Scicomm Science

The omicron variant and scicomm

Somewhere between the middle of India’s second major COVID-19 outbreak in March-May this year and today, a lot of us appear to have lost sight of a fact that was central to our understanding of COVID-19 outbreaks in 2020: that the only way a disease outbreak, especially of the novel coronavirus, can be truly devastating is if the virus collaborated with poor public health infrastructure and subpar state response. (Similarly, even a variant deemed mild in, say, the UK could lead to disaster in Chennai.) The virus alone doesn’t lead to catastrophic outcomes.

Just as India’s second outbreak was picking up speed, there was a considerable awareness that the delta variant was wreaking as much havoc as we were letting it. In fact, the Indian government was more than letting it. But since the outbreak began to subside in kurtotic fashion and, much later, as the omicron variant appeared on the scene, the focus on the latter has appeared to overwhelm – at least in public discourse – the extent to which we’re prepared (or not) to face it. Put another way, the focus on the omicron variant and the contexts in which it has been discussed have remained far too scientific. I’m not saying that it should become less scientific but that the social should start finding mention more.

I realise that everyone is weary of the pandemic and would like if it ended already, and together with the fact that most people in India’s cities have received their two doses of some COVID-19 vaccine, it might seem to everyone that there’s sufficient ground to persist with the idea that the omicron variant couldn’t possibly be devastating, and that we can all return to some kind of normal soon. Now, this is one kind of fatigue. There appears to be a second kind also, based on the fact that the delta variant was the first “major” variant, in a manner of speaking, and the way we talked about it and acted in its potential (and menacing) presence co-evolved with its dispersal through the population.

The omicron variant, on the other hand, affords both scientists and science communicators the option to simply refer to the narratives and discourses we developed with the delta variant, simply updated to match what we’re finding out about omicron. And this, not surprisingly, has led to a bit of laziness as well. The form I find most lazy, and most annoying, is some scientists’ insistence on pointing to graphs of the number of cases over time in different countries and saying, “If this doesn’t shake us out of our slumber, what will?”

This is scientism, pure and simple, even if it’s not on the nose: pointing to case trends alone isn’t going to solve anything, especially not in the face of the sort of significant, demographic-wide yearning for a ‘new normal’, or in fact any kind of normal, instead of more and more upheavals. In fact, consider the fact that for most of 2020, most poor people in India believed that if the novel coronavirus had an infection fatality rate of just 1%, it was no big whoop, and that they would continue going to work and eke out a living. Let’s be clear, this is perfectly reasonable. The idea of letting the virus take its course through the population went sideways in Sweden, but in India, if something has a 1% chance of getting you really sick – or even killing you – it’s tragically the case that it quickly falls down a long list of threats, most of which are often much more lethal, beginning, in too many parts of the country, with breathing the air around you or drinking the water that’s available to you.

To repeat in this context exhortations based solely on graphs printed in English and shared on Twitter that rapidly rising case-loads elsewhere on the planet should suffice to nudge us out of the Indian subcontinent’s collective torpor is a deference to facts that, I’m very tempted to say, understand only 1% of what is going on. Even if these exhortations are directed at state leaders and government officials, they are really misdirected: as I have written before in the context of Anthony Fauci’s senseless interview responses, if the government hasn’t done something that’s obvious to everyone, the reason just can’t be that it hasn’t seen the chart or the numbers you’ve seen to reach your conclusions. The only way such statements could make some sense is if they are intended to galvanise public opinion, but even then, I’m not convinced.

And seeing these scientists do what they do strikes me that just as much as we’d like to encourage scientists to communicate science as often as is possible, there may be virtue in casting science communication as much in terms of what it does as what it doesn’t. For example, as the number of cases due to the omicron variant of the novel coronavirus is increasing in different parts of the world, socially responsible science communication requires us to not stop at pointing at graphs but to continue to reflect on and articulate how much – or how little – the greater transmissibility of the variant means in and of itself. And in my view, not doing this would just be socially anti-responsible communication: sticking to the science, and accomplishing little overall.


Panicking about omicron

The new omicron variant of the novel coronavirus has got everyone alarmed – which is darkly ironic. This variant has reportedly racked up more mutations than previous variants of concern, including the delta, with virologists and epidemiologists from South Africa and the UK paying particular attention to real-world data that suggests it could be more transmissible and cause breakthrough infections and that some of the mutations in its RNA correspond to changes on the spike protein that could (speculatively) render the existing crop of WHO-approved COVID-19 vaccines less efficacious.

Uncertainty about what a new strain of the virus can do, or even uncertainty more broadly, has always been sufficient reason for panic. Nonetheless, the rise of the omicron variant is significant and the response to it more instructive because of its predecessor.

The delta variant set a new benchmark for how quickly the novel coronavirus could spread, but its effectiveness also prompted some wonderment if the virus may be approaching ‘peak mutation’ – that is, if the delta might represent one of the most transmissible forms of the virus and if future outbreaks happening in a partly vaccinated world may not be so deadly.

The omicron is thus significant because it dispels this line of thinking, while demonstrating that as bad as the delta was for global society, things can get worse if we let them. Clearly we have. And the world’s panic is ironic because of the particular ways in which we have.

As far as COVID-19 vaccination coverage is concerned, there are two distinct groups of people: those who have been fully vaccinated and those who have been partly vaccinated or haven’t been vaccinated at all. The corresponding split in India is qualitatively similar to the one worldwide, particularly in that it has come to be aligned almost perfectly with the class divide. This is the first point.

