After the (predictable) antics on Sunday night, am straining hard to keep this post apolitical and uncontroversial. But here goes anyway.
Given that the new normal is 450-500 infections a day in India (certainly not due only to the Tablighi Jamaat's undeniable idiocy, as the 24-hour news channels are propagating), it is clear that India is going to have to live with Covid-19 for a while. And "live" is the operative word.
Whether the geometric progression of community spread is in danger of happening or not, the massive damage from the lockdown is not being spoken about in the media anymore (if you've noticed, no more death tolls of migrant workers, which had almost caught up with the Covid toll in India on the sixth lockdown day itself, being tallied, very few of those stories being told anymore). But of course, the deliberate veering away from unpleasantness hasn't tempered the alarmism. A couple of days back, television news channels flashed this - "42% of cases in India are between 21-40 age-group" and seemingly educated urbane people were hyperventilating on how notions about age had been debunked, and bizarrely no one contradicted this (it should be obvious that infections are merely a function of which group is being tested currently for whatever reason; the death column is the one to watch and the fatality rate in that age group of people with no serious pre-existing conditions would most likely be zero).
In India, the litany of "testing, testing, testing" is becoming a bit of a joke now. First, because nobody gives a shit; we're still testing less than most countries in the world. It doesn't suit political narratives to increase those numbers unless absolutely required (i.e. when a rising death rate cannot justify less testing). Second, this is a country that so easily and quickly normalises social stigmatisation - there are thousands of people with symptoms terrified of going for testing because of how they will be treated post that (I actually spoke to one of them a couple of days ago); many are convinced their landlords will throw them out (it's an extremely valid fear, going by how many doctors and nurses were being treated in their own housing colonies last week). Third, and most important, the narrative of panic will subside if extensive testing reveals a far lower mortality rate than is being imagined currently, which does not seem to suit people in power or the media.
Has the whole world grossly overreacted by imposing lockdowns with neither compelling evidence to head in that direction nor a clear plan ahead? The West has anyway been committing cultural and political suicide for a while, most evident from the political expression within many of those countries, but now they've gone ahead and committed economic suicide as well. It completely fits the pattern of a highly polarised world, where only extreme reactions find expression and validity. And extremism can only end badly.
Going back to the evidence against lockdown: the perfect incubation example for Covid-19 being discussed worldwide is the Diamond Princess cruise liner and its naturally quarantined passengers. The case fatality rate there was 1%, in a densely packed closed, air-conditioned container. Moreover, this was a largely elderly population, in which the death rate from Covid-19 is much higher anyway. So, does this mean that a 1% fatality rate logically should be the worst case scenario?
In the early days of the virus, when Germany's first 10,000 infected cases were recorded, only 50-60 were severely ill, and only about 30 died (references in second comment). This, in a country where 2200 people over 65 years of age die everyday, out of which 60-odd are flu cases. Similarly, Sweden's progressive attempt at herd immunity (the only country of that size to have not imposed some kind of lockdown till date) leads to these numbers - on average, 53 out of every 10,000 people are infected; people showing symptoms are on average 61 years old and over 60% of the deceased are older than 80 years old. This, in a country where 200-300 die per month in winter seasons from the flu.
The idea of herd immunity, where the younger, healthier people are put in the line of fire (as their infections are almost never fatal; those with pre-existing conditions obviously have to be much more careful) so that they develop antibodies and immunity, actually ends up shielding the sick and the frail eventually. This is the time-honoured way to fight diseases (given India's average age of 26.8, not an illogical alternative here by any means, despite having a far higher population density than Sweden). As Fredrik Erixon said in The Spectator, "It’s not Sweden that’s conducting a mass experiment. It’s everyone else."
Meanwhile, there is another argument that is being raised in many quarters - are many normal flu deaths that are being attributed to Covid-19 deaths just because the deceased tested positive for Covid-19 but did not necessarily die from it? Even in India, it may be worthwhile asking why Swine Flu (H1N1 virus) deaths in India till March 1st just tallies to 28, when the monthly average in 2018 and 2019 was in the region of 100 per month. (Courtesy: Quartz - reference in second comment). This can only be answered across the board by comparing the death tallies from flu in 2020 so far with what the tallies have been in the last 2-3 years in the same months. It is mystifying why this exercise has not been carried out in any context.
There are two things known about lockdowns so far. One, they do not reduce cases, just delay the inevitable, which is only useful if the idea is to buy time to test more and ramp up quarantine facilities. Going by all the ostensible focus points and conversations, it is highly debatable that this has happened in India on any meaningful scale. And we now have far more cases than we did when lockdown began; which was highly predictable anyway (despite the attempts now to put the blame solely on Tablighi Jamaat). Two, the human cost is huge - obviously in terms of the economy, but also in terms of mental health and disadvantaged people, and also what it does to an already mentally diseased society like India's, filled with irrational prejudices and extreme instincts for self-preservation.
