India learns a bitter lesson for disregarding crucial warnings and recommendations on Covid-19

India learns a bitter lesson for disregarding crucial warnings and recommendations on Covid-19

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published Published on May 6, 2021   modified Modified on Aug 7, 2021

In the month of April this year, there has been an unprecedented upsurge in daily new cases and daily new deaths in the country due to Covid-19. States, which reported large increases in daily new cases and daily new deaths, are Maharashtra, Kerala, Karnataka, Delhi and Uttar Pradesh, to name but a few.
 
Data accessed from https://www.covid19india.org/, which is a crowdsourced platform and an independent aggregator of daily Covid-19 figures and information (created by techies and citizen volunteers), shows that from 4th April onwards this year (barring 5th April when then was a drop in the number of new cases), the number of novel coronavirus new cases (confirmed) exceeded 1 lakh per day. Since 15th April this year, the number of SARS-CoV-2 new cases on a daily basis surpassed 2 lakhs. Since 21st April this year, the number of novel coronavirus new cases has exceeded 3 lakhs per day. On 30th April, 2021, the number of new cases touched 4.02 lakh, if we use the https://www.covid19india.org/ database. Thus, one can observe that within a month or so, the total number of new cases per day quadrupled (as on 3rd May, 2021).  
 
Data accessed from https://www.covid19india.org/ also indicates that from 13th April onwards this year, the number of novel coronavirus related new deaths crossed 1,000 per day. From 20th April onwards this year, the number of Covid-19 new deaths surpassed 2,000 per day. Since 27th April, the number of novel coronavirus new deaths has exceeded 3,000 per day.
 
Media reports indicate that a large number of Covid-19 deaths in the capital of India (which has a relatively better health infrastructure in comparison to states like Uttar Pradesh and Bihar) and elsewhere have occurred primarily due to the lack of medical-use oxygen, followed by other reasons like unavailability of essential drugs, shortage of ventilators, dearth of hospital beds and intensive care units (ICUs), etc. Acute insufficiency of personal protective equipment (PPE) for the hospital staff and patient’s family members have also been noticed. Many people have lost their lives during home quarantine and their deaths have remained uncounted officially. The surge in Covid deaths, though not reflected in the official data, is corroborated by long queues outside crematoriums for funeral pyres. There has been a manifold increase in the number of dead bodies arriving in crematoriums in April as compared to normal times.     
 
Amidst the overwhelming rush in public and private hospitals in the capital of the country and elsewhere, it is worth noting that the Ministry of Home Affairs in February this year directed a phased closure of two special and temporary Covid-19 care centres -- one run by Defence Research and Development Organisation (DRDO) and manned by health professionals from the Armed Forces Medical Services (AFMS) and the other situated in the campus of the Radha Soami Beas at Chhattarpur and operated by doctors and paramedics from Indo-Tibetan Border Police (ITBP) -- in Delhi on account of the steady decline in coronavirus cases.  
 
So, a question that one can raise here: Did anyone predict the second wave coming? Yes, a Parliamentary Standing Committee report prepared in November last year had warned about the possibility of second and third waves (given the European experience last year) and gave recommendations to the Ministry of Health and Family Welfare as well as the Ministry of  AYUSH to bolster the health system in advance. Besides, news agency Reuters has reported recently that although a forum of scientific advisers -- Indian SARS-CoV-2 Genetics Consortium or INSACOG -- set up by the Government had warned the officials in early March of the presence a new and more contagious variant of the coronavirus, little was done by the Government to contain the spread of the infection. Millions of people without following the Covid-19 protocols (like wearing masks or keeping physical distance) attended religious festivals (Kumbh mela) and political rallies that were held during the recent assembly polls.
 
