Science, culture, complexity

Tag: Covaxin

  • It’s great that the WHO isn’t just ‘not cutting corners’

    Call me anti-national (and I’m sure many will) but I’m glad that the WHO isn’t just “not cutting corners” in the process of considering Bharat Biotech’s application for the UN body’s stamp of approval Covaxin but is also openly calling for more and more information from the company at periodic intervals.

    This isn’t just a validation process in the larger scheme of things – which could imply something as banal as the WHO considering a really complicated application – but has also served to humiliate the Indian government’s instruments, from the clinical trial regulation apparatus to the prime minister’s office (let’s not forget that the PM is indeed a tool). The WHO’s process is resistant to “diplomatic” and “political” inputs, even as every meeting of its vaccine approval committee has concluded thus far with demands for more information from Bharat Biotech. This doesn’t prove that the Drug Controller General of India and the Central Drug Standards Control Organisation screwed up their vetting process to push Covaxin’s emergency-use license through earlier this year – but surely suggests it, and that’s just as well.

    Everyone from Bharat Biotech’s upper management to Prime Minister Narendra Modi have failed to understand that bad data alone doesn’t cause vaccine hesitancy, that absent data has the same effect. The Indian government, specifically the Bharatiya Janata Party, dragged Covaxin to the centre of its vaccine triumphalism and afforded it the same privileges it has extended to other parts of government – trenchant opacity, approval sans data, vanishing accountability. As such, we were never talking about a product of the Indian medical research community as much as something resembling a corrupted political object, and that in turn should lead us to the conclusion that this vaccine deserved to be met with hesitancy, and the WHO’s repeated requests for more data indicates that it still deserves to be.

    Thus far, the current government has seemed most responsive (albeit like a child, lashing out and hurting someone else) to the threat of humiliation. So, glad, even if I’m sure it will be short-lived. Once the WHO grants its approval (although there’s no guarantee), the government will certainly embark on a past-washing campaign, pressing its ministers to the task of weaving together an alternative history of why the approval process was unusually protracted. Is there any way we can preempt that?

  • Where the atmanirbharta in spine?

    Truth be told, I didn’t expect CSIR chief Shekhar Mande could be so disingenuous. “India didn’t have to depend on western countries,” he says. What is this abject refusal to thank other countries for help – and preferring instead to take their help and rewriting the past to pretend we didn’t need any?

    Of all those who received at least one dose of a COVID-19 vaccine in India, 88% received Covishield, which was first conceived by scientists in the UK and licensed by a British-Swedish pharmaceutical company to an Indian manufacturer. Even Covaxin, which accounts for the remaining 12% (screw Sputnik V), draws on technologies perfected by scientists in the US, among other places, against the SARS and MERS viruses. And while India’s drug controller approved a glut of drugs to treat severe COVID-19, the rights to the most popular among them and which also demonstrated some efficacy in any well-designed trials and observational studies – remdesivir – belong to a Californian pharmaceutical company.

    Some of the special containers and chemical reagents required to conduct RT-PCR tests are mostly imported. Indian industry adapted in a relatively short span of time to boost local production of masks, PPE kits and syringes, but there’s a lot that it depended on the west for and for which the west depended on India.

    In The Statesman article, ICMR chief Balram Bhargava also says, “The experience of developing Covaxin has instilled self-confidence in us that India is now much more than the pharmacy of the world. It is also a vaccine superpower.” Kind sir, India is no longer the ‘pharmacy of the world’. And we’d have to be a shitty kind of “vaccine superpower”, whatever that means, to a) run low on vaccines and syringes and completely fail to see that coming, b) celebrate 100-crore preordained inoculations, c) go so gung-ho with COVID-19 that we fail to deliver doses of a DTP vaccine to 3 million children in a year (the world’s highest) and d) preferentially award vaccine-making contracts to private companies.

    Of course, BB has been a foregone conclusion for a while. But that Mande can thump his chest like this… Are we to believe, then, that the rumours about why the Manipal Centre for Virus Research was shut, just as the pandemic was beginning, are true? That it was poised to undermine, with its foreign funds, foreign collaborations and foreign-trained scientists, the ‘Make in India’ narrative that the government as much as the government-funded scientific enterprise is wedded to.