Not to speak of vulgar levels of thoughtlessness, outright corruption and of course, sheer stupidity; there are multiple stories of the rich and the powerful flouting lockdown protocols, people bursting crackers and shouting victorious slogans on one hand, desperate crowds congregating to just somehow get home on the other. And many mindless administrations imposing curfew, perhaps trying to win brownie points by showing their superdeep allegiance to those who ordered lockdowns. And now, so many administrations are asking for a lockdown, it boggles the mind. Is an irrational fear of the unknown making them shirk their true responsibility and go for the low hanging fruit of lockdown? But since these infection numbers are not going to go on decline for a long time (as testing will only increase, not decrease), perhaps for many weeks, the logic to lift the lockdown will get less and less all this while, unless the paradigm dramatically changes, for which we can't really hold our breath (no pun intended). Meanwhile, we haven't even touched upon crime yet, which is an absolute inevitability in such dire circumstances, if this continues for long. It is not just looniness that led to such high gun sales in the US so recently.
At a time when so many people around the world are speaking out against the idea of lockdown, in a country like India, it actually makes the least sense compared to anywhere else. So, given the huge amount of ignorance about the virus in India, isn't it time to level with the people here and tell them the score? This question is aimed at not just the political class but the medical community as well, at the higher echelons of which politics seems to be a far more prominent preoccupation than medicine. And of course, the media. This has been a worldwide phenomenon though, and it exposes the horrifyingly low levels of leadership in every one of these institutions. And a quality of education that seems to enable an obsession over detail rather than help discern, or perhaps even care about, the big picture. It is very sad that neither the media (which pretty much has the mandate to only focus on this one story currently) nor the academic fraternity can help measure the cost of a lockdown week-by-week, including projecting the number of likely lives lost from that. Nor have they bothered to juxtapose the number of deaths in India from previous years with death tallies from all causes this year (especially influenza), to at least rule out unintended overlaps and to bring a hugely-needed sense of proportion to what is actually unfolding.
Our societal immune systems to counter chaos have failed us - that is the biggest takeaway from this crisis. Given that, and the realities listed above, in an attempt to regain some sanity, is it time now to move the focus to the people themselves? By making a very conscious shift from being preoccupied about the number of infections to just worrying about the more severe cases?
Is it not time to aggressively and single-mindedly inform people about what to expect in case they develop symptoms (even after observing the protocols of social distancing and regular hand-washing as much as possible)? That it is NOT the kiss of death and nothing to be terrified of? That if they develop symptoms, to take a deep breath, relax and self-quarantine themselves to whatever extent possible and NOT go to the hospital? That in 80% cases, just resting with zero medication will self-dissolve the infection within a few days? That in some cases, the discomfort will be more acute (Testimonial A from the US, in the first comment) - lack of taste and smell, listlessness, loose motions, body ache, energy depletion? That if breathlessness occurs, even that is manageable (Testimonial B from the US, in the first comment), even if it seems a bit scary? At what point one needs to get admitted is tricky, thanks to the obstacle courses around getting tested and admitted (Testimony C from Mumbai, in the first comment), but perhaps certain markers can be defined for that clearly by the medical fraternity (if they could just agree)?
In the 15% cases where there may be breathing difficulty, medical help may be required. But instead of crowding hospitals perhaps there could be multiple telephonic healthlines manned by our array of doctors, who can just guide and reassure patients, and only instruct them to get to the hospital if their case is acute (and may require ventilator). They can also guide those (economically disadvantaged or people with elderly at home) people who cannot isolate themselves at home to quarantine centres.
Healthcare systems around the world appear to be collapsing primarily because it is not just the critical people rushing there for help (obviously the proportion of non-critical patients is far, far higher). By easing that load, won't things can be much more manageable in hospitals and quarantine centres?
This kind of communication focus would also hugely reduce the societal stigma this virus currently carries in India, which could be as big a contribution as critical patients exclusively receiving care. It would temper the alarmism hugely, and eradicate denial. The harsher symptoms will tell people what to expect, working both as deterrent at first, and later as an acceptable worst case scenario.
There are many reasons to give the benefit of doubt to India for overcoming this crisis. The young population is a good one (with an eye on herd immunity, as mentioned above), in a country where 94% people are below 65 years of age. Then there's the American study that suggests India's compulsorily enforced BCG vaccination reduces Covid-19 dangers, and the MIT study where the the heat-sensitivity of this virus was shown to not being able to withstand beyond 32 degrees. Then, there is a brand new study done by Translational Bioinformatics Group, New Delhi, that suggests a unique mRNA in the Indian genome, that apparently makes Indians more immune to Covid-19. Does the extreme alarmism that justifies the lockdown have any supporting evidence, however tentative, like that? Or is it based on extreme pessimism and the panic instinct of erring on the side of supposed caution?