The minutes of the meeting (held on 1st April, 2020) of one of the 11 Empowered Groups of Officers, which was tasked to coordinate with the private sector, NGOs and international organisations to come up with an effective response to the Covid-19 pandemic, reportedly said: “In the coming days India could face a shortage of oxygen supplies. To address this, CII will coordinate with Indian Gas Association and mitigate the lack of oxygen supply.” During the second meeting of the Empowered Group-VI (EG-VI), the warning of oxygen shortage was issued. That meeting was headed by NITI Aayog CEO Shri Amitabh Kant, and several senior level officials of other departments/ ministries also took part in it.
 
Four days after that EG-VI meeting, a nine-member committee was formed under the Department for Promotion of Industry and Internal Trade (DPIIT) Secretary Shri Guruprasad Mohapatra for ensuring adequate availability of medical oxygen in the wake of Covid-19 pandemic. The aforesaid EG-VI meeting made the concerned department responsible for looking into the issue of medical-use oxygen supply.  
 
Although the demand for medical oxygen reportedly went up from 1,000 metric tons per day during the pre-pandemic days to almost 3,000 metric tons per day (due to rise in the number of coronavirus new cases) on September 24th-25th (i.e. peak of the pandemic last year), it did not become a matter of concern then since the country was producing about 6,900 metric tons per day at that time.
 
The department-related Parliamentary Standing Committee report, which was prepared under the chairpersonship of Prof. Ram Gopal Yadav of Samajwadi Party for the Ministry of Health and Family Welfare and Ministry of AYUSH, tried to identify the implementation gaps during the course of executing the contingent plan of the Government for combating the Covid-19 pandemic. The report by the Parliamentary Standing Committee asked for adequate investment for the development of health infrastructure with the intent of making provision for the best healthcare delivery system.

The Parliamentary Standing Committee report on the outbreak of pandemic Covid-19 and its management, which was presented to the Chairman of Rajya Sabha on 21st November, 2020 and forwarded to the Speaker of Lok Sabha on 25th November, 2020, among other things, made the following recommendations and statements:
 
* The Parliamentary Standing Committee found an unprecedented increase in the demand for non-invasive oxygen cylinders and instances of lack of oxygen cylinders in the hospitals. So, the Committee advocated the National Pharmaceutical Pricing Authority (NPPA) to take appropriate steps for capping the price of the oxygen cylinders so that the availability as well as affordability of the oxygen cylinders is ensured in all hospitals for medical consumption. The Committee also recommended the Government for encouraging adequate production of oxygen for ensuring its supply as per demand in the hospitals.
 
* The Parliamentary Standing Committee observed that after a steady increase in the number of Covid-19 cases across the country, there was a fall in such cases last year. However, the Committee noted that the threat of Covid-19 is still looming large on the country keeping in view the second and third waves in European countries and spike in Delhi. In its report, it mentioned that the Secretary of the Department of Health and Family Welfare also expressed concern over the possible spike in the incidence of the Covid-19 cases due to super spreading forthcoming festive events in the country and advent of the winter season. The Committee asked the Ministry of Health and Family Welfare to take effective measures for controlling the scale of incidence of Covid-19 in the country. The Committee asked the states with high case load to adopt robust strategy for containment and mitigation of Covid-19.
 
* The Committee found that the capacities and health infrastructure were ramped up during the 4 months period following the announcement of nationwide lockdown. It was estimated that an arrangement was made for a total of 3,914 facilities in the country with 3.78 lakh isolation beds (without ICU support), 39,820 ICU beds and 1.42 lakh oxygen supported beds along with 20,047 ventilators. In terms of healthcare logistics, cumulatively 213.55 lakh N95 masks, 120.94 lakh PPEs and 612.57 lakh HCQ tablets were distributed.
 