    Perhaps the most regrettable thing about Mande’s comment is that – if the head of India’s largest government-funded scientific research establishment is prepared to lie in public, and to himself, that Indian researchers, manufacturers, traders, healthcare workers and patients didn’t want for anything that wasn’t already available in the country in early 2020, he is also prepared to believe there aren’t any problems that need to be fixed or resolved today either. I sincerely hope I’m wrong, but I don’t have my hopes up. Whatever we’re atma-nirbhar with today, it isn’t spine among government scientists, it seems.

  • Bharat Biotech gets 1/10 for tweet

    If I had been Bharat Biotech’s teacher and “Where is your data?” had been an examination question, Bharat Biotech would have received 1 out of 10 marks.

    The correct answer to where is your data can take one of two forms: either an update in the form of where the data is in the data-processing pipeline or to actually produce the data. The latter in fact would have deserved a bonus point, if only because the question wasn’t precise enough. The question should really have been a demand – “Submit your data” – instead of allowing the answerer, in its current form, to get away with simply stating where the data currently rests. Bharat Biotech gets 1/10 because it does neither; the 1 is for correct spelling.

    In fact, the company’s chest-thumping based on publishing nine papers in 12 months is symptomatic of a larger problem with the student. He fails to understand that only data is data, and that the demand for data is a demand for data per se. It ought not to be confused with a demand for authority. Data accords authority in an object-oriented and democratic sense. With data, everyone else can see for themselves – whether by themselves or through the mouths and minds of independent experts they trust – if the student’s claims hold up. And if they do, they confer the object of the data, the COVID-19 vaccine named Covaxin, with attributes like reliability.

    (Why ‘he’? The patriarchal conditions in and with which science has operated around the world, but especially in Europe and the US, in the last century or so have diffused into scientific practice itself, in terms of how the people at large have constituted – as well as have been expected to constitute, by the scientific community – scientific authority, expertise’s immunity to criticism and ownership of knowledge production and dissemination apparatuses, typically through “discrimination, socialisation and the gender division of labour”. Irrespective of the means – although both from the company’s and the government’s sides, very few women have fielded and responded to questions about drug/vaccine approvals – we already see these features in the manner in which ‘conventional’ scientific journals have sought to retain their place in the international knowledge production economy, and their tendency to resort to arguments that they serve an important role in it even as they push for anti-transparent practices, from the scientific papers’ contents to details about why they charge so much money.)

    However, the student has confused authority of this kind with authority of a kind we more commonly associate with the conventional scientific publishing paradigm: in which journals are gatekeepers of scientific knowledge – both in terms of what topics they ‘accept’ manuscripts on and what they consider to be ‘good’ results; and in which a paper, once published, is placed behind a steeply priced paywall that keeps both knowledge of the paper’s contents and the terms of its ‘acceptance’ by the journal beyond public scrutiny – even when public money funded the research described therein. As such, his insistence that we be okay with his having published nine papers in 12 months is really his insistence that we vest our faith in scientific journals, and by extension their vaunted decision to ‘approve of’ his work. This confusion on his part is also reflected in what he offers as his explanation for the absence of data in the public domain, but which are really his excuses.

    Our scientific commitment as a company stands firm with data generation, data transparency and peer-reviewed publications.

    Sharing your data in a secluded channel with government bodies is not data transparency. That’s what the student needs for regulatory approval. Transparency applies when the data is available for everyone else to independently access, understand and check.

    Phase 3 final analysis data will be available soon. Final analysis requires efficacy and 2 months safety follow-up data on all subjects. This is mandated by CDSCO and USFDA. Final analysis will first be submitted to CDSCO, followed by submissions to peer reviewed journals and media dissemination.

    What is required by CDSCO does not matter to those allowing Bharat Biotech’s vaccines into the bloodstreams, and in fact every Indian on whom the student has inflicted this pseudo-choice. And at this point to invoke what the USFDA requires can only lead to a joke: studies of the vaccines involved in the formal vaccination drive have already been published in the US; even studies of new vaccines as well as follow-ups of existing formulations are being placed in the public domain through preprint papers that describe the data from soup to nuts. All we got from the student vis-à-vis Covaxin this year was interim phase 3 trial data in early March, announced through a press release, and devoid even of error bars for its most salient claims.

