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Explainers

The Lancet Editorial Warns India Against COVID-19 False Optimism

The editorial lauds the early lockdown but warns that such a positive spin to the pandemic will hamper vital public health initiatives.

By - Shachi Sutaria | 27 Sept 2020 4:50 PM IST

Medical journal The Lancet on September 25, 2020 warned India's leaders and its scientific community to stop giving "a positive spin" to the ongoing Coronavirus crisis in the country.

While praising the country's lockdown preparations, the editorial felt that the easing of relaxations in June was premature and has added to the 'dramatic increase' in the number of COVID-19 cases in the country. 

With close to 60 lakh COVID-19 cases, India ranks only second to the US which has crossed the 70 lakh mark. The country has been reporting the highest number of daily cases since August 7.

The editorial remarked that the country was facing a dangerous period in its fight against the pandemic. Citing examples of how rural areas that were initially unaffected and now are facing an increase in cases, the editorial highlighted the "nuanced and complex spread" of the virus in India. 

The journal stated how the practice of not sharing negative news added to the burden on India's existing health infrastructure and public health initiatives.

"The epidemic in India is far from over, with a potentially huge burden of mortality and morbidity to come unless public health measures are used and adhered to. Without clear and honest communication of the risks of COVID-19 to the population, stemming the epidemic will be impossible," reads the editorial.

Observing the false optimism regarding the pandemic in the country, The Lancet noted, "According to news reports, hours before announcing the national lockdown, Prime Minister Narendra Modi told owners and editors from India's largest media organisations that it was important to tackle the spread of pessimism, negativity, and rumour." 

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The journal also commented on the role of the scientific community in creating an environment of false optimism. It felt that the Indian Council of Medical Research (ICMR), the apex research body in the country, strayed away from scientific evidence on several instances. It even labelled these moves to be "politically motivated" and "overly optimistic".

The journal mentioned three separate examples to underline this claim - the ICMR Director General's 'unrealistic' letter to 12 medical institutes for launching a COVID-19 vaccine by August 15, the institute's over-reliance on hydroxychloroquine for preventive treatment without scientific evidence, and the recent reports of the body asking experts not to publish study data on seroprevalence in the containment zones in a scientific paper.


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The editorial also questioned the transparency of India's low case fatality rate data while citing a World Report.  In every press conference, the Ministry of Health and Family Welfare has repeatedly highlighted the country's low case fatality rate (1.8%) and the country's low cases and deaths per million when compared to other countries. Several states such as Tamil Nadu, Maharashtra, Delhi revised their total death count after conducting death audits. This raised questions on whether India was under-reporting the total deaths in the country. 

The journal advised the government to effectively communicate every measure to stem the ongoing pandemic. "Perpetuating unrealistic claims or failing to honestly report negative news creates uncertainty among the public and health-care professionals, discouraging people from taking preventive action or taking public health messages seriously', the journal stated. 

The Positives

The journal applauded the country's timely lockdown enforcement and its testing capabilities. "The country has responded well in many regards, especially for such a large and diverse nation. India instigated a national lockdown in March, which was praised by WHO. During the lockdown period, tertiary care provision was increased, including access to specialist equipment such as ventilators. Testing numbers also increased quickly, with India being among the first to roll out innovations like pooled testing," the journal mentioned.

It also stated that India has been at the forefront of efforts to develop and manufacture a vaccine.

The editorial concludes at a hopeful note by stating that India has the potential to lead the fight through the pandemic but not by disrespecting scientific evidence and academic freedom. It insisted that the scientific community and the leadership should provide a transparent and truthful narrative.

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