Second, most – if not all – of the current WHO-approved vaccines haven’t been tested for their ability to directly prevent or reduce the transmission of the novel coronavirus (such as by reducing the amount of viral shedding). So there’s a not insubstantial possibility that even fully vaccinated individuals could get and transmit the virus, while enjoying the vaccine-granted privilege of not falling ill.

Third, we don’t know if the omicron variant can cause more severe disease, so let’s say that – at least to those of us who aren’t experts – right now the chance of it not being able to cause more severe disease is a reasonable 50%.

Taken together, the three points suggest that panic is understandable only among those who haven’t received one or both doses of their (two-dose) COVID-19 vaccines, and whose populations may have been ‘incubating’ the same or different variants by allowing them to persist for longer in their bodies, and replicate, in the absence of the vaccines (depending on each vaccine’s time-to-recovery). For these people, the chance of the omicron variant being able to last for longer in the body and cause more severe disease is already higher.

This is a crucial difference between the vaccinated and those who have been kept from getting vaccinated – a difference fostered by countries that hoarded vaccines, blocked attempts to ease patent protections and transfer technology and money – the same countries that are now blocking travel from parts of the world where their selfishness encouraged the rise of new variants.

On the other hand, panic verges on the offensive for fully vaccinated individuals – who are also likelier than not both in India and around the world to be able to access and afford good healthcare and antiviral drugs – to freak out about a viral variant that is currently only known to be able to be transmitted more effectively than the delta.

This shouldn’t bother us very much because most of us seemed to have stopped thinking about transmission even though the vaccines weren’t tested for preventing that, and went easier on masking up and washing hands just because we’d received our two doses, even as the delta variant continued to spread through the population. (Infections stopped surging but that’s not the way only way a virus can continue to circulate.)

It’s disingenuous to suggest now that the situation on the ground with omicron in play is somehow different (with the 50% disclaimer) even as we’re responding by blocking travel and trade instead of by increasing access to vaccines.

In fact, apart from whether any instance of panic could be pseudoscientific or offensive, there’s the question of whether it’s warranted. Among the fully vaccinated, it’s simply not. The rise of the omicron variant in a world of vaccine apartheid should in fact be a grim reminder that, again, we can’t afford to let things get worse, because they will. More people will fall ill, more people will die, more healthcare systems will collapse, more people ill with other diseases will be at greater risk of death or disability, and so forth.

If you’re fully vaccinated, mask up; if not, please go get vaccinated and still mask up. But if you can’t because vaccines are being withheld to your country – you may have reasonable cause for panic.

Analysis Scicomm Science

On the lab-leak hypothesis

One problem with the debate over the novel coronavirus’s “lab leak” origin hypothesis is a problem I’m starting to see in quite a few other areas of pandemic-related analysis and discussion. It’s that no one will say why others are wrong, even as they insist others are, and go on about why they are right.

Shortly after I read Nicholas Wade’s 10,000-word article on Medium, I pitched a summary to a medical researcher, whose first, and for a long time only, response was one word: “rubbish”. Much later, he told me about how the virus could have evolved and spread naturally. Even if I couldn’t be sure if he was right, having no way to verify the information except to bounce it off a bunch of other experts, I was sure he thought he was right. But how was Wade wrong? I suspect for many people the communication failures surrounding this (or a similar) question may be a sticking point.

(‘Wade’, after the first mention, is shorthand for an author of a detailed, non-trivial article that considers the lab-leak hypothesis, irrespective of what conclusion it reaches. I’m cursorily aware of Wade’s support for ‘scientific racism’, and by using his name, I don’t condone any of his views on these and other matters. Other articles to read on the lab-leak topic include Nicholson Baker’s in Intelligencer and Katherine Eban’s in Vanity Fair.)

We don’t know how the novel coronavirus originated, nor are we able to find out easily. There are apparently two possibilities: zoonotic spillover and lab-leak (both hypotheses even though the qualification has been more prominently attached to the latter).

Quoting two researchers writing in The Conversation:

In March 2020, another article published in Nature Medicine provided a series of scientific arguments in favour of a natural origin. The authors argued: The natural hypothesis is plausible, as it is the usual mechanism of emergence of coronaviruses; the sequence of SARS-CoV-2 is too distantly related from other known coronaviruses to envisage the manufacture of a new virus from available sequences; and its sequence does not show evidence of genetic manipulation in the laboratory.

Proponents of the lab-leak hypothesis (minus the outright-conspiratorial) – rather more broadly the opponents of the ‘zoonotic-spillover’-evangelism – have argued that lab leaks are more common than we think, the novel coronavirus has some features that suggest the presence of a human hand, and a glut of extra-scientific events that point towards suspicious research and communication by members of the Wuhan Institute of Virology.

However, too many counterarguments to Wade’s and others’ articles along similar lines have been to brush the allegations aside, as if they were so easily dismissed – like my interlocutor’s “rubbish”. And it’s an infuriating response. To me at least (as someone who’s been at the receiving end of many such replies), it smacks of an attitude that seems to say (a) “you’re foolish to take this stuff seriously,” (b) “you’re being a bad journalist,” (c) “I doubt you’ll understand the answer,” and (d) “I think you should just trust me”.

I try not to generalise (c) and (d) to maintain my editorial equipoise, so to speak – but it’s been hard. There’s too much of too many scientists going around insisting we should simply listen to them, while making no efforts to ensure non-experts can understand what they’re saying, much less admitting the possibility that they’re kidding themselves (although I do think “science is self-correcting” is a false adage). In fact, proponents of the zoonotic-spillover hypothesis and others like to claim that their idea is more likely, but this is often a crude display of scientism: “it’s more scientific, therefore it must be true”. The arguments in favour of this hypothesis are also being increasingly underrepresented outside the scientific literature, which isn’t a trivial consideration because the disparity could exacerbate the patronising tone of (c) and (d), and render scientists less trustworthy.