    So even for an imprecisely worded question, it has done well to elicit a telling answer from the student: that the data does not exist, and the student believes he is too good for us all.

    Thanks to Jahnavi Sen for reading the article before it was published.

  • Magic bridges

    The last two episodes of the second season of House, the TV series starring Hugh Laurie as a misanthropic doctor at a facility in Princeton, have been playing on my mind off and on during the COVID-19 pandemic. One of its principal points (insofar as Dr Gregory House can admit points to the story of his life) is that it’s ridiculous to expect the families of patients to make informed decisions about whether to sign off on a life-threatening surgical procedure, say, within a few hours when in fact medical workers might struggle to make those choices even after many years of specific training.

    The line struck me to be a chasm stretching between two points on the healthcare landscape – so wide as to be insurmountable by anything except magic, in the form of decisions that can never be grounded entirely in logic and reason. Families of very sick patients are frequently able to conjure a bridge out of thin with the power of hope alone, or – more often – desperation. As such, we all understand that these ‘free and informed consent’ forms exist to protect care-providers against litigation as well as, by the same token, to allow them to freely exercise their technical judgments – somewhat like how it’s impossible to physically denote an imaginary number (√-1) while still understanding why they must exist. For completeness.

    Sometimes, it’s also interesting to ask if anything meaningful could get done without these bridges, especially since they’re fairly common in the real world and people often tend to overlook them.

    I’ve had reason to think of these two House episodes because one of the dominant narratives of the COVID-19 pandemic has been one of uncertainty. The novel coronavirus is, as the name suggests, a new creature – something that evolved in the relatively recent past and assailed the human species before the latter had time to understand its features using techniques and theories honed over centuries. This in turn predicated a cascade of uncertainties as far as knowledge of the virus was concerned: scientists knew something, but not everything, about the virus; science journalists and policymakers knew a subset of that; and untrained people at large (“the masses”) knew a subset of that.

    But even though more than a year has passed since the virus first infected humans, the forces of human geography, technology, politics, culture and society have together ensured not everyone knows what there is currently to know about the virus, even as the virus’s interactions with these forces in different contexts continues to birth even more information, more knowledge, by the day. As a result, when an arbitrary person in an arbitrary city in India has to decide whether they’d rather be inoculated with Covaxin or Covishield, they – and in fact the journalists tasked with informing them – are confronted by an unlikely, if also conceptual, problem: to make a rational choice where one is simply and technically impossible.

    How then do they and we make these choices? We erect magic bridges. We think we know more than we really do, so even as the bridge we walk on is made of nothing, our belief in its existence holds it up and stiff beneath our feet. This isn’t as bad as I’m making it seem; it seems like the human thing to do. In fact, I think we should be clearer about the terms on which we make these decisions so that we can improve on them and make them better.

    For example, all frontline workers who received Covaxin in the first phase of India’s vaccination drive had to read and sign off on an ‘informed consent’ form that included potential side effects of receiving a dose of the vaccine, its basic mechanism of action and how it was developed. These documents tread a fine line between being informative and being useful (in the specific sense of the risk of debilitating action by informing too much and of withholding important information in order to skip to seemingly useful ‘advice’): they don’t tell you everything they can about the vaccine, nor can they assert the decision you should make.

    In this context, and assuming the potential recipient of the vaccine doesn’t have the education or training to understand how exactly vaccines work, a magic bridge is almost inevitable. So in this context, the recipient could be better served by a bridge erected on the right priorities and principles, instead of willy-nilly and sans thought for medium- or long-term consequences.

    There’s perhaps an instructive analogy here with software programming, in the form of the concept of anti-patterns. An anti-pattern is a counterproductive solution to a recurrent problem. Say you’ve written some code that generates a webpage every time a user selects a number from a list of numbers. The algorithm is dynamic: the script takes the user-provided input, performs a series of calculations on it and based on the results produces the final output. However, you notice that your code has a mistake due to which one particular element on the final webpage is always 10 pixels to the left of where it should be. Being unable to identify the problem, you take the easy way out: you add a line right at the end of the script to shift that element 10 pixels to the right, once it has been rendered.

