I’m writing this article as a follow up to my previous short piece which attracted a surprising amount of attention. The situation in India is rapidly evolving, so I’m adding a more detailed update because it was published three weeks ago and things have changed. Firstly, I want to emphasise that it’s very difficult to talk about India as a homogenous nation-state given the country’s vast landmass and population that crosses six climate zones. Indians live in vastly different environmental conditions depending on their location. So, it’s perhaps unwise to speak of public health conditions in India as ‘national’ in any meaningful sense. I was recently interviewed by radio reporter Michael Welch about the background to my previous article, so this update is based on a series of questions he sent to me and is presented in a question-and-answer format. My intention is not to suggest there is no crisis, but that there are multiple contributing factors involved. Many of my sources on the ground are related to the food bank I set up in India to counter hunger caused by lockdowns. If, after reading this article, you feel inclined or able to donate, please click on the link at the end. Thanks.
1. Can you highlight the air pollution situation? Is there a ‘season’ where it is more intense than others? Or time of day? How has distress from pollution-related disorders changed before and after COVID? How long has oxygen for pay been a market and has it shifted the focus of oxygen to the wealthy?
Again, with air pollution, it depends on the region, the climate, and whether we are talking about urban or rural areas. Given the COVID outbreaks have tended to cluster in urban areas, especially the megacities of Mumbai, New Delhi, Kolkata, Bengaluru, and Chennai, then it makes sense to look at the problem of air pollution and its impact on respiratory health in those areas. Delhi has become world-famous for its toxic air which has led to city-wide shutdowns previously due to the high risk of developing respiratory problems outside. The images in the media of people lying on trollies gasping for air outside overflowing hospitals were from New Delhi which often battles with surges in respiratory crises when pollution poses a significant danger to life. The worst times are generally during the intense dry and hot season before the monsoon (now- April/May) and the stubble burning season in Haryana and the Punjab which creates a lot of smoke that settles into a thick smog that envelopes Delhi during the months of November and December. The cities on the coast- Mumbai and Chennai tend to have fewer pollution problems- it gets blown out to sea, but when I lived In Bengaluru in 2018 air quality was periodically pretty bad due to a mixture of traffic fumes, widespread construction creating a lot of dust, burning solid fuel for heat and cooking, and trash burning due to a lack of civic trash collection services.
A report in the Lancet stated that in November 2019, the air in Delhi was so noxious that authorities declared a public health emergency and ordered the closure of schools in the city and surrounding suburbs for several days. All industries powered by coal and diesel were also ordered to close by the Supreme Court mandated Environment Pollution Prevention and Control Authority.
Oxygen bars for the wealthy started springing up a couple of years ago in many major cities. They sell oxygen therapy to manage stress and other health problems like muscle aches, migraines, and headaches. I can’t imagine that the supplies involved would impact on the national oxygen supply as such but can’t be sure. In a recent interview, health activist Yohan Tengra explained that India began exporting oxygen two years ago and has suffered from a shortage for the last 6 months. Meanwhile, the poor who work outside and live in unsealed dwellings bear the brunt of the poor air quality and have no access to the luxury of oxygen bars. I must emphasise that I am not saying that COVID 19 cases are not ‘real’ in any sense, only that there are several contributory factors that need to be understood to place the current crisis in context. One is the problem of air pollution. Another recent study published in the Lancet showed that India’s toxic air—particulate matter and household air pollution—claimed 1·24 million lives in 2017. That’s 12·5% of the deaths recorded that year in India. I find that a relevant consideration when discussing the current crisis.
2) COVID 19 pales in comparison to other viruses. The reference article was written in March 2020. Do the numbers remain true in spite of an escalation in recent cases?
There is a government Twitter account #IndiaFightsCorona with constantly updated COVID figures; however, COVID stats are collected differently as a rolling total of cases and deaths since the pandemic began, rather than an annual total of cases and deaths as for other diseases. Even so, it still doesn’t register as one of the top ten causes of death annually to date (as stated in the referenced TOI article) if we believe that the government figures are reliable, of course. Different media commentators have challenged the figures as both overestimates and underestimates. The data collection process is not perceived as transparent. In a recent interview linked above, Yohan Tengra reported that PCR testing has been forced on people in the street in Mumbai as the municipality had to meet targets of 45,000 tests a day. People with no symptoms were offered a test and they had to comply to avoid being charged under the Epidemic Diseases Act. He argues that most positives are asymptomatic or have very mild symptoms. In Bengaluru, the Bangalore Mirror reported that 99.4% of patients are asymptomatic and, according to Tengra’s research, PCR CT cycles are set at 35 which generates a huge number of false positives.