Science communication and/or journalism are conspicuous by absence here, but I also think the problem with the scientists’ attitude is broader than that. Short of engaging directly in the activities of groups like DRASTIC, journalists take a hit when scientists behave like pedagogic communication is a waste of time. More scientists should make more of an effort to articulate themselves better. It isn’t wise to dismiss something that so many take seriously – although this is also a slippery slope: apply it as a general rule, and soon you may find yourself having to debunk in great detail a dozen ridiculous claims a day. Perhaps we can make an exception for the zoonotic-spillover v. lab-leak hypotheses contest? Or is there a better heuristic? I certainly think there should be one instead of having none at all.

Proving the absence is harder than proving the presence of something, and that’s why everyone might be talking about why they’re right. However, in the process, many of these people seem to forget that what they haven’t denied is still firmly in the realm of the possible. Actually, they don’t just forget it but entirely shut down the idea. This is why I agree with Dr Vinay Prasad’s words in MedPage Today:

If it escaped due to a wet market, I would strongly suggest we clean up wet markets and improve safety in BSL laboratories because a future virus could come from either. And, if it was a lab leak, I would strongly suggest we clean up wet markets and improve safety in BSL 3 and 4 … you get the idea. Both vulnerabilities must be fixed, no matter which was the culprit in this case, because either could be the culprit next time.

His words provide an important counterweight of sorts to a tendency from the zoonotic-spillover quarter to treat articles about the lab-leak possibility as a monolithic allegation instead of as a collection of independent allegations that aren’t equally unlikely. For example, the Vanity Fair, Newsweek and Wade’s articles have all also called into question safety levels at BSL 3 and 4 labs, whether their pathogen-handling protocols sufficiently justify the sort of research we think is okay to conduct, and allegations that various parties have sought to suppress information about the activities at such facilities housed in the Wuhan Institute.

I don’t buy the lab-leak hypothesis and I don’t buy the zoonotic-spillover hypothesis; in fact, I don’t personally care for the answer because I have other things to worry about, but I do buy that the “scientific illiberalism” that Dr Prasad talks about is real. And it’s tied to other issues doing the rounds now as well. For example, Newsweek‘s profile of DRASTIC’s work has been a hit in India thanks to the work of ‘The Seeker’, the pseudonym for a person in their 20s living in “Eastern India”, who uncovered some key documents that cast suspicion on Wuhan Institute’s Shi Zhengli’s claims vis-à-vis SARS-CoV-2. And two common responses to the profile (on Twitter) have been:

  1. “In 2020, when people told me about the lab-leak hypothesis, I dismissed them and argued that they shouldn’t take WhatsApp forwards seriously.”
  2. “Journalism is redundant.”

(1) is said as if it’s no longer true – but it is. The difference between the WhatsApp forwards of February-April 2020 and the articles and papers of 2021 is the body of evidence each set of claims was based on. Luc Montagnier was wrong when he spoke against the zoonotic-spillover hypothesis last year simply because his reasoning was wrong. The reasons and the evidence matter; otherwise, you’re no better than a broken clock. Facile WhatsApp forwards and right-wingers’ ramblings continue to deserve to be treated with extreme scepticism.

Just because a conspiracy theory is later proven to have merit doesn’t make it not a conspiracy theory; their defining trait is belief in the absence of evidence. The most useful response, here, is not to get sucked into the right-wing fever swamps, but to isolate legitimate questions, and try and report out the answers.

Columbia Journalism Review, April 15, 2020

The second point is obviously harder to fight back, considering it doesn’t stake a new position as much as reinforces one that certain groups of people have harboured for many years now. It’s one star aligning out of many, so its falling out of place won’t change believers’ minds, and because the believers’ minds will be unchanged, it will promptly fall back in place. This said, apart from the numerous other considerations, I’ll say investigations aren’t the preserve of journalists, and one story that was investigated to a greater extent by non-journalists – especially towards a conclusion that you probably wish to be true – has little necessarily to do with journalism.

In addition, the picture is complicated by the fact that when people find that they’re wrong, they almost never admit it – especially if other valuable things, like their academic or political careers, are tied up with their reputation. On occasion, some turn to increasingly more technical arguments, or close ranks and advertise a false ‘scientific consensus’ (insofar as such consensus can exist as the result of any exercise less laborious than the one vis-à-vis anthropogenic global warming), or both. ‘Isolating the legitimate questions’ here apart – from both sides, mind you – needs painstaking work that only journalists can and will do.

Featured image credit: Ethan Medrano/Pexels.

Scicomm Science

Broken clocks during the pandemic

Proponents of conspiracy theories during the pandemic, at least in India, appear to be like broken clocks: they are right by coincidence, without the right body of evidence to back their claims. Two of the most read articles published by The Wire Science in the last 15 months have been the fact-checks of Luc Montagnier’s comments on the two occasions he spoke up in the French press. On the first, he said the novel coronavirus couldn’t have evolved naturally; the second, he insisted mass vaccination was a big mistake. The context in which Montagnier published his remarks evolved considerably between the two events, and it tells an important story.

When Montagnier said in April 2020 that the virus was lab-made, the virus’s spread was just beginning to accelerate in India, Europe and the US, and the proponents of the lab-leak hypothesis to explain the virus’s origins had few listeners and were consigned firmly to the margins of popular discourse on the subject. In this environment, Montagnier’s comments stuck out like a sore thumb, and were easily dismissed.