    This is a primitive example of an anti-pattern, an action that can’t be determined by the principles governing the overall system and which exists nonetheless because you put it there. Andrew Koenig introduced the concept in 1995 to identify software programs that are unreliable in some way, and which could be made reliable by ensuring the program conforms to some known principles. Magic bridges are currently such objects, whose existence we deny often because we think they’re non-magical. However, they shouldn’t have to be anti-patterns so much as precursors of a hitherto unknown design en route to completeness.

  • What the DNA Bill needs

    The following article has been published in The Wire, but since it began as a blog post and because I haven’t published anything else in a while, I’m using it here as well.

    The Parliamentary Standing Committee on S&T, Forests and Climate Change has submitted its review on the DNA Technology (Use and Application) Regulation Bill 2019 to parliament. On page 9, the report considers the lack of “academic work” on the use of “scientific evidence” in Indian courts and writes:

    The Committee, therefore, underlines with utmost importance that it is essential the Bill enables the creation of an ecosystem that benefits from scientific evidence like DNA, therefore allowing the legal system to become experienced in the use and appreciation of DNA evidence. This will enable the legal system to understand the technology’s limitations, identify when it is appropriate to use DNA technology to solve crimes appropriate and over time, substantially minimise all possible errors. Widespread and extensive training is of paramount importance.

    These are sage words – but the “creation of an ecosystem that benefits from scientific evidence” requires one more thing that the committee’s report doesn’t mention: humility, of sorts.

    At the outset, any ecosystem that upholds the dignity of both science and the law must also accommodate conditions in which scientists can develop a deeper understanding, free of any interference, of the instruments and methods underlying evidence. They must be free to speak up as often as they’re required to do so in the public domain, and, finally, be heard instead of silenced. In addition, given the revolutionary nature of DNA profiling vis-à-vis forensic science, and its vaunted feature of being accurate 99.x% of the time, it takes a certain humility to be able to identify the exceptional instances before it is too late.

    The COVID-19 pandemic has taught us many things, including the fact that even when the government is confronted with good science, it will not tolerate disagreement, and dissent even less. In the past 10 months, a small clutch of scientists and other experts have repeatedly spoken up against government mistakes and deceptions while the wider community of experts has stayed noticeably quiet. In turn, the government has pushed back against comments from senior, well-regarded scientists by attacking their credentials instead of their arguments, orchestrating signature campaigns against them and, in one case, going so far as to dismiss legitimate questions because the scientist in question had disagreed with the government’s Citizenship (Amendment) Act 2019.

    In addition, no court’s judgment is pronounced in a vacuum. Even if scientists are called to consult on a case, to advise a judge or weigh in for a report, the context in which the scientist discusses a problem, the information that has been shared with them as well as the information based on which they supply their own wisdom matters – especially if the defendant faces many years of imprisonment or the death penalty.

    For example, it used to be that investigators could check for the presence of seminal fluid in a given sample; if it was present, the court could conclude the fluid came from the suspect. Today, investigators can – and thus need to – extract Y chromosomes from the seminal fluid, ascertain a match with the suspect, and submit it in court with the caveat that the fluid could have come from the suspect, his father or his grandfather, etc.

    But one forensic scientist in the US told The Wire that investigators often skip the seminal-fluid check and jump to a DNA analysis to cut time. This could be a problem if the suspect has aspermia: a condition in which a person’s semen doesn’t have sperm. In such cases, an investigator running a DNA test on some semen will get no results – i.e. a false negative.

    More broadly, she continued, there are two new problems today, among others: of analysts exaggerating their results in court, and of investigators overestimating what DNA analysis can tell us. For example, she said, microscopic analysis of hair used to be the norm but today DNA analysis has taken its place. However, only hair root contains nuclear DNA, which can help identify specific people. The rest of the hair contains mitochondrial DNA, which can only say if it came from the suspect, their mother or her grandmother, etc. (even if the suspect is male).

    In addition, studying the DNA can’t tell us if the hair has been damaged in a particular way. That information can come only from microscopic analysis – which investigators have been neglecting.