* Data from National Health Profile–2019 states that there are overall 7.14 lakh Government hospital beds available in the country, which amounts to 0.55 beds per 1,000 population. As per various reports, in 12 states the figures are far below the national level figure. The Parliamentary Standing Committee noted that the lack of hospital beds and inadequate number of ventilators further complicated the efficacy of the containment plan against the pandemic. As the number of cases were on the rise last year, a frantic search for vacant hospital beds became quite harrowing. Instances of patients being turned away from overburdened hospitals due to lack of vacant beds became the new normal. The scenario of patients holding oxygen cylinders rushing from pillar to post in search of bed in AIIMS Patna is a fact that cannot be ignored. Given the poor state of the healthcare system, the Committee recommended the Government to increase investment in public health and take appropriate steps to decentralise the healthcare services/ facilities in the country.
 
* The Parliamentary Standing Committee observed that in Ram Manohar Lohia (RML) hospital, out of the 1,572 beds, only 242 beds were dedicated Covid beds whereas in Safdarjung Hospital, out of 2,873 beds, only 289 were reserved for Covid patients. The Committee questioned the allocation of a limited number of beds for Covid-19 patients in the Central Government hospitals, especially at a time when the number of Covid-19 patients were increasing rapidly in the capital of the country.
 
* Although the Parliamentary Standing Committee appreciated the measures taken by the Government of India last year like Janata Curfew, imposition of four months long lockdown and its gradual opening, travel restrictions and other social distancing measures to contain the spread of coronavirus, it observed that there have been a few glaring lapses in the battle against pandemic like shortage of emergency supplies, red-tapism, shortage and quality of testing kits, delay in domestic production, etc.
 
* The Parliamentary Standing Committee noted that the Ministry of Health and Family Welfare's projected demand for the five year period from 2021-22 to 2025-26 is roughly Rs. 6.16 lakh crore. This demand has been spread over some very crucial aspects of the health sector like setting up of medical colleges, National Health Mission (NHM), post-Covid health sector reforms, etc. The Committee found that the health sector in India lacks adequate investment and health infrastructure as well as human resources deserves high priority. Higher public investment in health is significant for fulfilling the goals of Universal Health Coverage and making the healthcare services accessible. The Committee appreciated the goal of the National Health Policy, 2017 which calls for the attainment of the highest possible level of health and well-being for all at all ages, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence. The Committee stated that the Government will have to considerably increase its spending on the health sector to achieve this envisaged goal. The Committee strongly recommended the Government to increase its investments in the public healthcare system and make consistent efforts to achieve the National Health Policy targets of expenditure up to 2.5 percent of GDP within two years as the set timeframe of 2025 is far away and public health cannot be jeopardised till that time schedule.
 
* The Ministry of Health and Family Welfare during the examination of the Demand for Grants 2020-21 of the Department of Health and Family Welfare had submitted that Indian Government's health expenditure as a percentage of the current health expenditure is only 27.1 percent. In India, the out-of-pocket health expenditure is 62.4 percent and India ranks 15 out of 186 countries in out-of-pocket expenditure as percentage of current health expenditure. The Committee apprehended that amidst the pandemic and the uncertainty in the treatment protocol, the out-of-pocket health expenditure may have further driven many families to below the poverty line.
 
* The Parliamentary Standing Committee observed that closure of outpatient department (OPD) services in Government hospitals in the wake of the outbreak of Covid-19 pandemic crippled the healthcare delivery system in the country. Non-covid patients, especially female patients and the patients with chronic and lethal diseases were the worst sufferers. The Committee report mentioned the death of at least 61 pregnant women and 877 newborns in Meghalaya in the four months after April, 2020. It was observed by the Committee that the health machinery was diverted to fight the pandemic, which left the poor public without a healthcare support system.
 
* The Committee found that the healthcare workers had to work under huge stress due to shortage of PPE kits amidst impending threat of novel coronavirus infection as a result and quite many of them had to lose their precious lives.
 
