Prominent public health experts in India, including two members of a research group constituted by the National Task Force set up by the Indian Council for Medical Research, have criticised the Narendra Modi government’s handling of the coronavirus outbreak and the failure to consult epidemiologists about the disease.
A joint statement by the Indian Public Health Association, Indian Association of Preventive and Social Medicine and Indian Association of Epidemiologists was submitted to Prime Minister Narendra Modi on May 25. The statement was signed by Dr DCS Reddy, a former professor at the Banaras Hindu University and Dr Shashi Kant, professor and head of community medicine at All India Institute of Medical Sciences.
Both Reddy and Kant are part of the epidemiology and surveillance research group constituted by the National Task Force on April 6. Reddy heads the research group.
“It is unrealistic to expect that Covid-19 pandemic can be eliminated at this stage given that community transmission is already well-established across large sections or sub-populations in the country,” the statement said. The Centre has consistently refused to admit to community transmission of the virus even as India has recorded over 1.82 lakh cases.
The signatories said the Centre should have approached epidemiologists following the outbreak for a better understanding of the disease. “Had the government of India consulted epidemiologists who had better grasp of disease transmission dynamics compared to 4 modelers, it would have perhaps been better served,” the statement said. “From the limited information available in the public domain, it seems that the government was primarily advised by clinicians and academic epidemiologists with limited field training and skills. Policy makers apparently relied overwhelmingly on general administrative bureaucrats. The engagement with expert technocrats in the areas of epidemiology, public health, preventive medicine and social scientists was limited.”
The signatories also include former advisors to the health ministry, current and former professors at the All India Institute for Medical Sciences, Banaras Hindu University, Jawaharlal Nehru University, Postgraduate Institute of Medical Education and Research, among others.
The experts said that the coronavirus cases have increased exponentially despite India’s “draconian lockdown”, adding that enough scientific and evidence-based interventions are available to control the spread of the infection. “India is paying a heavy price both in terms of humanitarian crisis and disease spread,” the statement said. “The incoherent and often rapidly shifting strategies and policies especially at the national level are more a reflection of ‘afterthought’ and ‘catching up’ phenomenon on part of the policy makers rather than a well thought cogent strategy with an epidemiologic basis.”
The experts said the current situation could have been avoided had the government allowed migrant workers to go home before imposing the nationwide lockdown in March, when the spread of the disease was very low. “The returning migrants are now taking infection to each and every corner of the country; mostly to rural and peri-urban areas, in districts with relatively weak public health systems [including clinical care],” they added.
The signatories recommended the Centre to constitute a panel of interdisciplinary public health and preventive health experts and social scientists at central, state and district levels to tackle the crisis. They also suggested that all data, including test results, should be made available in public domain for the research community to access, analyse and provide real-time context-specific solutions.
“These measures should be implemented while at the same time ensuring optimal provisions for the livelihood of the poor and marginalised,” the experts said. “Simultaneously, provision of health care for all, especially children and women and those suffering from chronic conditions and emergencies requiring medical attention is an urgent imperative.”
Meanwhile, Reddy and Kant told The Indian Express that they stand by the statement. “Yes I am aware of the statement, it was circulated to all of us and wherever we had doubts, we have raised it,” said Reddy, the head of the research group.
The Centre on Saturday extended the nationwide lockdown until June 30 in the containment zones, but permitted restaurants, malls and religious places to reopen elsewhere from June 8. A decision to reopen schools and educational institutes will be taken in July.