    “It’s not the science that’s flawed. It’s the people that claim to be scientists who are often the problem,” the scientist said. “Many investigators in the US have no more than a high-school diploma – but unless they go through rigorous training at the UG level in science, they may not even understand hypothesis testing” to eliminate biases.

    So deliberation and accountability are paramount. Transparency will help but simply sharing information may not help so much when complex technical information is involved. Independent experts will need data, and independence itself. And observers such as politicians and policymakers will need to pay close attention to debates between scientists – and listen to them.

    In turn, the people at large must be sufficiently informed to understand a verdict and question it if necessary. A topical example where public mobilisation matters is that of air pollution in North India. The Supreme Court of India has on more than one occasion asked the Delhi government why it isn’t installing more smog towers in the city. But as multiple experts have written, smog towers are useless, a waste of money and only perpetuate a fetish with technological solutions that are not designed to solve what remains a deeply regulatory problem.

    Finally, an honest appreciation of scientific evidence requires one to admit that one may not know something in the first place, instead of bristling at presumed accusations of ignorance or even impudence, as more than a few members of the judicial system have done of late. Science in particular requires its exponents to begin by acknowledging that they may not know something, and to graduate from this position to learning about it while constantly eliminating biases along the way.

    A direct consequence of this process is a heightened appreciation for what science can’t tell us. Until the Supreme Court banned the practice in 2013, for example, officials in India had deemed the two-finger test to be a ‘scientific’ check of whether a victim of rape had been “habituated to sex”, based on digitally probing the laxity of the victim’s vaginal muscles. But the test has nothing to do with science, of course, let alone the possibility of rape having been committed. Instead, it’s rooted in the cultural idea that only those women who don’t have sexual intercourse until after marriage are of ‘good character’ and can therefore be violated at all.

    Humility offers a way to negotiate all of these issues – if it existed. India, especially the Government of India, currently has a ‘jagatguru’ complex, presuming to know everything worth knowing before anyone else, thanks to the mythological feats of Hindus who lived here thousands of years ago. This attitude is deeply antithetical to the humility required in a given moment to consider the evidence, set aside any other claims, and determine – in a necessarily limited amount of time – if one is addressing the 99.8% or the 0.2%.

    Many experts have previously written that DNA data alone shouldn’t be used to open or close cases, and that it is at best complementary in nature. If followed, this precept should offer a valuable safeguard against overstating the importance of genetic evidence over, say, physical evidence. Another safeguard comes from the judicial system as it is: the integrity of the various courts and their staff members, including the judges, and their daily interpretation of the law.

    But having said all this, the possibility exists in India’s wider political climate for judgments to be misled by half-baked science, half-baked scientists, government interference and either public indifference or public arrogance. This is more so since the room to disagree with the government has practically vanished, and those who still disagree are threatened with disproportionate consequences.

    In addition, as the forensic scientist said, the science is comfortable with its limitations; it is its practitioners that are often the problem. Just last month, nearly 50 “eminent scientists and doctors” signed a letter saying they were okay with the national drug regulator’s decision to approve two COVID-19 vaccine candidates: one had no efficacy data and the other was confused about the interdose gap. In addition to such unabashed sycophancy, bad journalism has often contributed to the impression that scientists themselves don’t know what they are doing, frequently confusing debate for rhetoric.

    As the committee’s report on the DNA Bill says, “widespread and extensive training is of paramount importance.” These words are well-taken but a lot needs to change – more than whatever the Bill by itself could ever manage – for the system to appreciate and use ‘scientific evidence’ right.

  • Pandemic: Science > politics?

    By Mukunth and Madhusudhan Raman

    Former Union health secretary K. Sujatha Rao had a great piece in The Indian Express on January 14, whose takeaway she summarised in the following line:

    Science, evidence and data analytics need to be the bedrock of the roll-out policy, not politics and scoring brownie points for electoral advantages.

    However, we can’t help but be reminded of the difference between what should be and what will be. We all (at least those of us who have been on the same side since 2014) know what should be. But as we’ve seen with the National Registry of Citizens (NRC), the Citizenship (Amendment) Act (CAA) 2019 and most recently the farm laws, our present government doesn’t change its mind.