* The Committee mentioned that health workers at higher risk of infection must be advised quarantine and the same period must be treated as ‘on duty’. The Committee recommended the health ministry to provide paid sick leave to the healthcare workers who have been infected and advised isolation. The Committee recommended the health ministry to ensure that all the healthcare workers are given timely salary and allowances and all their grievances must be addressed. The doctors, who have laid down their lives in the fight against the pandemic, must be acknowledged as martyrs and their families be adequately compensated. The Committee advocated a two pronged strategy: (i) incentives to healthcare workers; and (ii) to redress their grievances, which is expected to boost their morale and enhance their performance. The Committee recommended the Ministry of Health and Family Welfare to ensure every effort to end the stigma and violence against the healthcare workers. The Ministry should ensure that the healthcare workers have defined working hours, reliever rosters and scheduled off-duty days. The Committee acknowledged that amidst an already fragile healthcare system, the healthcare workers were forced to take the brunt of the increasing number of Covid cases. Long working hours and inadequate protection against the virus overburdened the healthcare workers.
 
* The Parliamentary Standing Committee found a shortage of healthcare providers due to vacancies in the State run hospitals in the country. Many hospitals and medical colleges across the country are functioning below the sanctioned strength and speciality departments are non-functional due to lack of required faculty. The Committee recommended the Ministry of Health and Family Welfare and the states/ UTs to fill up these vacancies at the earliest. The Committee felt that healthcare providers from other regions may be deputed to districts with higher burden of Covid-19 cases. The Committee expressed concerns over the large numbers of vacancies in secondary and tertiary public hospitals, which considerably increased the dependence on private providers and contractual workers.
 
* The Parliamentary Standing Committee recommended the Ministry of Health and Family Welfare to collaborate with Serum Institute of India and other vaccine manufacturers so that vaccines are easily available at an affordable rate to the general public. The Committee asked the Ministry to subsidise the vaccine cost for the weaker sections of the country, especially in rural and urban slum areas. The Ministry should be cautious in its efforts to check instances of black-marketing and shortage of vaccines. The Committee also recommended the health ministry to administer the vaccines according to the WHO’s “strategic allocation” approach or a multi-tiered risk-based approach.
 
* The Committee stated that letting people get infected with the virus till they develop herd immunity would result in a high mortality rate. The Committee agreed that given the poor health infrastructure in the country, the effect could be really adverse. The Committee noted that the trials of the vaccines are still underway and providing vaccine doses to a population of 1.3 billion will take time. The Committee said that the best strategy available at present is to increase the testing capacity and isolate the affected persons to contain the further spread of the virus and keep infected persons under appropriate medical observation.
 
* The Committee found that as per the recent UIS data (UNESCO Institute of Statistics data), India invests only 0.65 percent of GDP on Research and Development. India's GERD as a percentage of GDP was 0.67 percent in 2017 and 0.65 percent in 2018. The Gross domestic expenditure on R&D (GERD) as a percentage of GDP is the total intramural expenditure on R&D performed in the national territory during a specific reference period expressed as a percentage of GDP of the national territory. The Committee noted that India's GERD is well below the world average and the GERD of other countries. Countries like the United States of America spend almost 2.84 percent of its GDP on research whereas China also spends 2.19 percent of its GDP on research. The R&D sector has been neglected in the country. The Committee recommended that the Ministry of Health and Family Welfare should at least increase its spending on research to the world average of 1.72 as a percentage of GDP within two years. The Committee also recommended the Ministry to set specific expenditure targets for R&D and for promotion of science, technology and innovation (STI). This dedicated separate budgetary allocation should be supported even in financial crisis situations so that research activities do not suffer in the wake of any unforeseen circumstances.
 
* As per the UIS data, there are almost 252 researchers per million population in India against 1,370 researchers in China. The Committee stated that the Ministry of Health and Family Welfare should focus on linking research with education and teaching and give incentives for increasing the retention rate in the health research field. The Committee recommended the creation of a pool of talented health research personnel with upgraded skills of faculty of medical colleges, mid-career scientists, medical students, etc. The Department (i.e. ICMR) should also chalk out specialised training courses regarding infectious disease epidemiology risk on viral infection especially co-morbidities, micro behavioral factors and related multi-disciplinary research and support the trainees to take up research projects for addressing critical national and local health problems. The Committee in this connection recommended the Ministry to launch health specific research programs for generation of a research culture in the country and encourage the young undergraduates/ postgraduates to pursue research in science and technology. The Ministry should provide financial assistance to institutions for conducting research in health specific areas. Financial incentive in the form of research grants should also be provided to young graduates proposing to undertake health research projects. The Ministry should also assess the quality and outcome of research projects from time to time by evaluating the research outcomes and results.
 