Removing the lockdown doesn't mean other measures can't be taken on an emergency footing (including keeping the lockdown only in some select hotspots, for a short while and ramping up testing, smartly). But the shift in mindset to stop being alarmed about infections and focus on protecting those most vulnerable while keeping life as we know it going (even if on a diminished scale), with all sensible precautions like social distancing and frequent hand-washing intact, will infuse some hugely-needed sanity back into proceedings.
And will save a lot of lives - that we are criminally not even paying attention to currently.
UPDATE: This post is largely for the Indian lockdown and not a comment on others, even though I have referenced other countries. Simply because the collateral lockdown cost in India is far higher than anywhere else. And the US, particularly, I wouldn't even presume to comment on; don't know the ground reality there, and haven't read up enough to do that. Also, they're at a very different stage than we are in India.
(This is merely an attempt to connect some dots, rightly or wrongly, at a time when so many experts are not only disagreeing with each other, but many are very oddly silent. If we accept such a generation-defining jolt to our lives blindly without even questioning its very foundation, even when so much appears utterly irrational, why don't we also only say "baa" from now on? This time, mindful of finite energy and time, will only respond to comments very selectively, so please don't take it personally.)
I can fill in a bit here - the test looks for presence of the virus. The less accurate test as in the screenshot (was it you writing to someone? don't know) is an antibody test. AKA serology. We are currently at the cutting edge of serology tests for COVID19. The advantage is that it's fast. But the problem is that it gives false negatives - someone can show nothing and still be infected.
The better test (which is what we've been doing all along) is RT-PCR - Reverse Transcriptase-Polymerase Chain Reaction. This one looks for the viral RNA in the blood by converting it to DNA (that's the Reverse Transcriptase) and then multiplying it so it's readable (the PCR). This one is sure-shot - if you don't show up on this, you have such a minimal viral load that you won't be infectious. But it takes time (I've read anything between 3 hours and 3 days depending on the lab), and it's expensive. They also tend to do this in batch because that makes it faster.
As
Venkat Krishnan N
says, a "cured" patient who's showing no symptoms could still be a carrier, and the only way to verify that is by doing at least a serology, or better, RT-PCR.Most live vaccines are made based on the principle that when the disease producing virus is made to pass through a series of hosts it looses its virulence over time. That's because producing disease in the host(killing him sometimes) is not beneficial to the virus. It only shows mal adjustment to its environment. Through multiple hosts the virus evolves to make peace with the host. IMO we should allow local short range transmission so that the virus is made to pass through many hosts only to travel 50 - 100 kms. With reduction of virulence. It's only the long range transmission we should guard against. This my personal view. - by a doctor
(Long post alert, on the madness around Covid-19 worldwide, but the beauty of free will is that you can stop reading anytime, or not read at all. But then again, free will has also resulted in a rash of irrationality this year unprecedented in human history, elaborated on below, through an Indian prism. Note: all references in first comment.)
HOW COVID-19 BECAME GOWILD-20
Ganesh idols in India ostensibly drank milk in September 1995 but the hysteria lasted just one day. That Covid-19’s publicly supported hysteria has already lasted more than two months is a grim sign of things to come.
The least deadly pandemic in recorded human history (in terms of fatality rate) has shut the world down. After the Internet met mobile telephony and the world changed very rapidly, Covid-19 is the first true test the world has had to face collectively. A test the social media-affected virtue-signalling world has comprehensively failed in 2020.
This is not at all to belittle the deadliness of C-19 in some quarters or the people suffering from it. But only to ask if living with death hasn’t always been our way of life? And if “living with the virus” really just means that?
So, in an attempt to find some common-sense answers…
1. BUSINESS AS USUAL OTHERWISE?
On an average 56 million people die every year around the world in this era. That comes to 4.67 million deaths a month. So, at the end of five months, in a normal year, the tally would be in the region of 23.4 million. Adjust a little for the first three months which see the most deaths in the year (along with December), and the number would go a little above 24 million by the end of May in a normal year in this era. This is the average, some years are more; in 2014, 57 million people died without a pandemic (which also means a higher proportion of people, as the world population was less.)
So, how many have died this year? According to Worldometer - about 24.3 million. According to the World Death Clock - about 23 million.
Approximately, 370,000 people have died from C-19 so far. That’s 1.5% of total deaths worldwide. For this, we shut the world down?