    In the last example, the Supreme Court intervened to stay the laws’ implementation but the mediation committee it put together somehow wound up with most members being known to be sympathetic to the government’s position. So what will be, will be – and this is likely to be true vis-à-vis Covaxin as well.

    Prime Minister Narendra Modi has already guaranteed as much by determining to foot the cost of 5.5 million doses of Covaxin using the PM CARES fund, which lies beyond public oversight. The Central Drug Standards Control Organisation also played its part by pushing through Covaxin’s approval on terms no one has heard of – and which no one can therefore falsify.

    However, this isn’t a pitch for a nihilist position. When Sujatha Rao writes that the government should prize science, evidence and data more than politics and elections, she is right – but we must also ask why. The government has clear incentives to prioritise politics. By thrusting Bharat Biotech – Covaxin’s maker – to the forefront, Modi can claim his ‘Atma Nirbhar’ and ‘Make in India’ schemes have been successful. Also, two important state elections are around the corner: West Bengal and Tamil Nadu.

    These are issues that people, but especially ‘Middle Indians’, have an eye on and according to which they vote. The government has also said it is approving Covaxin because it is concerned with the ‘UK variant’. While no reason can be good enough to justify the use of a vaccine candidate in the population sans data from phase 3 clinical trials, the government has effectively set up Covaxin to be failure-proof: if it works, it works; if it doesn’t, it becomes the fault of the variant.

    Taken together, Modi’s biggest mistake here is criminal negligence – for pushing Covaxin in the absence of efficacy data (which leads to a cascade of ethical dilemmas) – especially since there are fewer questions over Covaxin’s safety. And negligence is a difficult case to stick to this party or in fact to many people.

    Granted, public-spirited science teachers, communicators and journalists can take it upon themselves (ourselves) to persuade readers as to why Covaxin’s approval is really bad – that though everything may turn out okay, it sets a terrible precedent for what this government is allowed to do, how such unchecked power may wreak deadly havoc in future crises, and ultimately that we become a people okay with settling for less, increasingly blind to the banal incrementalism of evil.

    In fact, if the mainstream press manages to forget concerns about vaccine apartheid within the country, the dominant narrative as the vaccine roll-out is a few months in is going to be: “India is doing just fine, thank you very much.”

    But while the Modi government’s actions may only be negligent – albeit criminally so – in the domains of public healthcare and ‘scientific temper’, they amount to something more egregious if we include the political dimensions of our present moment as well.

    None of this means words like those of Sujatha Rao are unnecessary. We need to never forget what should be, and we need to keep protesting for our own sakes. (“Protests sometimes look like failures in the short term, but much of the power of protests is in their long-term effects, on both the protesters themselves and the rest of society.” – Zeynep Tufekci) If we don’t, this government might pretend even less than it currently does that it is following some rules or guidelines from time to time.

    However, limiting our exhortations to insist at every turn that “science is more important than politics during a pandemic” risks playing down the importance and influence of political motivations altogether – as well as assuming that the state machinery will automatically give way to scientific ones when lives are at stake.

    A politician’s principal responsibility is not to govern but to win elections; good governance is a means to this electoral end. And the way people have voted for many decades attests to the reality of this incentive. While this claim may not be palatable from a theoretical point of view, consider it empirically: the Indian government has seldom responded to national crises to the detriment of potential electoral gains. Examples of such crises include the 1962, 1971 and 1999 conflicts, the nuclear tests and economic liberalisation. During the Emergency, the government itself embodied this crisis.

    More recently, numerous ministers and diplomats urged the India and Pakistan governments to find diplomatic solutions after the Pulwama attack and also after the questionable Balakot airstrike, in early 2019. In previous years, they had been preceded by the disagreeable events of Aadhaar implementation, demonetisation and the Goods and Services Tax. But Modi and his fellows won by a bigger margin in 2019 than they had five years earlier.

    This happened partly because his success in elections rests on his impression as the Strongman of India, so his resolutions of choice involve flashy displays of strength and machismo.