But when Montagnier said in May 2021 that mass vaccination is a mistake, the context was quite different: in the intervening period, Nicholas Wade had published his article on why we couldn’t dismiss the lab-leak hypothesis so quickly; the WHO’s missteps were more widely known; China’s COVID-19 outbreak had come completely under control (actually or for all appearances); many vaccine-manufacturers’ immoral and/or unethical business practices had come to light; more people were familiar with the concept and properties of viral strains; the WHO had filed its controversial report on the possible circumstances of the virus’s origins in China; etc. As a result, speaking now, Montagnier wasn’t so quickly dismissed. Instead, he was, to many observers, the man who had got it right the first time, was brave enough to stick his neck out in support of an unpopular idea, and was speaking up yet again.

The problem here is that Luc Montagnier is a broken clock – in the way even broken clocks are right twice a day: not because they actually tell the time but because the time is coincidentally what the clock face is stuck at. On both occasions, the conclusions of Montagnier’s comments coincided with what conspiracists have been going on about since the pandemic’s start, but on both occasions, his reasoning was wrong. The same has been true of many other claims made during the pandemic. People have said things that have turned out to be true but they themselves have always been wrong, whenever they have been wrong, because their particular reasons for something to be true were wrong.

That is, unless you can say why you’re right, you’re not right. Unless you can explain why the time is what it is, you’re not a clock!

Montagnier’s case also illuminates a problem with soothsaying: if you wish to be a prophet, it is in your best interests to make as many predictions as possible – to increase the odds of reality coinciding with at least one prediction in time. And when such a coincidence does happen, it doesn’t mean the prophet was right; it means they weren’t wrong. There is a big difference between these positions, and which becomes pronounced when the conspiratorially-minded start incorporating every article published anywhere, from The Wire Science to The Daily Guardian, into their narratives of choice.

As the lab-leak hypothesis moved from the fringes of society to the centre and came mistakenly to conflate possibility with likelihood (i.e. zoonotic spillover and lab-leak are two valid hypotheses for the virus’s origins but they aren’t equally likely to be true), the conspiratorial proponents of the lab-leak hypotheses (the ones given to claiming Chinese scientists engineered the pathogen as a weapon, etc.) have steadily woven imaginary threads between the hypothesis and Indian scientists who opposed Covaxin’s approval, the Congress leaders who “mooted” vaccine hesitancy in their constituencies, scientists who made predictions that came to be wrong, even vaccines that were later found to have rare side-effects restricted to certain demographic groups.

The passage of time is notable here. I think adherents of lab-leak conspiracies are motivated by an overarching theory born entirely of speculation, not evidence, and who then pick and choose from events to build the case that the theory is true. I say ‘overarching’ because, to the adherents, the theory is already fully formed and true, and that pieces of it become visible to observers as and when the corresponding events play out. This could explain why time is immaterial to them. You and I know that Shahid Jameel and Gagandeep Kang cast doubt on Covaxin’s approval (and not Covaxin itself) after the time we were aware that Covaxin’s phase 3 clinical trials were only just getting started in December, and before Covishield’s side-effects in Europe and the US came to light (with the attendant misreporting). We know that at the time Luc Montagnier said the novel coronavirus was made in a lab, last year, we didn’t know nearly enough about the structural biology underlying the virus’s behaviour; we do now.

The order of events matters: we went from ignorance to knowledge, from knowing to knowing more, from thinking one thing to – in the face of new information – thinking another. But the conspiracy-theorists and their ideas lie outside of time: the order of events doesn’t matter; instead, to these people, 2021, 2022, 2023, etc. are preordained. They seem to be simply waiting for the coincidences to roll around.

An awareness of the time dimension (so to speak), or more accurately of the arrow of time, leads straightforwardly to the proper practice of science in our day-to-day affairs as well. As I said, unless you can say why you’re right, you’re not right. This is why effects lie in the future of causes, and why theories lie in the causal future of evidence. What we can say to be true at this moment depends entirely on what we know at this moment. If we presume what we can say at this moment to be true will always be true, we become guilty of dragging our theory into the causal history of the evidence – simply because we are saying that the theory will come true given enough time in which evidence can accrue.

This protocol (of sorts) to verify the truth of claims isn’t restricted to the philosophy of science, even if it finds powerful articulation there: a scientific theory isn’t true if it isn’t falsifiable outside its domain of application. It is equally legitimate and necessary in the daily practice of science and its methods, on Twitter and Facebook, in WhatsApp groups, every time your father, your cousin or your grand-uncle begins a question with “If the lab-leak hypothesis isn’t true…”.

Analysis Op-eds

The problems with one-shot Covishield

NDTV quoted unnamed sources in the Indian government saying it will be conducting a study to assess the feasibility of deploying the Covishield vaccine in a single-dose regimen instead of continuing the extant double-dose regimen.

At any other time, such a statement may have been sufficient to believe the government would organise and conduct a well-designed trial, publicise the findings and revise policy (or not) to stay in line with the findings, informed by socio-economic considerations. But the last 15 months have thrown up enough incidents of public-health malpractice on the state’s part to make such hope outright stupid. I’m fairly certain, especially if the vaccine shortage persists and the outbreaks on an upward trajectory in some parts of the country at the moment aren’t tamped down quickly, that the government is going to conduct a trial, not publish its methods and findings and push through a policy to deploy Covishield as a single-dose shot.