Meanwhile, here are other yearly facts: 17 million people die every year from cardiovascular diseases, 9.5 million from Cancer, 3.91 million from respiratory diseases, 1.5 million people from TB, almost a million people still from HIV/AIDS, 650,000 from Flu, 600,000 people from Malaria and 160,000 from Cholera. These are deaths, not cases; presumably most brains would short-circuit if we decided to calculate cases? And stuck cameras in wards to share them on social media?
2. A BAD CHOICE OF DATA CAN ONLY RESULT IN POOR DECISIONS
Why are we measuring C-19 with worthless numbers such as “Number Of Cases” and “Recovered”? And why is that nonsense the foundation of public policy today? “Number Of Cases” is entirely a function of how much testing is done, where and on whom, and what is discovered. There can be considerable luck involved in this, as well as the potential for much calibration and indeed, manipulation. Meanwhile, the “Recovered” statistic merely represents an on-going process (and seems to purely exist for manipulation). For these numbers to be at the centre of all discourses today shows how any entity wrongly represented by data with falsely drawn-out foundations, results in low IQ conclusions. Cricket statistics have already demonstrated that, but that’s just a measly sport with a stupider essential accounting than any other sport whereas Covid-19 is literally about life and death.
Here, the only number that should matter is the “Deaths” figure, despite all the talk about manipulation and hiding. That’s the only number worth engaging with, and if public policy were reversed with that as the focus and not “Number Of Cases”, the environmental system around Covid-19 would change. For starters, that would seriously moderate the hugely corrosive stigma Covid-19 is rapidly causing in India on a scale unprecedented in the world. As it is, given its history of caste and communal disharmony, this is statistically the smallest-minded country that has ever existed (its ironic foundations of democracy notwithstanding), and C-19’s presence in this discourse is comfortably, and dangerously, fitting in with the existing poison.
The use of “Number Of Cases” only had value at an early stage when random testing, contact tracing and isolation had meaning. Now, with that phase long gone in India (with very few states having shown the ability to pull that off), this number should be banished from public usage, and every ounce of energy from the authorities should be spent around prioritising the expansion of ICU spaces and the safety of healthcare workers, so that the death toll is controlled. This would mean clear communications lines between the public and the authorities to reduce panic in a single-minded way and make testing and patient inflow painless and efficient, once anyone symptomatic with severe symptoms shows up. But none of this has been the thrust at all.
3. COULD HOSPITALS BE REARRANGED?
The focus on deaths would also address the greatest fear associated with this virus – overloading the hospitals. It would be well known by now that 80% of infected people develop mild and easily manageable symptoms and essentially require two-week rest. What’s not so well known is that only 5% of the people tested for C-19 actually turn out positive. Which means that 95% of these people who are crowding hospitals on the basis of feared symptoms should not be there at all. The most logical solution then seems to be to discourage people from coming to be tested. That can only happen if the fear psychosis around being infected goes away, and only people with recognisably severe symptoms are allowed in.
Moreover, at the moment, everyone who tests positive ends up in the Covid-19 quarantine ward, even if they belong to the 80% mild symptoms category. Which means that hospitals could comfortably get rid of at least 80% symptomatic patients and ask them to go home and quarantine themselves (those who can’t or those who have elderly people at home can choose to stay). That space can be invaluable for creating more makeshift ICU spaces, which is the critical element in combating this fear. Most people below 60 who have died after being infected, whether in Italy or New York or indeed Mumbai or Delhi, as per the accounts that have appeared, tragically perished only because they were not treated on time, or more accurately, they could not make it to the ICU in time.
If the entire focus of the administration were on guiding people through telephone lines and smartphones to the right place to go for diagnosis and ICU admission, much of the panic and frankly, cluelessness about a post-positive diagnosis would come under control. Apparently, this is just beginning to happen in some parts of India, including Mumbai, but it needs to happen as a clear, communicated homogeneous policy, which is still not the case.
This is particularly critical in light of the dread that is apparently there in many Mumbai hospitals currently bracing for what they feel is to come as the lockdown lifts. The healthcare staff are the most at risk, and every effort from the authorities should be focussed on them, from PPEs to just their general morale, to help provide a larger picture and dispel the panic, whether the storm hits or not.
4. PANIC-MONGERS’ DELIGHT?
Perhaps there ought to be some kind of legislation against panic-mongers, and we might want to start with the media. Like Rediff.com who published an interview of a senior scientist on May 4th, who made this pronouncement, 'If you look at the age group of people who died in India, the average age is 35!' (reference in first comment). The senior journalist who interviewed this scientist whose name appears in the by-line, and the portal who made this claim the subhead should at least have been publicly admonished or shamed for this. (While there have been young casualties, presumably among the migrants, the majority deceased still remains people over 60, with comorbidities playing a big part with the rest – reference in first comment). Even otherwise, it is strange to see columnists who transparently do not care to do enough reading on the worldwide facts err on the side of alarm too, as if on reflex. It is odd because the facts do not suggest a worldwide catastrophe on any metrics.