    Against this background: we need to admit political factors into the conversations we – rather, experts like health policymakers, heads of institutions, epidemiologists, healthcare workers, etc. – have from the beginning, instead of ruing the inevitable influence of politics later, so that we may anticipate it and take advantage of it.

    For example, consider the conversation surrounding academic publishing. Academics perform most of the work that goes into publishing an academic paper (research, writing and reviewing). Publishing houses add only marginal value to journals – yet publishers charge exorbitant fees to access the results of publicly funded research once it is published. This is unfair, and many academics have said so.

    However, the fact that publishing conglomerates are publicly traded companies whose primary responsibility is to generate profits for their shareholders finds little mention in conversations. In this case, the publishers’ profit-seeking motives are fundamental to the problem at hand – but are often disregarded in the first analysis (what should be) and subsequently bemoaned (what will be). For this to happen once is tragic; for it to repeat itself every few months is wasteful.

    Similarly, the nationwide lockdown from March to July 2020 served a political purpose: it was a grand gesture, decisive, appealing to ‘Middle Indians’, in addition to supplying the government a pretext to disband protests against the CAA and the NRC. Just before the lockdown, the public conversation had been centred on what the government should be doing. However, most scientists and economists didn’t engage with the political dimension of this decision.

    If we had, we may not have been side-tracked into conversations about weekend curfew versus night curfew, or cash transfers versus vouchers, etc. We would perhaps have recognised that our responsibility is not to operate within the parameters set by the government (“How effective was the lockdown?”) but instead recognise that the government’s decisions are politically motivated – so we can ask “Why lock down in the first place?”

  • India’s missing research papers

    If you’re looking for a quantification (although you shouldn’t) of the extent to which science is being conducted by press releases in India at the moment, consider the following list of studies. The papers for none of them have been published – as preprints or ‘post-prints’ – even as the people behind them, including many government officials and corporate honchos, have issued press releases about the respective findings, which some sections of the media have publicised without question and which have quite likely gone on to inform government decisions about suitable control and mitigation strategies. The collective danger of this failure is only amplified by a deafening silence from many quarters, especially from the wider community of doctors and medical researchers – almost as if it’s normal to conduct studies and publish press releases in a hurry and take an inordinate amount of time upload a preprint manuscript or conduct peer review, instead of the other way around. By the way, did you know India has three science academies?

    1. ICMR’s first seroprevalence survey (99% sure it isn’t out yet, but if I’m wrong, please let me know and link me to the paper?)
    2. Mumbai’s TIFR-NITI seroprevalence survey (100% sure. I asked TIFR when they plan to upload the paper, they said: “We are bound by BMC rules with respect to sharing data and hence we cannot give the raw data to anyone at least [until] we publish the paper. We will upload the preprint version soon.”)
    3. Biocon’s phase II Itolizumab trial (100% sure. More about irregularities here.)
    4. Delhi’s first seroprevalence survey (95% sure. Vinod Paul of NITI Aayog discussed the results but no paper has pinged my radar.)
    5. Delhi’s second seroprevalence survey (100% sure. Indian Express reported on August 8 that it has just wrapped up and the results will be available in 10 days. It didn’t mention a paper, however.)
    6. Bharat Biotech’s COVAXIN preclinical trials (90% sure)
    7. Papers of well-designed, well-powered studies establishing that HCQ, remdesivir, favipiravir and tocilizumab are efficacious against COVID-19 🙂

    Aside from this, there have been many disease-transmission models whose results have been played up without discussing the specifics as well as numerous claims about transmission dynamics that have been largely inseparable from the steady stream of pseudoscience, obfuscation and carelessness. In one particularly egregious case, the Indian Council of Medical Research announced in a press release in May that Ahmedabad-based Zydus Cadila had manufactured an ELISA test kit for COVID-19 for ICMR’s use that was 100% specific and 98% sensitive. However, the paper describing the kit’s validation, published later, said it was 97.9% specific and 92.37% sensitive. If you know what these numbers mean, you’ll also know what a big difference this is, between the press release and the paper. After an investigation by Priyanka Pulla followed by multiple questions to different government officials, ICMR admitted it had made a booboo in the press release. I think this is a fair representation of how much the methods of science – which bridge first principles with the results – matter in India during the pandemic.