Of course I would be happy to be proven wrong – but in the event that I’m not, I’m already filled with a mix of sadness and fury. The government seems set on finding new ways to play with our lives.

News that the government is going to conduct a feasibility study broke to the accompaniment of a suggestion, by NDTV’s same unnamed sources, that Covishield was originally intended as a single-dose vaccine and that it was later found to be better as a two-dose vaccine. This is ridiculous to begin with, considering Covishield’s phase 3 trials around the world, conducted by AstraZeneca and the University of Oxford, tested the two-dose regimen.

But it is rendered more ridiculous because Public Health England (PHE) reported just a week ago that two doses of Covishield are necessary for a recipient to be sufficiently protected against infections by the B.1.617.2 variant. The PHE study found that one dose of Covishield had an efficacy of 33% against symptomatic COVID-19 caused by the variant, increasing to 60% after both doses. Has the Indian government forgotten that B.1.617.2 is becoming the more common variant circulating in the country? Or is laundering the national party’s image more important than the safety of hundreds of millions? (The latter is entirely plausible: in the last seven years, the country has seldom been larger than the supreme leader’s ego.)

The PHE study isn’t without its shortcomings – but I’d be more inclined to pay attention to them at this moment if:

  1. I didn’t have to contend with the non-trivial possibility that the Indian government will bury, obfuscate and/or twist the data arising from its assessment, and therefore we (the public) need to bank on whatever else is available;
  2. I didn’t have to contend with the fact that data from Covaxin’s phase 3 trial (which apparently went past its final interim-analysis endpoint in April) and Covishield’s bridging trial (which IIRC concluded on March 24) are still missing from the public domain;
  3. If we could access large-scale effectiveness data of the two vaccines (the National Institute of Epidemiology, Chennai, is set to begin collecting such data this week); and
  4. If there was any other reliable data at the moment about the two vaccines vis-à-vis the different variants circulating in India.

There is another problem. If Covishield is administered as a single-dose vaccine, its efficacy against symptomatic COVID-19 caused by B.1.617.2 viral particles is 33% – which is below the WHO’s recommended efficacy threshold of 50% for these vaccines. If the Indian government formalises the ‘Covishield will be one dose’ policy and if the B.1.617.2 variant continues its conquest, will the vaccine, as it is used in India, lose its place on the WHO’s vaccine list? And what of the consequences that will follow, including other countries becoming reluctant to admit Indians who received one dose of Covishield and one dose of the BJP’s way of doing things?

I would be wary, too. The longer the particles of the novel coronavirus are able to circulate within a population, the more opportunities they will have to mutate, and the more mutations they will accumulate. So any population that allows the virus to persist for longer automatically increases the chance of engendering potentially deadlier variants within its borders. One-dose Covishield plus B.1.617.2, and other variants, will set just such a stage – compounded by the fact that Serum Institute, which makes Covishield, has a much larger production capacity than Bharat Biotech, the maker of Covaxin.

(The PHE study also found that Covishield and the Pfizer-BioNTech vaccine had an efficacy of “around 50%” against symptomatic COVID-19 caused by an infection of the B.1.1.7 variant.)

In fact, the government could have made more sense today by saying it would prioritise the delivery of the first dose to as many people as possible before helping people get the second one. This way the policy would be in line with the most recent scientific findings, be synonymous with a single-dose campaign and keep the door open to vaccinating people with both doses in a longer span of time (instead of closing that door entirely), while admitting that the vaccine shortage is real and crippling – something most of us know anyway. But no; Vishwaguru first.


On The Lancet editorial

On May 8, The Lancet published an editorial criticising the Narendra Modi government’s response to India’s second COVID-19 outbreak, which has been redefining the meaning of ‘snafu’. All hell broke loose. Of course, hell has been breaking loose for quite some time in India now, but the latest episode was in one specific sense also gratifying to behold.

There were the usual rumbles in the week following the editorial’s appearance, until on May 17 India’s health minister Dr Harsh Vardhan shared a blog post penned by a Pankaj Chaturvedi deriding The Lancet‘s choice of arguments. (I’m fond of emboldening the honorific: it shows doctors can be stupid, too.) The post is mostly whataboutery studded with a few gems about how people who liked the editorial aren’t pissed enough that favipiravir and hydroxychloroquine were approved for use – as Dr Vardhan’s ministry did. More importantly, it seems Dr Vardhan, and his colleagues in fact, threw themselves into the barrel looking for anything with fully formed sentences that said The Lancet was wrong – a sign that their government still gives a damn about what foreign journals, and perhaps magazines and newspapers too, say about it.

We need to use this to the fullest extent, and I daresay that it’s the sort of resource the government is going to find difficult to duplicate as well. There was recently an article about Modi doing a great job during India’s second wave, published in an outlet called The Daily Guardian. There was enough confusion to draw the UK’s The Guardian forward and clarify that it was an unaffiliated entity – but no amount of confusion can supplant an institution, no matter how illiberal. Aakar Patel wrote in 2018: “The fact is that intelligent and intellectual bigotry is very difficult. There are very few people who can pull that off and that is why we can count the major ones on our fingers.” This is also why the government has twitched every time the New York Times, the Washington Post, BBC, The Lancet, Science and The BMJ have published articles critical of India, even if this isn’t the full picture.

It’s doubly interesting that the sophistry of the rejoinders aside, Dr Vardhan, his colleagues in government and his party’s supporters have all been antagonised by what they perceive to be a political act by a medical journal. This is an untenable distinction, of course – one that fantasises about a clear divide between the Watchers, who look out, and the Watched, who dare not know what the Watchers see. More pertinently, it’s a reflection of what they desperately expect from their own compatriots: to ignore how bad political leadership could help a virus ravage hundreds of thousands of families.