It has been even more shocking to see even the most sober of channels, NDTV, and their normally moderate founder Prannoy Roy, peddling the most insidious extreme view (like the “computational biologist” he interviewed, who stated with impunity that without lockdown, India would have had 150,000 deaths and 25 lakh cases on May 17th) on an on-going basis, and even making that the official line for the channel in some shows. Variations of this have abounded Indian news centres, with very little meaningful space to other opinions (Dr Jayaprakash Muliyil’s view on herd immunity was presented as an outlandish alternative view in some mainstream spaces).
The granddaddy of C-19 panic-mongers is, of course, Neil Ferguson, chief epidemiologist at Imperial College, London, who played a significant role (even if not the only one) in the UK and US lockdowns. This man predicted 150,000 deaths in 2001 from foot-and-mouth disease; less than 200 died. He was convinced 50,000 would die from mad cow disease in 2002; 177 died. In 2005, he predicted 150 million would die from bird flu; 282 died. In 2009, his "advice" was that 65,000 would die from Swine flu; 457 died. And now, in 2020, he predicted that more than 500,000 people would die in Britain and 2.2 million in the US if they did not go for a lockdown. The most shocking thing is not that this man kept his job for so long (after all, the ICC's official cricket statisticians have also enjoyed similar largesse), but that the UK government based its lockdown policy based on his report and the "left liberal" British media championed this report to successfully sell the lockdown to its citizens. In true social media fashion, Ferguson is now discredited only because of his sex scandal earlier this month, when it appeared he did not believe in his own rules of "social distancing". This would be an exaggerated comedy sketch if it weren’t such a tragedy.
5. LOCKDOWN MYTHS PERSIST
It was always clear that lockdowns do not reduce infections but only slow it down, and only really have value if that slowing down is used to buttress systems - health, administration and any other. But there is absolutely no evidence, historically, or from the current crisis, that eventual death tolls are reduced by lockdowns.
If such an extreme measure is to be undertaken which results in enormous collateral damage, how can it be done on such arbitrary parameters, with no proof on any score? If there was no collateral damage, there would literally be no case against the lockdown, so it is pointless to not factor that in.
Italy’s lockdown began when the death toll was 366 (it is now at 33,000-plus), Germany’s when it was 55 (now 8500-plus), Spain’s when it was 191 (now 27,000-plus), UK’s when it was 281 (now almost 38,000). Germany was praised for being proactive but India went the other extreme and clamped down with just 9 casualties, giving just a four-hour notice to its 1.38 billion people, not caring that 80% of the country lives in rural conditions or in urban slums, and in most of these places, social distancing is a cruel joke. It did not care that 220 million of its population are daily-wage workers. Such a horrifying unconcern for the poor is ironic from a PM who played the poverty card so emphatically to get elected (as ironic is his gumption to close down the country, so transparently only because the US and UK did, and then saying that his dream is to see the country self-sufficient).
The migrant labour tragedy in India (and it is not the only tragedy by any means, as will become clear in coming weeks) that has unfolded is completely predictable; to knowingly inflict this upon the same public that had to bear the well-documented disaster of demonetization three-and-a-half years ago is touching levels of apathy on a scale that the world has seldom witnessed in modern history. In 1947, the estimated number displaced because of partition is capped at 15 million. In 2020, the Indian migrant labour displacement figures are estimated to be 40 million. Even if the death toll now is not in the range of 1.5 million as it was in 1947, it will almost certainly be far, far more significant than the Covid-19 death toll will be, especially over a period of time, thanks to the effect of lockdown. This is shooting oneself in the foot in slow motion, with the pain just as keenly felt in real time.
That most migrant workers do not vote (due to the wandering nature of their job, they are registered elsewhere most times) actually seems like a minor justification for what is a staggeringly evil act (and people who support or justify the dispensation that caused this might find this is the now a path of no return). The speculation that this dispensation actually wants to destroy poverty by simply eliminating poor people (an idea, again, worthy of an exaggerated comedy sketch), whether true or not, at least does not seem like an outlandish conspiracy theory anymore. After all, this is a country where the Government proudly chose to fight for and tom-tom its new “Developed Nation” status despite losing huge economic subsidies and benefits because of that (as happened in February this year). It is this same extreme craziness that makes forty migrant trains go to the wrong stations, reportedly because the stations weren’t ready for arrivals, without providing any extra food or warning to the migrants.