* The Parliamentary Standing Committee found that the testing facility is only limited to bigger districts and cities. Lack of testing facilities in rural areas resulted in under reporting of cases. The PHCs and the CHCs are still largely devoid of any testing facilities and the required technical workforce. The Committee strongly recommended the health ministry to establish a strong network of Viral Research & Diagnostic Laboratories (VRDLs) in the country to tackle the constantly increasing incidences of Covid-19 cases.
 
* The Committee observed with concern that as compared to other departments involved in scientific research, the budgetary allocation of the Department of Health Research has been one of the lowest in 2019-20, i.e, Rs. 1,900 crores. For the year 2020-21, the budget marginally increased to Rs. 2,100 crores. The Committee, in its 119th Report on the Demands for Grants for the year 2020-21 of the Department of Health Research, had expressed its deep concern over the lower budgetary allocation during 2020-21 vis-à-vis projected demands under various components of Department of Health Research (DHR) schemes/ ICMR. The Committee had highlighted that the shortfall in allocations under the schemes would severely impact the establishment of new Viral Research & Diagnostic Laboratories; Multidisciplinary Research Units in Medical Colleges (MRUs), Model Rural Health Research Units (MRHRUs) in states and funding of projects under the schemes of Human Resource & Capacity Development. The Committee reiterated its recommendations as made in the 119th Report that the budgetary allocation to the Department of Health Research should be increased.
 
* The Committee appreciated the documentation done by the Ministry of Health and Family Welfare for post-Covid sequelae where a number of people have been found to suffer from heart related, respiratory, renal problems post recovery from Covid.
 
* The Committee noted that contact tracing, testing and isolating are the crucial components for Covid-19 containment strategy. The Committee stated that poor contact tracing and slow testing in the initial phase of pandemic led to the increased number of infections in the country.
 
* The outbreak of Covid-19 has created an unprecedented load on the healthcare infrastructure. Further the situation was aggravated because of the non-participation of a large number of private healthcare providers due to several reasons, including increased overhead expenditure related to procurement of PPE and sanitisation materials. During the lockdown period, it was observed that while 19 percent pre-Covid active AB-PMJAY (Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana) hospitals (private) had closed down their operations during the Covid times, 34 percent hospitals had scaled down their operations by more than 50 percent, and 25 percent hospitals had scaled down their operations by less than 50 percent. Thus, 79 percent of private hospitals have been impacted during Covid times. This is based on the comparison of utilisation data of pre-Covid (Jan to March, 2020) with post Covid (April to June, 2020). The Committee mentioned that the monitoring of empanelled hospitals must be done to ensure that treatment is not denied to anyone because it will have a direct impact on the out-of-pocket expenditure of the poor patients. The Parliamentary Standing Committee said that it is the moral duty of the Government to take care of its poor citizens especially in critical times like these.
 
* The Committee recommended the Ministry of Health and Family Welfare to ensure that the states strictly implement the guidelines on management of coronavirus related bio-medical waste and take all sorts of requisite safety measures.

