COVID-19 pandemic

Tamil Nadu’s lukewarm heatwave policy

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From ‘Tamil Nadu heatwave policy is only a start’, The Hindu, November 21, 2024:

Estimates of a heatwave’s deadliness are typically based on the extent to which the ambient temperature deviates from the historical average at a specific location and the number of lives lost during and because of the heatwave. This is a tricky, even devious, combination as illustrated by the accompanying rider: “to the reasonable exclusion of other causes of hyperthermia”.

A heatwave injures and/or kills by first pushing more vulnerable people over the edge; the less vulnerable are further down the line. The new policy is presumably designed to help the State catch those whose risk exposure the State has not been able to mitigate in time. However, the goal should be to altogether reduce the number of people requiring such catching. The policy lacks the instruments to guide the State toward this outcome.

An infuriating editorial in Science

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I’m not just disappointed with an editorial published by the journal Science on November 14, I’m angry.

Irrespective of whether the Republican Party in the US has shifted more or less rightward on specific issues, it has certainly shifted towards falsehoods on many of them. Party leaders, including Donald Trump, have been using everything from lazily inaccurate information to deliberately misleading messages to preserve conservative attitudes wherever that’s been the status quo and to stoke fear, confusion, uncertainty, and animosity where peace and good sense have thus far prevailed.

Against this backdrop, which the COVID-19 pandemic revealed in all its glory, Science‘s editorial is headlined “Science is neither red nor blue”. (Whether this is a reference to the journal itself is immaterial.) Its author, Marcia McNutt, president of the US National Academy of Sciences (NAS), writes (emphasis added):

… scientists need to better explain the norms and values of science to reinforce the notion—with the public and their elected representatives—that science, at its most basic, is apolitical. Careers of scientists advance when they improve upon, or show the errors in, the work of others, not by simply agreeing with prior work. Whether conservative or liberal, citizens ignore the nature of reality at their peril. A recent example is the increased death rate from COVID-19 (as much as 26% higher) in US regions where political leaders dismissed the science on the effectiveness of vaccines. Scientists should better explain the scientific process and what makes it so trustworthy, while more candidly acknowledging that science can only provide the best available evidence and cannot dictate what people should value. Science cannot say whether society should prioritize allocating river water for sustaining fish or for irrigating farms, but it can predict immediate and long-term outcomes of any allocation scheme. Science can also find solutions that avoid the zero-sum dilemma by finding conservation approaches to water management that benefit both fish and farms.

Can anyone explain to me what the first portion in bold even means? Because I don’t want to assume a science administrator as accomplished as McNutt is able to ignore the narratives and scholarship roiling around the sociology of science at large or the cruel and relentless vitiation of scientific knowledge the first Trump administration practiced in particular. Even if the editorial’s purpose is to extend an olive branch to Trump et al., it’s bound to fail. If, say, a Republican leader makes a patently false claim in public, are we to believe an institution as influential as the NAS will not call it out for fear of being cast as “blue” in the public eye?

The second portion in bold is slightly less ridiculous: “science can only provide the best available evidence and cannot dictate what people should value.” McNutt is creating a false impression here by failing to present the full picture. During a crisis, science has to be able to tell people what to value more or less rather than what to value at all. Crises create uncertainty whereas science creates knowledge that is free from bias (at least it can be). It offers a pillar to lean on while we figure out everything else. People should value these pillars.

When a national government — in this case the government of one of the world’s most powerful countries — gives conspiracies and lies free reign, crises will be everywhere. If McNutt means to suggest these crises are so only insofar as the liberal order is faced with changes inimical to its sustenance, she will be confusing what is today the evidence-conspiracy divide for what was once, but is no longer, the conservative-liberal divide.

As if to illustrate this point, she follows up with the third portion in bold: “Science cannot say whether society should prioritize allocating river water for sustaining fish or for irrigating farms, but it can predict immediate and long-term outcomes of any allocation scheme.” Her choice of example is clever because it’s also fallacious: it presents a difficult decision with two reasonable outcomes, ‘reasonable’ being the clincher. The political character of science-in-practice is rarely revealed in debates where reasonability is allowed through the front door and given the power to cast the decisive vote. This was almost never the case under the first Trump administration nor the parts of the Republican Party devoted to him (which I assume is the whole party now), where crazy* has had the final say.

The choice McNutt should really have deliberated is “promoting the use of scientifically tested vaccines during a pandemic versus urging people to be cautious about these vaccines” or “increasing the stockpile of evidence-backed drugs and building social resilience versus hawking speculative ideas and demoralising science administrators”. When the choice is between irrigation for farms and water for fisheries, science can present the evidence and then watch. When the choice is between reason and bullshit, still advocating present-and-watch would be bullshit, too — i.e. science would be “red”.

This is just my clumsy, anger-flecked take on what John Stuart Mill and many others recognised long past: “Bad men need nothing more to compass their ends than that good men should look on and do nothing.” But if McNutt would still rather push the line that what seem like “bad men” to me might be good men to others, she and the policies she influences will have committed themselves to the sort of moral relativism that could never be relevant to politics in practice, which in turn would be a blow for us all.