3) You said COVID vaccines are diverting resources away from treating urgent public health issues. including access to water, sanitation, clean air, and treatments for other communicable diseases. Can you explain further with individual cases from your contacts?
The Indian government is spending millions on procuring vaccines which has diverted resources from other health programmes, including TB vaccination programmes. TB kills between 450,000 and 500,000 people a year in India on average. Given the government-funded health care system is fragile at best, any sudden upsurge in respiratory viral illness will overwhelm the system and for much of India, April begins the respiratory virus season prior to the monsoon.
The point my first article was making is that in a country with a fragile and creaking health system, diverting resources to procure and roll out mass vaccinations is bound to divert spending away from other public health issues that are far more serious and life-threatening than coronavirus is to the majority of the young and healthy population. Vaccination programmes against TB, measles and polio have all been set back meaning cases will rise.
In Bihar, where I fundraise for a food bank that alleviates the hunger caused by lockdowns, I have heard widespread reports of doctors refusing to treat and consult with those with symptoms of respiratory tract infections out of fear of getting COVID, meaning this season, complications of respiratory infections are going untreated and becoming serious, then presenting to emergency services in need of oxygen.
Meanwhile, one of my contacts in Maharashtra told me a story about his grandmother being admitted to hospital with typhoid but contracting COVID while in hospital, then he says dying of COVID but typhoid being entered on the death certificate. He believes there is serious underreporting of COVID deaths in the area due to many contracting the virus in hospital and the government wanting to disguise the situation. Yet, the state of Maharashtra has by far the highest number of cases at present.
These reports suggest people may avoid presenting for treatment of a range of diseases out of fear of contracting COVID in the doctors’ surgery or hospital, then delaying treatment for complications of seasonal respiratory viruses and other respiratory infections which may develop into pneumonia and a need for oxygen. As testing is uneven or often absent there are two further dangers- that respiratory symptoms are being assumed as COVID leading to overestimates, or that COVID cases are underestimated due to the lack of adequate testing. The testing itself, of course, may be a problem, as PCR tests have proven unreliable with a high false-positive rate. I was also sent some video footage of swabs being packed in India by homeworkers and their children in ordinary domestic conditions which would contaminate the swabs (on Telegram so cannot link but will do so if you have Telegram). This kind of information is anecdotal and often circulated on social media. Presenting the direct effects of vaccination spending on specific individuals with untreated health problems is not really possible given the current chaos. However, it stands to reason that investing in new emergency nationwide health programmes will divert resources from other public health initiatives. The same has happened in the UK which now has a huge backlog of untreated cancer patients, for example.
4) Can you give examples of distortions in local Indian journalism. Is it having an impact?
Most people get their news from television. People that I have spoken to in the north perceive distorted reporting of the threat of COVID as ramping up fear and pressuring them to accept the vaccine. Many suspect that ordinary seasonal flu-type illnesses are being diagnosed as COVID to escalate figures- however, it really isn’t possible to check that out. It remains a theory.
There are highly political divisions in the approach to reporting on COVID- some independent media are claiming that the figures are a gross underestimate of deaths and infections (such as the Wire- who are anti-BJP and the Modi government) and others claiming the exact opposite. I watched a report from the Wire today based on an interview with Dr Murad Banaji, a mathematician from Middlesex University here in the UK who is deploying different models to estimate what he claims is the true death account- likely between double and five times higher than official data. However, closer inspection of his previous research reveals he has worked on modelling with Imperial College (who receive a lot of funding from the Gates Foundation, and was responsible, via Neil Ferguson- for the model overestimating viral death tolls in the UK, EU and the US), and has been funded by the Wellcome Institute and Leverhulme Trust- the charitable foundation wings of GlaxoSmithKline and Unilever respectively, both of whom stand to make huge profits out of COVID through selling vaccines, sanitary products, PPE, and the manufacture of ventilators.
Given my academic background, I’m wary of scientists’ motivations when they are funded or have a history of being funded by multinational corporations with a vested interest in inflating the pandemic and expanding the medical-industrial complex. However, it’s very important to obtain a balanced picture of the different perspectives on India. I subject every scientist to careful scrutiny as my own direct experience of research funding is that it is deeply political. I prefer a very sober approach to data analysis that is based on empirical evidence not modelling, especially when we are dealing with so many unknowns- potential confounding variables. To date, mathematical models have resulted in wild over-estimates in the US, UK, and EU, and have been proven deeply unreliable. Those responsible have a history of funding by grant-awarding bodies with a vested interest in inflating figures and ramping up fear.