* The 'Strengths' of the Government's contingent and mitigation plans pertaining to Covid-19 have been identified as: (i) Coordinated national response and proactive surveillance; (ii) Early impact of lockdown on virus dissemination and deaths; (iii) Step up in National capacity for manufacture of medical equipment, test kits and drugs; (iv) Increase in healthcare facility for quarantine, isolation, treatment and intensive care; (v) Increase in testing labs and testing rates; (vi) Diligent contact tracing to identify primary and secondary contacts of cases; (vii) Capacity Building of all levels of workers through tailor made modules; (viii) Risk communication through various means and campaigns like ‘Break the Chain’; (ix) Digital healthcare modals like tele-medicine, e-ICU etc. enabling access to quality healthcare; (x) Delegation of powers to local administration under Disaster Management Act facilitated inter-institutional coordination (health, police, municipal, local govt. etc.) planning and response at district level; (xi) Convergence among the Department of Health, WCD Education, Rural Development Panchayat Raj and others for Food distribution, IEC, local surveillance, availability of masks, sanitisers, screening and vigilance and awareness etc.; and (xii) ASHAs and Angandwadi workers playing a critical role in community outreach.

* The 'Weaknesses' of the Government's contingent and mitigation plans pertaining to Covid-19 have been identified as: (i) Inadequate healthcare spending with no focused budget for Covid; (ii) Inadequate primary and secondary healthcare infrastructure and staffing in many areas. Absence of organised urban primary healthcare has been a major weakness; (iii) Although health infrastructure was massively upgraded but the scale and speed was not commensurate to the population size and demand for services for the peak transmission season; (iv) Districts and states with already fragile health infrastructure unable to cope with demand for testing, tracing and treatment during peak transmission; (v) Gaps in implementation strategies and measures by some states especially in initial months; (vi) Delays in coordination between the Centre and states; (vii) Inadequate contact tracing in many areas leading to high rates of viral spread despite increased testing; (viii) Lack of public health expertise at various levels of the health system; (ix) Reverse migration during lockdown and the inability of the system to cope up with the huge migrating population; (x) Excessive dependence on Rapid Antigen Tests which have low sensitivity; (xi) Data collection system not providing complete, timely and accurate data on newly tested persons, ratio of RT-PCR to other tests, Covid-19 related deaths, co-morbidities, antibody surveillance studies and hospital bed availability; (xii) Multiple guideline with differences in interpretations; (xiii) Although first lockdown was appropriate to identify and locate the active Covid-19 transmission zones and facilitated source reduction and containment of the disease especially in metros but further lockdown could have had a more nuanced and tailored approach incorporating risk of infection and disease transmission; and (xiv) Economic slowdown precipitated by global pandemic and restrictions of travel and trade to prevent the spread of the virus also impacted the country. Poor and vulnerable populations (elderly, women, children and infants) were disproportionately affected.

* The 'Opportunities' of the Government's contingent and mitigation plans pertaining to Covid-19 have been identified as: (i) Covid-19 pandemic has exposed the broken links of the economic system and linkages of health to economic progress. This provides an opportunity to increase investments in the health sector significantly (3.0 percent of GDP); (ii) Enhanced investment in health should have both a short and medium term perspective. In the short term, opportunities should be utilised to upscale the current size of human resources for health particularly in smaller towns and rural areas. With a medium to long term perspective, increased investment should be undertaken for creating health infrastructure with a decentralised approach; (iii) Provides an opportunity to develop an integrated healthcare system where service provisioning can be by both public and private sector and individual patients may have choice. Eligibility criteria of Ayushman Bharat maybe expended to other vulnerable population groups and expanding the package of services by including outpatient care for women, children, elderly and NCDs and empanelling more hospitals from rural and remote districts; (iv) R&D research and innovation can be harnessed by creating a network of labs and institutions engaged in fundamental research and transnational research, linking them with the industry to develop self-reliance in healthcare technology pharmaceuticals and diagnostics; (v) Making ‘AtmaNirbhar Bharat’ and stress on “Vocal for Local”; (vi) India’s manufacturing capacities for PPEs, Masks, ventilators, testing kits etc. have been immensely augmented; (vii) To maintain and expedite digital healthcare models with inbuilt safeguards; (viii) Increased testing capacities; and (ix) Mortality kept low due to focus on systems and manpower.

