Prime Minister Narendra Modi’s attempts to curb criticism and open discussion during the coronavirus pandemic are “inexcusable”, an editorial published in medical journal The Lancet said on Saturday.

“At times, Prime Minister Narendra Modi’s government has seemed more intent on removing criticism on Twitter than trying to control the pandemic,” it said. It was referring to Twitter complying with the Indian government’s request last month to take down 52 tweets, most of which were critical of India’s handling of the second wave of the coronavirus pandemic.

India is reporting an alarming number of cases and deaths during the second wave of the pandemic, which has crumbled the health infrastructure in the country. On Saturday, India recorded 4,187 coronavirus-related deaths, the highest ever since the pandemic broke out last year. With this, the toll rose to 2,38,270.

The country also recorded 4,01,078 new cases in 24 hours, taking the tally of infections in the country to 2,18,92,676. This is the fourth time since May 1 when the count rose by more than 4 lakh.

Citing the Institute for Health Metrics and Evaluation’s estimates that India may see 10 lakh Covid-19 deaths by August 1, the editorial said: “If that outcome were to happen, Modi’s government would be responsible for presiding over a self-inflicted national catastrophe.”

The second wave of the coronavirus pandemic in India has left hospitals overwhelmed and medical workers exhausted. Social media is full of desperate people seeking medical oxygen, hospital beds and other necessities. “Yet before the second wave of cases of Covid-19 began to mount in early March, Indian Minister of Health Harsh Vardhan declared that India was in the ‘endgame’ of the epidemic,” the editorial said.

It claimed that despite repeated warning of the dangers of a second wave, the government gave the impression that India has beaten the coronavirus pandemic. “Modelling suggested falsely that India had reached herd immunity, encouraging complacency and insufficient preparation, but a serosurvey by the Indian Council of Medical Research in January suggested that only 21% of the population had antibodies against SARS-CoV-2,” it said.

The editorial added:

“Until April, the government’s COVID-19 taskforce had not met in months. The consequences of that decision are clear before us, and India must now restructure its response while the crisis rages. 

The success of that effort will depend on the government owning up to its mistakes, providing responsible leadership and transparency, and implementing a public health response that has science at its heart.”

— The Lancet

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The Lancet also castigated the Modi government for holding religious festivals as well as huge election rallies without considering that such events lack mitigation measures for the coronavirus. The Centre had faced massive criticism for holding Kumbh Mela and rallies during the state Assembly elections in four states and one Union Territory.

The violation of Covid-19 protocols during the Kumbh Mela had attracted attention from across the world. However, state authorities, including Chief Minister Tirath Singh Rawat, tried to downplay the risks. As for the Assembly elections, Union Home Minister Amit Shah had said that it was “not right” to link them to the surge in coronavirus cases in the country. Despite the worsening situation in India, political leaders, including Prime Minister Narendra Modi, had addressed massive rallies and roadshows without masks.

The editorial criticised the country’s vaccination campaign and pointed out that India has vaccinated less than 2% of the population. “At the federal level, India’s vaccination plan soon fell apart,” it said. “The government abruptly shifted course without discussing the change in policy with states, expanding vaccination to everyone older than 18 years, draining supplies, and creating mass confusion and a market for vaccine doses in which states and hospital systems competed.”

In the third phase of the immunisation drive, the Centre allowed vaccine manufacturers to sell 50% of their vaccines directly to states and private hospitals. The other half is to be supplied to the central government. While the current phase covers all above 18 years, various states have reported a shortage of vaccine doses, failing to start the immunisation programme on May 1, the day of the rollout.

The editorial suggested that India should rationalise the “botched” vaccination campaign. “There are two immediate bottlenecks to overcome: increasing vaccine supply (some of which should come from abroad) and setting up a distribution campaign that can cover not just urban but also rural and poorer citizens, who constitute more than 65% of the population (over 800 million people) but face a desperate scarcity of public health and primary care facilities,” it said.

The journal also suggested controlling the transmission of the vaccination while administering vaccines. “Genome sequencing needs to be expanded to better track, understand, and control emerging and more transmissible SARS-CoV-2 variants,” it said. “Local governments have begun taking disease-containment measures, but the federal government has an essential role in explaining to the public the necessity of masking, social distancing, halting mass gatherings, voluntary quarantine, and testing.”