In India, the real plague of these times is this lethal combination of unfeeling irrationality. But the rest of the world isn’t doing too well on the latter either.
There has been too much talk in the media about vaccines stopping the virus, with a clear implication (even stated in some cases) that the lockdowns will continue in some form or the other till then. These people are actually implying (even stating at times) a lockdown for more than a year as a best-case scenario, going by the past history of vaccines. It is very strange how much this brand of crazy talk is being legitimised in the mainstream media; it complements the irrational alarmism perfectly. This is also where that part of the medical community that contributes to public policy (which makes them more politicians than medical practitioners) has let the world down, and resulted in so many conspiracy theories floating around, some of which actually seem more logical than the official courses of action being taken.
6. FALSE EQUIVALENCES ABOUND
It actually does not follow that a country (or city or state) having fewer cases or even deaths from C-19 has done better than another country with higher numbers. Every region has been dealt a different set of cards. Every country has its own challenges as per age profiles and diet. For example, Brazil with about 28,000 deaths has not been as badly hit as Belgium with about 9,400 deaths. Simply because Brazil’s population is almost 20 times more than Belgium’s. The deaths per million column is a much better indicator of this; Brazil has had 132 deaths per million, Belgium 814. (India, by the way, has had 4.)
Similarly, with over 100,000 deaths, the USA is seen as the worst-hit country in the world, but it may be useful to remember that ten countries in Europe which together equal USA’s population (the UK, Ireland, Italy, Spain, France, Germany, Belgium, Sweden, Netherlands and Switzerland) have 50% more deaths from C-19 than the US.
There are two key commonalities that keep coming up when it comes to causes of death from C-19: age and diet. So, countries with a higher average age are at a higher risk – this is primarily why Europe has been so badly hit. As are countries with higher obesity (both as percentage of population and absolute numbers). This is also why the USA has raced to the no. 1 position; with a 36% rate it is the obesity capital of the world. And why the Black community has been the most badly hit (the connect between economic backwardness and fast food is well documented in the USA).
Climate has also clearly played a part – the hotter countries have all had relatively fewer fatalities, except Brazil – the only hot weather country whose deaths per million toll crosses 100. And here, the obese factor comes into play – Brazil’s 22% obesity rate is not amongst the highest in the world (even if significant), but in a high population base, it becomes more lethal. The next badly hit hot weather country (though much, much lower down the list), in terms of deaths per million, is Kuwait – one of the world’s most obese countries (but within a minuscule population). It’s curious that this factor is not being discussed as much as it should be; perhaps the cues for that lie in the “critical” piece at the very vanguard of brain-dead Woke “journalism” – The Guardian, where the headline itself shrieked that “America is victim-blaming the coronavirus dead”. Yeah, wow. It is better to not discuss facts just in case we end up gaining some insight rather than “offend” people who are basically idiots to start with. This is our Brave New World today.
Perhaps, the best way to judge whether a country/ state/ city has done a good job in dealing with the Covid-19 crisis is to look at the levels of panic in its population, as well as clarity about threat factors. India is pitifully low down the international ladder on that score. For authorities here to continually say that its citizens have to be forced to keep the rules of social distancing, wearing masks and maintain hygiene is dishonest when there is no effort made to inform the public in a clear-eyed way about risk factors or do anything to lower the panic. Obviously, the low hanging fruit option of universal lockdown is perfect for authorities of this mindset.
A relevant side note here: In 1994, a psychologist and a political scientist co-wrote and published a book called “The Bell Curve” which argued that “ human intelligence is substantially influenced by both inherited and environmental factors and that it is a better predictor of many personal outcomes”. One of the chapters in it quoted a study that compared IQ in racial groups (with the very clear proviso that differences within groups are greater than between groups, therefore people should always be judged as individuals and not in a group dynamic). But on the basis of one its findings – that the white group had a higher IQ than the black group, the book was deemed racist and thoroughly discredited (with all kinds of motives attributed to them and the book). The surviving writer Charles Murray still gets physically attacked in public, 25 years after the book was published. Here’s the interesting thing that no one speaks about - this might be the perfect time to bring it up. That exact same study also claimed that the Asian group (from the Far-East, not South Asians) had a higher IQ than the white group. This inconvenient snippet is never brought up, as it would dismantle the idiot Woke outrage in one fell swoop. It’s perhaps good timing to bring this up now because this has been comprehensively proven during the Covid-19 crisis, in the manner in which those countries dealt with both the threat of the virus and their own populations (even if they were dealt a less severe card because of obesity, and therefore low immunity, not being a widespread factor in these countries); none of these countries went for a strict lockdown at any stage, but focussed on aggressive testing, contact tracing and quarantining. The group dynamic, however limited its scope, can have its uses while formulating public policy and its execution. (It is probably not a coincidence as well that India’s most successful state in dealing with Covid-19 has been Kerala – India’s most literate state by a distance, and many would say, the most intelligent, as a collective – they followed exactly the same procedures as the Far Eastern countries and exercised the same discipline.)