Meanwhile, anecdotal reports of vaccine injuries including sudden death after taking the vaccine are circulating and being documented in local media and social media groups on Telegram but are underreported in national TV media. People don’t trust mainstream national media as reporting is politically compromised. Journalists expressing counter-narratives to government policy are at risk of being labelled enemies of the state under India’s sedition law. Ayesha Pattnaik, an independent researcher in India, wrote that despite a constitution that defends Indian’s right to freedom of speech, it is India’s sedition law that is being used by the state to control public opinion. I quote: ‘Terms like ‘anti-national’ have gradually become more common to describe activists, intellectuals and other members of society expressing dissent, and the sedition law has played a crucial role in this. The sedition law and the discourse it creates around nationalism is directly pitted against the language of human rights and citizenship in the country. Bail pleas and press articles especially describe the sedition law as a violation of rights of freedom and expression. Human rights activists have been a frequent target of the sedition law.’
When we take these complex dynamics into account it’s clear that obtaining unbiased reports on the situation in India is near impossible (as it is in any other country). The people on the ground know this and don’t trust a lot of the information they receive, preferring to share their experiences informally on the village grapevine or uncensored social media platforms like Telegram. Obviously, this situation risks creating many problems- as you’d expect.
5) How does vaccine hesitation in India compare with countries in the global north? What kinds of experiences did Indians suffer in the past to warrant this speculation? Any examples?
Vaccine hesitation varies. In Bihar in the north uptake has been low in the rural areas due to reports of adverse reactions and deaths shortly after vaccination. Many have religious objections due to the belief that ingredients in the vaccine are derived from animal products. Other reports from the southern state of Tamil Nadu describe how many are avoiding the vaccine out of concerns about adverse reactions requiring them to take time off work to look after older relatives when they simply can’t afford to. 80% of India’s workforce is employed in the informal economy on a day-by-day basis and have incurred big debts following the previous lockdowns. Many simply cannot afford to take the risk of an adverse reaction and prefer to use home remedies and Ayurvedic medicines to treat respiratory viruses. An article in the Print states ‘Despite high education levels and a fairly robust health infrastructure, vaccine hesitancy is said to be rampant in Tamil Nadu’ with only 6.31 per cent of the total population receiving a first dose, and 16,08,046 a second dose, which makes up only 2.11 per cent of the population. One of the reasons cited for the prevalent suspicions about the Covid vaccine is the death of the popular Tamil actor Vivekh last month. He was being paid to promote the vaccines and received the jab just a day before he died of a cardiac arrest on April 17th.
There have been previous reports of polio in children causes by oral vaccination programmes, with numbers in the hundreds. Still, the relevant authorities perceive the benefits as outweighing the risks involved. There were also human rights violations in clinical trials of Gardasil in India, the HPV vaccination project. The two vaccines on offer in India are the AstraZeneca which has been banned over blood clot issues in many European countries and Covovax which is an indigenous vaccine. However, both companies also have funding ties with the Gates’ Foundation which also funded the Gardasil trials in India.
In 2009, the states of Andhra Pradesh and Gujarat launched a research project for the Gardasil vaccination against the human papilloma virus (HPV) which can cause cervical cancer. Adolescent girls between the ages of 10 –14 were vaccinated. The vaccines were provided by GlaxoSmithKline and Merck. The project was designed and executed by PATH (Programme for Appropriate Technology in Health) and funding was received from the Bill & Melinda Gates Foundation. In April 2010, however, the Government of India suspended the programme as several violations of ethical standards by PATH were widely reported by human rights organisations. However, by that time, 24,000 girls were already vaccinated and seven had died during the trial. Many of the girls were from poor Dalit and tribal backgrounds.
The parliamentary committee found that the Gardasil monitoring system did not report all adverse events. The monitoring of clinical trials is, however, essential to identify injuries and respond promptly and adequately. While the project was intended to benefit the Indian population, in August 2013, a second parliamentary committee severely condemned PATH as it concluded that “its sole aim has been to promote the commercial interests of HPV vaccine manufacturers who would have reaped windfall profits had PATH been successful in getting the HPV vaccine included in the UIP [universal immunisation programme] of the Country” (72nd Report, Department of Health Research, Ministry of Health and Family Welfare, Para. 7.13).
