scientists. The three representatives who appear at each press conference are Lav Agarwal, Joint Secretary of the Union Ministry of Health; Punya Salila Srivastava, Joint Secretary of the Union Ministry of the Interior; and an official from the Press Information Office.
Of these three, questions intended for scientists generally end in Agarwal, and some of Agarwal’s statements have disturbingly revealed a complete ignorance of basic epidemiology. For example, on three separate occasions, journalists asked him when the Indian epidemic of COVID-19 would peak.
An outbreak is said to peak when the total number of daily new cases (or deaths) reaches its highest point, and begins to decrease thereafter. The director of the All India Institute of Medical Sciences in Delhi, Randeep Guleria, said the outbreak is expected to peak in July. The ICMR researchers also reportedly modeled the progress of COVID-19 in India to get an idea of when the peak might hit. So the journalists’ questions were perfectly reasonable.
However, on all three occasions, Agarwal said India could avoid the spike if people diligently practiced physical distancing. It does not take an epidemiologist to understand the absurdity of this statement. Never reaching a peak alone means that the outbreak will continue indefinitely. And the fact that he repeated this statement three times suggests that no one bothered to correct it. Such oversight with scientific terminology is why journalists have been asking ICMR scientists to speak instead.
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Arbitrary attack on scientists
Another question that Dutta raised in his article that is now missing in The new Indian express It was about ICMR recently dismantling a panel of experts it had appointed to study the new COVID-19 drugs and vaccines. His article said the trigger was criticism of the government by members of the panel, although Dutta did not name any of the members in particular.
But the next day The Hindu More details of the dissolution were published. The panel had been chaired by microbiologist Gagandeep Kang, and its members are unsure why it was divided. Some of them told the newspaper that the panel’s goals had not been met. The Wire Science also contacted one of them, Debashish Mitra, director of the Center for Fingerprinting and DNA Diagnostics, Hyderabad, who reiterated that he did not know the reasons behind the ICMR decision.
ICMR’s Bhargava did not respond to The Wire ScienceQuestions on the matter.
Why would a key committee of experts studying the important issue of new drugs and vaccines for COVID-19 dissolve so arbitrarily? This question is particularly important because this is not the first time that the health ministry and ICMR have been accused of penalizing scientists for no apparent reason. For example, The wire reported in February that the ministry had accused the Manipal Institute of Virology (formerly the Manipal Center for Virus Research) of storing samples of the Nipah virus even though it was not allowed to do so. ICMR subsequently removed the institute from its network of Virus Research and Diagnostic Laboratories, and the Ministry of the Interior revoked the license of the institute’s Foreign Contribution Regulation Act (FCRA) 2. Neither the ICMR nor the health ministry shared any evidence of their allegations.
Even today, the Manipal Institute of Virology is not one of more than 350 laboratories in India testing COVID-19. Instead, academic institutions with no history of medical diagnostic testing, such as the Birbal Sahni Institute of Paleosciences, have been cornered, presumably to bridge the acute deficit in testing capacity.
Also read: What Curve is the Flattening of India: New Cases? Or tests for the disease?
This erratic behavior by the country’s main policy makers is disturbing. An epidemic like COVID-19 is a time for the country to gather its best scientists instead of leaving them unexplained. Such whimsical decisions can cost lives. The Manipal Virology Institute is widely recognized for identifying the Nipah virus early during the 2018 Kerala outbreak, allowing the state to generate a quick and effective response. Separately, Gagandeep Kang was a key member of the team that developed India’s first indigenous rotavirus vaccine. Surely its deletion from India’s COVID-19 response needs more clarity. (Kang declined to comment for this story.)
The new Indian express The article appeared at this juncture, summarizing the disturbing opacity in the government’s response. And the fact that a newspaper decided to retract without explanation is the final irony. When the government hoards information and silences scientists, at least the fourth state should speak. But if Indian citizens can’t wait that long from their most powerful means, they have more than a pandemic to worry about.
Priyanka Pulla is a scientific writer.
The reporting on this story was funded by a public health journalism grant to Priyanka Pulla from The Thakur Family Foundation.
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