It is simply wrong to attribute India’s relatively lower death rate to lockdown. India’s median age of 28.4 puts it at a distinct advantage as does its low obesity rate of 3%. Still, the baseline health standard is low in India, and anxieties about its capacity to cope if it goes out of hand are valid, but so far the evidence does not suggest an extraordinary outbreak in India at all. Not so far.
But false equivalences are not limited to just this - media people around the world, for some reason, keep making the analogy that the Covid-19 death toll is higher than that of the US in the Vietnam war (even Rajdeep Sardesai said this in our quarters). Besides being a repugnant way to selectively focus on certain death tolls (the Vietnamese death toll was five times more, for example), this analogy is utterly cuckoo as it compares the deaths of young people in their prime and that of mainly retired people or those with underlying serious illnesses. Further insanity manifests when the US toll is calculated to be 33 times that of the 9/11 attacks, putting terrorism and disease on the same plane.
7. THE RIGHT COMPARISON
The Hongkong flu pandemic of 1968 (the third and last pandemic of that century) is actually a good one to compare Covid-19 with. Originating in Hongkong (though unofficially it is believed this originated in China as well), the influenza A subtype H3N2 virus (which is still around as seasonal flu), after spreading to Vietnam and Singapore, travelled to Philippines, India, Europe and Australia, and notably through soldiers returning home, to the US. The pandemic came in two waves, the second was more lethal and killed more people in 1969/70.
However, economic activity was not ceased anywhere, and the population, while taking precautions and being forced to quarantine at times, did not collectively panic anywhere. In fact, the legendary Woodstock music festival (with 400,000 attending) was held between the two waves (no, the festival did not cause the second wave; that came later). Overall, one million people died worldwide from this pandemic including 100,000 in the US, and 80,000 in the UK. It can be argued that if these two countries had shut their countries down as they did this year, the history of the world might have been different thereafter as their economies might have collapsed, and since the Soviet Union was not affected much by the pandemic. But intellectually, creatively and culturally, there is so much evidence that that period, despite all the warts, was when the human race got more evolved than any other period.
That pandemic had a lower fatality rate than the previous two pandemics, and the Covid-19 pandemic has an even lower one. The Diamond Princess cruise ship study still serves as the only “closed-door lab experiment” equivalent for Covid-19. In an enclosed space over several days, out of 3711 people, the vast majority of whom were over 70 years of age, just 712 people were infected - a 19% infection rate. 18% people had no symptoms. 8 died - thus a fatality rate of 1% amidst its core victim base. In studies that have emerged from Germany, Orange County in L.A., Qatar and Singapore, within a wider age-group, the fatality rate has shown signs of being closer to 0.1-0.3%. Nothing is conclusive yet, which it can’t be so soon, but in all probability by extrapolating the death rate in India, the number of cases in India is in the region of 20 lakhs. Testing for the purpose of quarantining is then an utterly pointless exercise, as are lockdowns.
8. EVERYTHING ENDS LIKE SWEDEN
Sweden is the only country in the eye of the Covid storm that did not lock down. But it is wrongly assumed in many quarters that they did it out of some kind of bravado. It was not just pure common sense but also the path that history had thoughtfully laid down. The phrase “herd immunity” triggers people these days that gets them to make Armageddon-like calculations, by making absolute percentage calculations, without accounting for the nature of infections and the geographical limitations of each spread. Which is why Swedish authorities have never officially used this phrase in their public announcements. Of course they are aiming for immunity, which is the only long-lasting way to deal with viral outbreaks, though not necessarily on the scale “herd immunity” lays down. And social distancing and all other precautions are very much in play there as well. They just haven’t shut down life as they know it.
Sweden has had more deaths than they hoped for, primarily because of their failure in protecting old-age homes as they themselves admitted officially, and their economy has taken a beating as well, but nowhere near as badly as other countries which went for the lockdown option.
As the Swedes have said repeatedly, their eventual death tolls over a period of time will eventually be more or less the same as the other countries in the eye of that same storm, but they will not bear the economic cost as those countries will (which is huge, and comes in the currency of human suffering and lives lost as well in the longer run).