* The 'Threats' of the Government's contingent and mitigation plans pertaining to Covid-19 have been identified as: (i) Spikes in Covid cases still being seen in affected regions and India yet to reach its peak; (ii) Unpredictable pandemic with possibility of second wave like in Europe; (iii) Inability to stop or slow down transmission to rural areas and small towns; (iv) Lack of threat perception in sections of the people; (v) Crowd density in urban areas especially slums, areas of indoor employment and in public transport; (vi) Unaddressed issues of communicable, non-communicable diseases, maternal and child health issues, rampant malnutrition; (vii) Loss of livelihood of many leading to various concuss; (viii) Closure of schools and administrative institutions led to suboptimal performance and anxiety; (ix) Lack of firm action by administration to prevent large gatherings; (x) Non-adherence by people to public health measures like physical (social) distancing, masks and hand-washings; (xi) Population density, high public morbidity; (xii) Violence on healthcare workers; (xiii) Psycho-social impact on the people; (xiv) Poor risk perception at the individual level and stigma associated with the disease; (xv) Dependency on global economic and supply chain systems; (xvi) Violence against women and children; and (xvii) Adverse impact on reproductive health care services such as clean and safe deliveries, contraceptives and pre and post natal care.

 
References
 
Parliamentary Standing Committee Report on Health and Family Welfare: The Outbreak of Pandemic Covid-19 and its Management, Report No. 123, Presented to the Chairman, Rajya Sabha on 21st November 2020 and Forwarded to the Speaker, Lok Sabha on 25th November 2020, Ministry of Health and Family Welfare and Ministry of AYUSH, Rajya Sabha Secretariat, please click here to access

National Health Policy 2017, Ministry of Health and Family Welfare, please click here to access

The Covid-19 hospital in India so bad patients want to get out -Sandi Sidhu, Julia Hollingsworth, Clarissa Ward, Rishabh Pratap, Elizabeth Joseph and Tanya Jain, CNN, 4 May, 2021, please click here to access

Dr. Rakesh Mishra, member of the Indian SARS-CoV-2 Genome Sequencing Consortia (INSACOG), interviewed by Karan Thapar, TheWire.in, 4 May, 2021, please click here to access

EXCLUSIVE: Scientists say India government ignored warnings amid coronavirus surge -Devjyot Ghoshal and Krishna Das, Reuters, 3 May, 2021, please click here to access

Bhopal COVID-19 deaths mismatch: Government says 104, crematoriums say 2,557, PTI, The New Indian Express, 2 May, 2021, please click here to access

‘We’re burning pyres all day’: India accused of undercounting deaths -Hannah Ellis-Petersen and Mohammad Sartaj Alam, The Guardian, 1 May, 2021, please click here to access

‘We are not special’: how triumphalism led India to Covid-19 disaster -Michael Safi, The Guardian, 29 April, 2021, please click here to access

Data can play an important role in helping India recover from COVID-19 -Harsh Vardhan Pachisia and Sriram Gutta, World Economic Forum, 29 April, 2021, please click here to access

Citizens Are Plugging India’s Gaping, Governance Gaps In Covid Care -Salik Ahmad, Article-14.com, 29 April, 2021, please click here to access

Parliamentary panel predicted second Covid wave in November -Meghnad S, Newslaundry.com, 28 April, 2021, please click here to access

At Delhi crematoriums, corpses wait in 20-hour queues to burn, PTI, Hindustan Times, 27 April, 2021, please click here to access 

April, November last year: Officials, House panel flagged oxygen need, shortage -Harikishan Sharma, The Indian Express, 23 April, 2021, please click here to access

Officers, Parl. Committee Had Flagged Oxygen Supply as an Issue in April, November 2020, Report Says, Newsclick.in, 23 April, 2021, please click here to access

MHA orders closure of 2 special COVID centres in Delhi as cases decline, Business Today, PTI, 23 February, 2021, please click here to access

 

Image Courtesy: ICMR, please click here to access



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