Laurie Penny wrote an essay in 2018 with some life-saving prescriptions, including that victories against fascists can never be had in the realm of reason. But when The Lancet publishes an editorial, The BMJ the work of an investigative reporter or even The Economist a tightly worded admonishment, they’re both reasoning and enacting a theatre of reason, and the latter seems to bother right-wing ideologues. These people are not going to heed reason, not now and not ever, but it’s heartening, even if my hope is naïve or misplaced, that they’re tractable in some meagre measure… less like dark matter and more like neutrinos.

Featured image credit: Kunj Parekh/Unsplash.


Courts and COVID

India’s courts have played a prominent in helping (or not) the country manage its COVID-19 epidemic, especially during the second wave this year – from asking the government to explain which proofs of identity will be accepted at vaccination centres to recommending lockdowns. Two high courts, Madras and Allahabad, have also expressed sentiments that had until then been confined to Twitter – that the Election Commission should assume responsibility for the deaths of thousands of people and that state failures to supply oxygen amount to “genocide”. Here are some of the more notable search results from Bar & Bench, plus one from The Wire.

Death of COVID patients due to Oxygen shortage nothing less than genocide: Allahabad High Court orders inquiry

“Election Commission should be put up on murder charges:” Madras High Court on ECI’s failure to stop “abuse” of COVID norms in election rallies

Delhi High Court seeks report from Delhi Police in plea alleging hoarding of COVID-19 medicines by political leaders

Pained that orders are being completely ignored: Gujarat High Court asks why real-time updates on hospital beds are not available

Karnataka High Court suggests judicial inquiry into death of 24 patients in Chamarajanagar COVID-19 facility due to lack of oxygen

Overcrowding at COVID vaccination centres could become a “super spreader:” Kerala High Court registers suo motu case

Structured response required to give adequate relief to voiceless and the marginalised sections: Delhi High Court

News of death not negative: Delhi High Court dismisses PIL to regulate “negativity” due to reporting on COVID-19

“Current COVID vaccine policy will create disparity; Bahujans, marginalised groups may not have ability to pay:” Supreme Court

Is Aadhaar necessary for COVID-19 vaccination? Bombay High Court asks Central, Maharashtra government to clarify

“All you are showing is that things will be hunky-dory in June, did Central govt consult experts?” Madras High Court

SC Stays Delhi HC Order on Contempt Proceedings Against Centre Over Oxygen Supply

I’m not yet sure if one variety of proclamation will be more effectual than the other (social-media outrage versus outbursts from the courts) in terms of causing real change.

In addition, while the courts’ expertise is less questionable on matters related to the people’s rights and governments’ responsibilities, they do trip up when they recommend lockdowns or the supply of unproven drugs the same way the Supreme Court has tripped up asking for smog towers in Delhi. Have the courts assessed the trial data? Have they consulted doctors? If so, which ones were consulted? Do the courts also intend to ensure migrant and daily-wage workers don’t get fucked over this time?

It’s good that the judiciary is cracking the whip when almost no one else is, but knowing how the judicial system works, I’m not sure if we should rejoice already… “This is what things have come to, and the courts can help ensure the only way we go from here is up” is not a bad argument in their favour. But you may also notice a distinction between the high courts and the apex court: the latter seems reluctant to admit the idea that the government is responsible for the mess that almost everyone else (on this side of the aisle) believe it created. Is recovery sans accountability a good bargain?

Op-eds Science

Being apolitical doesn’t mean politics doesn’t exist

A few years ago, we had a writer who would constantly pitch articles to us about how the Indian government should be doing X, Y or Z in the fight against this or that disease. Their submissions grew quickly tiresome, and then wholly ridiculous when, in one article (well before the pandemic), they wrote that “the government should distribute good-quality masks for TB patients to use”. That the government should do this is a banal truism. But to make this recommendation over and over risks hiding from sight the fact that the government probably isn’t doing it not because it doesn’t know it should be done but because it has decided that what it is doing is more important, more necessary.

I find myself contending with many similar articles today. It is people’s right to express themselves, especially on counts on which the Indian government has dropped the ball via-à-vis the country’s COVID-19 epidemic. But to repeat recommendations that are often staring most of us in our faces I fear could be harmful – by only reminding us of what needs to be done but hasn’t been, over and over, is an act that deepens the elision and then the forgetting of the real reason why it hasn’t been done.

This doesn’t mean reminders are redundant; to the contrary, there is important value in repetition, so that we may not lose sight of which outcomes are ultimately desirable. But in tandem, we also need to start acknowledging what could be standing in the way and contemplating honestly whether what we’re advocating for could surmount that barrier. (This issue is also of a piece with the one about processes and outcomes – whereby some commentators stress on what the outcomes can or should be but have nothing to say about the processes that will get us there.)

For example, what happened to the rapid self-administered COVID-19 tests that many scientists in India developed last year? A reporter with an appetite for a small investigation could speak to the researchers, university administrators, the DST or the DBT as the case may be, and finally to officials in the Union health ministry, and weave together a story about where exactly in this pipeline of translation from the lab to the market the product vanished. There is value in knowing this but it is not paramount value. It is on equal footing with the view, from the perch of the political economy of public healthcare, that the Modi government is unlikely to okay the widespread use of such tests because many Indian states, especially BJP strongholds like Uttar Pradesh and Gujarat, are widely underreporting cases and deaths, and a state-managed project to suppress this data is easier to do with centralised testing facilities instead of freely distributed rapid tests whose results can also be quickly crowdsourced.