In the end, every country, every region will have to do what Sweden did; it is just a matter of time. There is no coherent exit strategy for a lockdown (as numbers will invariably rise) and the cost of an indefinite lockdown is quite simply untenable. After getting out of the lockdown, protecting the vulnerable, maintaining social distancing and hygiene protocols and aiming for immunity through the younger population is the only option.
9. INDIA’S NATURAL ADVANTAGE
India has two major things going for it when it comes to Covid-19 – one of the youngest populations in the world, on a massive scale. And hot summer weather, which seems to suggest a far lower virulence of the virus.
For a while, it had seemed as if Indonesia and Philippines would be exceptions among hot weather countries, but after initial spurts, the death rate palpably settled down there. Brazil had a few cases in the hotter period, but from April, as the temperature began to cool down, cases began to gradually rise; there is a scary spurt now. The obesity factor and poor leadership that did not advocate proper social distancing and hygiene protocols have led to Brazil becoming the biggest hotspot currently. But heat definitely appears to have a say in the virulence of the virus, and Indians must take heart from this.
10. THE WAY FORWARD
In a country where 22,500 people die every day, the C-19 Indian death toll is negligible even now, despite the ostensible community spread. India should ideally have relaxed its lockdown in April itself and very consciously taken the sting away from “number of cases” by tailoring all public communication towards that end. And single-mindedly focussed on just keeping the death toll down, by ensuring that every ounce of energy was dedicated to creating space for ICU patients. And build up a cogent and responsive system to answer queries from prospective patients. They can still do all of this. There is quite simply no better route worth attempting – that is what history and the multiple international responses to Covid-19 show us.
Testing, contact tracing and isolating is really for an early stage where the number of infections is manageable. India is past that stage now, especially in Mumbai. This is the time to activate pure common sense and explore options like as many as possible working in three shifts (which can help in reducing traffic when things go back to normal later), while maintaining all the social distancing and hygiene protocols, protecting the vulnerable and taking the public to confidence by levelling with it. Those who wish to quarantine themselves can do so, cower in fear at home all they like, and wear gloves and masks when they go out (which they should regardless, definitely the latter). Sadly, with the kind of corruption that is being exposed every second day (fully in keeping with what the national character has become), the priorities seem different. This is the great tragedy of India, not the Covid-19 crisis.
In a polarised world where authoritarianism has taken new hold, and extreme behaviour is destroying every well-meaning instinct (left liberalism, the #MeToo movement, the Woke mindset), far too many reactions that determined public policy to combat Covid-19 have been extreme. From shockingly-flawed data analytics to fear-mongering to obviously myopic policy decisions by governments - each one seemed to want to outdo the other in extremism. This is an era of distraction, of abdicating responsibility, of cowardice and deflection, of entitlement and rapidly taking offence. If this reminds you of the new generation, that is not a coincidence. That it is not just the new generation that has fallen prey to this is the really bad news.
But what has been most disconcerting is how so many people have seen nothing wrong in willingly shutting themselves down for so long, fearing disease and death to such an irrational degree. Even with the odds so low of perishing to Covid-19, they have been willing to forego life as they know it. Even though the respect of death over life is not new, this kind of fear of death certainly is. Liberation from this fear might just be the next revolution.
For everyone scaremongering with random statistics. Make the time to read the figures below.
Remember with every thoughtless post from the confines of comfortable homes, you are putting in one more nail in the struggling efforts of the poor to survive.
As they sit with their flowers and coconuts and sewing machines. On empty streets.
Yes take some basic precautions as it's a contagious fever, but don't trade in meaningless terror.
*Quick facts about Global Pandemic and the Global Economy:
~ Covid - 19 has so far killed 26,348 people worldwide.
~ Total 1.5 million people die per year from Tuberculosis + HIV i.e. about 4,100 deaths per day. TB is one of the top 10 causes of death globally. About 10 Mn people fell ill with TB in 2018.
~ Globally at least 17.9 Mn people die of Cardiovascular Heart diseases each year i.e. about 49,000 deaths per day. An estimated 31% of all deaths worldwide.
~ Cancer is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer. This is about 26,300 deaths per day.
~ Around 9 Mn people die of hunger and hunger related diseases like malnutrition. This is more than total deaths due to HIV, Malaria and TB combined. A whopping 24,600 deaths per day.
~ At least 2.4 Mn people die of Kidney diseases each year i.e. about 6,600 deaths per day.
~ At least 1.6 Mn people die of Diabetes Mellitus each year i.e. about 4,400 deaths per day.
~ Flu kills 646,000 people per year i.e. about 1800 person per day.
~ Globally roughly 400,000 people die due to malaria worldwide. i.e. 1,100 death per day.
~ Globally roughly 151,500 people die every day.
Data Compiled by Jayant Khatri on 27.03.2020
Reference WHO website.
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