The Lancet, the peer-reviewed medical journal, in its editorial in its September 26 issue, has highlighted the dangers of the Indian government’s policy. It says presenting the current situation in India with a too positive spin not only clouds reality but also hampers vital public health initiatives.

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, it warns.

The Lancet says India has the expertise in medicine, public health, research, and manufacturing to lead the nation through the pandemic. To capitalise on these attributes, the country's leaders must respect scientific evidence, expert commentary, and academic freedom, and not provide false optimism.

Despite a strong response at the outset of the pandemic, India has the world's fastest growing outbreak of Covid-19 in absolute numbers according to WHO, reporting more than 5•6 million infections.

With the restrictions being lifted even in the face of a continuing dramatic increase in case numbers nationally, the pattern of spread of the disease is nuanced and complex, with marked differences between states, and between rural and urban areas. For example, cities like Kolkata and rural areas in the north of India were relatively spared the outbreak initially, whereas Delhi, with strong international connections, was at the forefront of the first wave. Even so, India is clearly facing a dangerous period.

Lancet notes how the lockdown created a parallel crisis for many people as income fell dramatically, hunger increased, and many migrant workers walked long distances home. GDP was already decreasing before the outbreak of the pandemic, but the contraction of almost 25 percent year on year in the quarter April to June could make India one of the worst affected countries economically.

As the outbreak has spread from its initial foothold in cities to smaller urban areas and villages, pre-existing disparities in health-care provision have become increasingly relevant. Rural health infrastructure can be sparse, and some smaller private hospitals have reported equipment shortages, especially oxygen.

Most crucially, the rapidly growing case numbers, alongside the continuing relaxation of restrictions, are creating an atmosphere of fatalism mingled with false optimism that undermines effective use of non-pharmaceutical interventions such as masks and physical distancing.

The journal notes that 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, it warns.

The Modi government feels it is important to tackle the spread of pessimism, negativity, and rumour. The pressure to avoid negative news, and to offer reassurance, appears to have been felt by several professional scientific organisations in India, the journal points out.

The Indian Council of Medical Research (ICMR) has been singled out by experts for straying from scientific evidence, appearing at worst politically motivated and at best overly optimistic. The journal, in fact, quotes the letter from the IVMR Director General Balram Bhargava, which said the ICMR envisaged launching a coronavirus vaccine the Independence Day, a deadline considered unrealistic by most medical experts.

ICMR has also been faulted for supporting treatment with hydroxychloroquine despite insufficient evidence amidst reports that data on coronavirus infection were removed from a scientific paper.

Transparency of the data on Covid cases and deaths, especially those underpinning the case fatality rate, has also been questioned. The Indian government reports a case fatality rate of 1•8 percent, much lower than the reported rate in other countries, but it is difficult to know if the numbers are comparable, Lancet laments. (IPA Service)