The article in ScienceMag linked above explains that the three-dose HPV series costs approximately $150 in India and states:
‘The fact that Merck, which makes Gardasil, and GlaxoSmithKline, maker of Cervarix, donated almost $6 million worth of their vaccines to the PATH trial “wasn’t philanthropy,” asserts Chandra M. Gulhati, editor of the Monthly Index of Medical Specialities, an influential journal in India. “It is shocking to see how an American organisation used surreptitious methods to establish itself in India,” he charges. “This is an obvious case where Indians were being used as guinea pigs,” contends Samiran Nundy, a gastrointestinal expert at the Sir Ganga Ram Hospital in New Delhi and editor emeritus of the National Medical Journal of India’.
So, this high-profile case raised general awareness of the risks of new vaccines in the Indian general public, and the funding connections between the Gardasil rollout and current Covid vaccine rollouts have raised alarm and also fuelled vaccine hesitancy.
6) Can you explain the timing of this urgent situation. Is it just fear for the desperate need of people or is there a connection with the desperate launching of vaccines? (Hundreds of millions at stake!) Does it have implications for people in other countries?
The vaccine rollout has coincided with the rise in cases in many countries, and many critics of the Indian government are suggesting that widespread vaccine injuries are contributing to the hospital bed shortage and are being underreported. Also, there is some evidence that the immune system may be depressed for a few days following the first shot, while other scientists have proposed that exposure to the wild virus after vaccination could lead to antibody-dependent enhancement of COVID 19 disease. These events are not exclusive to India and have been reported in UK Column News who continue to investigate. However, I have heard many stories of vaccine injuries in India from people I know who live there and seen reports of deaths and other serious adverse effects such as paralysis, stroke, and so on that are published in local media and then shared on Telegram.
Again, returning to Yohan Tengra’s research linked above, he says that PCR testing and misdiagnosis combined with people who want to intervene early with the mildest symptoms have been filling up the beds, preventing access to those who really need them. Addressing the much-publicised shortage of oxygen, Tengra implies this too is a result of inept policies, with exports of oxygen having increased in recent times, resulting in inadequate backup supplies when faced with a surge in demand. According to Tengra, the case fatality rate for COVID-19 in India was over 3% last year but has now dropped to below 1.5 per cent. The infection fatality rate is even lower, with serosurvey results showing them to be between 0.05 per cent to 0.1 per cent.
It seems that the picture in India is much the same as other countries as the IFR has fallen to around the same as the flu.
7) How is politics (e.g., the farmer’s protests) being affected by the COVID emergency? What does Modi get out of it other than the satisfaction of doing what is right for millions of people? How might this affect programmes such as the food bank and other initiatives that you worked on previously?
This question is difficult for me to answer given I’m not there and the food bank is a crowdfunded mutual aid project run by community volunteers. It is wholly apolitical.
I do know the farmers have been undeterred by COVID, and their camps and community kitchens remain. I know that these kitchens are supplying food to hospitals, and at bus and railway stations during the crisis to those travelling for health care and in search of work. Farmers have been asked to disperse over the threat of the virus while large political rallies and religious gatherings have been permitted. So, the farmers have stood their ground until what they call the ‘black laws’ pushing for the corporate takeover of food production are repealed.
Modi made a very public statement about India’s role in the new world order he said will emerge after the pandemic, and that the next decade will be a very important one just like the decade after the second world war. He said that unlike in the past, “we are not going to be a mute spectator”. This suggests he is in full support of the globalist ‘Great Reset’ agenda and the new stakeholder capitalism of the 4th industrial revolution. The farmers’ protests have taken a stand against that agenda in favour of protecting small farmers from top-down corporate control of all agricultural inputs and outputs, from seed to the pricing of crops. Of course, the globalists pushing the ‘Great Reset’ and ‘Build Back Better’ are also those pushing for a global bio-security state reliant on annual rounds of vaccines and international vaccine passports, which most governments in the west are supporting despite growing resistance on the ground. It may be that the main political struggle in India is over who will lead the country into the ‘New Normal’ of the two main political parties, Congress and the BJP, rather than about any dissent from the agendas of the new world order. This appears to be the case in all the world’s largest economies; so, India is no exception. It seems we are facing a global class war, and the first goal seems to be the elimination of much of the middle class to enforce technocratic serfdom.
If after reading this article you would like to know more about the food bank and feel willing or able to donate, please visit our Just Giving page here. A little goes a long way in India. We feed each family household for just £5 a week and also supply hot meals to hungry street children. Thank you.