Quite a few authors of articles (many of them scientists) also like to say that we shouldn’t politicise the pandemic. They ignore, deliberately or otherwise, the fact that all pandemics are political by default. By definition, a pandemic is an epidemic of the same disease occurring in multiple geographically distinct regions at the same time. Governments have to get involved to manage them. Pandemics are not, and should never be, carte blanche for scientists to assume power, their prescriptions to assume primacy and their priorities to assume importance – by default. This can only lead to tunnel vision that is blind to problems, and in fact solutions, that arise from social and political compulsions.

Instead, it would be much more valuable if scientists, and in fact any expert in any field, could admit the politically motivated parts of a government’s response to its local epidemic instead of forcing everyone else to work around their fantasies of separation – and even better if they could join the collaborative efforts to develop solutions instead of trying to solve it like a science problem.

Anthony Fauci demonstrates this same… attitude (for lack of a better word), in an interview to Indian Express. When asked how he might respond to India’s crisis, he said:

The one thing I don’t want to do and I hope it doesn’t turn out this way, is to get involved in any sort of criticism of how India has handled the situation because then it becomes a political issue and I don’t want to do that since I’m a public health person and I’m not a political person.

It just seems to me that, right now, India is in a very difficult and desperate situation. I just got off, in preparation for this interview, I watched a clip from CNN… it seems to me it’s a desperate situation. So when you have a situation like that you’ve got to look at the absolute immediate.

I mean, first of all, I don’t know if India has put together a crisis group that would meet and start getting things organised. I heard from some of the people in the street bringing their mothers and their fathers and their sisters and their brothers searching for oxygen. They seem to think there really was not any organisation, any central organisation.

When asked about what India should do towards getting more people vaccinated:

You’ve got to get supplies. You’ve got to make contractual arrangements with the various companies that are out there in the world.

😑 And what about the fact that the US didn’t just advance-book the doses it needed but hoarded enough to vaccine its population thrice over, and blocked a petition by India and South Africa, and some other countries, to release the patents on US-made vaccines to increase global supply?

Fauci’s answers are, again, a reminder of which outcomes are or ought to be ultimately desirable – what goals we should be working towards – but simply repeating this needs to stop being a virtue. Fauci, like many others before him, doesn’t wish to consider why we’re not on the path to achieving these outcomes despite fairly common knowledge of their existence. He may not be a political person but being apolitical doesn’t mean politics isn’t involved. The bulk of India’s response to its COVID-19 epidemic has been driven by political strategy. Is the idea that even the ideal part science can play in this enterprise is decidedly finite so off-putting?

And even if there is a legitimate aspiration to expand the part science should be allowed to play in pandemic governance, scientists need to begin by convincing political institutions – and not attempt to seize power. They may be tempted to, as we all are, because our current national government seems to think accountability is blasphemy, and without being accountable it has stopped speaking for the people of the country, even those who put it in power. Nonetheless, the fruits of scientific work need to be democratic, too.

I would also contend that Fauci complicates the picture by implying that there can be a clean separation of political and scientific issues on this matter; many scientists in India and perhaps too many people in India have an elevated opinion of Fauci, to the point of considering his words to be gospel. As one friend put it recently, “Unbelievable – the idea that a single white man is the foremost disease epidemiologist in the world” (emphasis in the original). “How do people say it with a straight face?”

This post isn’t intended to disparage Fauci, even if our exalted opinion of him deserves to be taken down a few notches. Instead, I hope it highlights how Fauci nicely demonstrates a deceptively trivial prejudice against politics that, I could argue, helped land India in its latest disaster. Even when he pitches, for example, that India should lock itself down for a few weeks – instead of a few months like it did last year – he is at liberty to ignore the aftermath. We are not. Does that mean a lockdown shouldn’t come to be? No. But if he accommodated the political in his considerations, will it mean a man of his smarts will be able to meaningfully contemplate what the problem could really be? Maybe.

Featured image: Former US President Donald Trump, VP Mike Pence and NIAID director Anthony Fauci at a press briefing at the White House on April 16, 2020. Credit: Public domain.

Op-eds Scicomm

The constructionist hypothesis and expertise during the pandemic

Now that COVID-19 cases are rising again in the country, the trash talk against journalists has been rising in tandem. The Indian government was unprepared and hapless last year, and it is this year as well, if only in different ways. In this environment, journalists have come under criticism along two equally unreasonable lines. First, many people, typically supporters of the establishment, either don’t or can’t see the difference between good journalism and contrarianism, and don’t or can’t acknowledge the need for expertise in the practise of journalism.

Second, the recognition of expertise itself has been sorely lacking across the board. Just like last year, when lots of scientists dropped what they were doing and started churning out disease transmission models each one more ridiculous than the last, this time — in response to a more complex ‘playing field’ involving new and more variants, intricate immunity-related mechanisms and labyrinthine clinical trial protocols — too many people have been shouting their mouths off, and getting most of it wrong. All of these misfires have reminded us of two things: again and again that expertise matters, and that unless you’re an expert on something, you’re unlikely to know how deep it runs. The latter isn’t trivial.

There’s what you know you don’t know, and what you don’t know you don’t know. The former is the birthplace of learning. It’s the perfect place from which to ask questions and fill gaps in your knowledge. The latter is the verge of presumptuousness — a very good place from which to make a fool of yourself. Of course, this depends on your attitude: you can always be mindful of the Great Unknown, such as it is, and keep quiet.

As these tropes have played out in the last few months, I have been reminded of an article written by the physicist Philip Warren Anderson, called ‘More is Different’, and published in 1972. His idea here is simple: that the statement “if everything obeys the same fundamental laws, then the only scientists who are studying anything really fundamental are those who are working on those laws” is false. He goes on to explain:

“The main fallacy in this kind of thinking is that the reductionist hypothesis does not by any means imply a ‘constructionist’ one: The ability to reduce everything to simple fundamental laws does not imply the ability to start from those laws and reconstruct the universe. … The constructionist hypothesis breaks down when confronted with the twin difficulties of scale and complexity. The behaviour of large and complex aggregates of elementary particles, it turns out, is not to be understood in terms of a simple extrapolation of the properties of a few particles. Instead, at each level of complexity entirely new properties appear, and the understanding of the new behaviours requires research which I think is as fundamental in its nature as any other.”

The seemingly endless intricacies that beset the interaction of a virus, a human body and a vaccine are proof enough that the “twin difficulties of scale and complexity” are present in epidemiology, immunology and biochemistry as well – and testament to the foolishness of any claims that the laws of conservation, thermodynamics or motion can help us say, for example, whether a particular variant infects people ‘better’ because it escapes the immune system better or because the immune system’s protection is fading.

But closer to my point: not even all epidemiologists, immunologists and/or biochemists can meaningfully comment on every form or type of these interactions at all times. I’m not 100% certain, but at least from what I’ve learnt reporting topics in physics (and conceding happily that covering biology seems more complex), scale and complexity work not just across but within fields as well. A cardiologist may be able to comment meaningfully on COVID-19’s effects on the heart in some patients, or a neurologist on the brain, but they may not know how the infection got there even if all these organs are part of the same body. A structural biologist may have deciphered why different mutations change the virus’s spike protein the way they do, but she can’t be expected to comment meaningfully on how epidemiological models will have to be modified for each variant.

To people who don’t know better, a doctor is a doctor and a scientist is a scientist, but as journalists plumb the deeper, more involved depths of a new yet specific disease, we bear from time to time a secret responsibility to be constructive and not reductive, and this is difficult. It becomes crucial for us to draw on the wisdom of the right experts, who wield the right expertise, so that we’re moving as much and as often as possible away from the position of what we don’t know we don’t know even as we ensure we’re not caught in the traps of what experts don’t know they don’t know. The march away from complete uncertainty and towards the names of uncertainty is precarious.

Equally importantly, at this time, to make our own jobs that much easier, or at least less acerbic, it’s important for everyone else to know this as well – that more is vastly different.


The Government Project

Considering how much the Government of India has missed anticipating – the rise of a second wave of COVID-19 infections, the crippling medical oxygen shortage, the circulation of new variants of concern – I have been wondering about why we assemble giant institutions like governments: among other things, they are to weather uncertainty as best as our resources and constitutional moralities will allow. Does this mean bigger the institution, the farther into the future it will be able to see? (I’m assuming here a heuristic that we normally are able to see, say, a day into the future with 51% uncertainty – slightly better than chance – for each event in this period.)

Imagine behemoth structures like the revamped Central Vista in New Delhi and other stonier buildings in other cities and towns, the tentacles of state control dictating terms in every conceivable niche of daily life, and a prodigious bureaucracy manifested as tens of thousands of civil servants most of whom do nothing more than play musical chairs with The Paperwork.

Can such a super-institution see farther into the future? It should be able to, I’d expect, considering the future – in one telling – is mostly history filtered through our knowledge, imagination, priorities and memories in the present. A larger government should be able to achieve this feat by amassing the talents of more people in its employ, labouring in more and more fields of study and experiment, effectively shining millions of tiny torchlights into the great dark of what’s to come.

Imagine one day that the Super Government’s structures grow so big, so vast that all the ministers determine to float it off into space, to give it as much room as it needs to expand, so that it may perform its mysterious duties better – something like the City of a Thousand Planets.

The people of Earth watch as the extraterrestrial body grows bigger and bigger, heavier and heavier. It attracts the attention of aliens, who are bemused and write in their notebooks: “One could, in principle, imagine ‘creatures’ that are far larger. If we draw on Landauer’s principle describing the minimum energy for computation, and if we assume that the energy resources of an ultra-massive, ultra-slothful, multi-cellular organism are devoted only to slowly reproducing its cells, we find that problems of mechanical support outstrip heat transport as the ultimate limiting factor to growth. At these scales, though, it becomes unclear what such a creature would do, or how it might have evolved.”

One day, after many years of attaching thousands of additional rooms, corridors, cabinets and canteens to its corse, the government emits a gigantic creaking sound, and collapses into a black hole. On the outside, black holes are dull: they just pull things towards them. That the pulled things undergo mind-boggling distortions and eventual disintegration is a triviality. The fun part is what happens on the inside – where spacetime, instead of being an infinite fabric, is curved in on itself. Here, time moves sideways, perpendicular to the direction in which it flows on the outside, in a state of “perpetual freefall”. The torch-wielding scientists, managers, IAS officers, teachers, thinkers are all trapped on the inner surface of a relentless sphere, running round and round, shining their lights to look not into the actual future but to find their way within the government itself.

None of them can turn around to see who it is that’s chasing them, or whom they’re chasing. The future is lost to them. Their knowledge of history is only marginally better: they have books to tell them what happened, according to a few historians at one point of time; they can’t know what the future can teach us about history. And what they already know they constantly mix and remix until, someday, like the progeny of generations of incest, what emerges is a disgusting object of fascination.

The government project is complete: it is so big that it can no longer see past itself.