(* My colloquialism for the policy of being in power for the sake of being in power, rather than to govern.)

Tamil Nadu’s lukewarm heatwave policy

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A sunny evening in Madurai.

I published this article here by mistake. I’d intended for it to appear in a different forum and I have submitted it there. If and when it’s published there, I will link to it here. My apologies.

India-based neutrino oblivion

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In a conversation with science journalist Nandita Jayaraj, physicist and Nobel laureate Takaaki Kajita touched on the dismal anti-parallels between the India-based Neutrino Observatory (INO) and the Japanese Kamioka and Super-Kamiokande observatories. The INO’s story should be familiar to readers of this blog: a team of physicists led by those from IMSc Chennai and TIFR Mumbai conceived of the INO, identified places around India where it could be built, finalised a spot in Theni (in Tamil Nadu), and received Rs 1,350 crore from the Union government for it, only for the project to not progress a significant distance past this point.

Nandita’s article, published in The Hindu on July 14, touches on two reasons the project was stalled: “adverse environmental impacts” and “the fear of radioactivity”. These were certainly important reasons but they’re also symptoms of two deeper causes: distrust of the Department of Atomic Energy (DAE) and some naïvety on the scientists’ part. The article mentions the “adverse environmental impacts” only once while “the fear of radioactivity” receives a longer rebuttal — which is understandable because the former has a longer history and there’s a word limit. It bears repeating, however.

Even before work on the INO neared its beginning, people on the ground in the area were tense over the newly erected PUSHEP hydroelectric project. Environmental activists were on edge because the project was happening under the aegis of the DAE, a department notorious for its opacity and heavy-handed response to opposition. The INO collaboration compounded the distrust when hearings over a writ petition Marumalarchi Dravida Munnetra Kazhagam chief Vaiko filed in the Madras high court revealed the final ecological assessment report of the project had been prepared by the Salim Ali Centre for Ornithology and Natural History (SACON), which as the law required at the time hadn’t been accredited by the Quality Council of India and was thus unfit to draft the report. Members of the INO collaboration said this shouldn’t matter because they had submitted the report themselves together with a ‘detailed project report’ prepared by TANGEDCO and a geotechnical report by the Geological Survey of India. Perhaps the scientists thought SACON was good enough, and it may well have been, but it’s not clear how submitting the report themselves should have warranted a break from the law. Given all the other roadblocks in the project’s way, this trip-up in hindsight seems to have been a major turning point.

Locals in the area around the hill, under which the INO was to be built, were also nervous about losing access to part of their grazing land and to a temple situated nearby. There was a report in 2015 that police personnel had blocked people from celebrating a festival at this temple. In an April 2015 interview with Frontline, when told that local police were also keeping herders from accessing pastureland in the foothills, INO spokesperson Naba Mondal said: “The only land belonging to INO is the 26.825 ha. INO has no interest in and no desire to block the grazing lands outside this area. In fact, these issues were discussed in great detail in a public meeting held in July 2010, clearly telling the local people this. This is recorded in our FAQ. This was also conveyed to them in Tamil.” In response to a subsequent question about “propaganda” that the project site would store nuclear waste from Tamil Nadu’s two nuclear power facilities, Mondal said: “The DAE has already issued a press statement in this regard. I do genuinely believe that this has allayed people’s concerns.”

Even at the time these replies hinted at a naïve belief that these measures would suffice to allay fears in the area about the project. There is a difference between scientists providing assurances that the police will behave and the police actually behaving, especially if the experience of the locals diverges from what members of the INO collaboration believe is the case. Members of the collaboration had promised the locals they wouldn’t lose access to grazing land; four years later, the locals still had trouble taking their word. According to an investigation I published at The Wire in 2016, there was also to be a road that bypassed the local villages and led straight to the project site, sparing villagers the noise from the trucks ferrying construction material. It was never built.

One narrative arising from within the scientific community as the project neared the start of construction was that the INO is good for the country, that it will improve our scientific literacy, keep bright minds from leaving to work on similar projects abroad, and help Indians win prestigious prizes. For the national scientific enterprise itself, the INO would make India a site of experimental physics of global importance and Indian scientists working on it major contributors to the study of neutrino physics. I wrote an article to this effect in The Hindu in 2016 and this is also what Takaaki Kajita said in Nandita’s article. But later that year, I also asked an environmental activist (and a mentor of sorts) what he was thinking. He said the scientists will eventually get what they want but that they, the activists et al., still had to do the responsible thing and protest what they perceived to be missteps. (Most scientists in India don’t get what they want but many do, most recently like the ‘Challakere Science City’.)

Curiously, both these narratives — the activist’s pessimism and the scientists’ naïvety — could have emerged from a common belief: that the INO was preordained, that its construction was fated to be successful, causing one faction to be fastidious and the other to become complacent. Of course it’s too simplistic to be able to explain everything that went wrong, yet it’s also of a piece with the fact that the INO was doomed as much by circumstance as by historical baggage. That work on the INO was stalled by an opposition campaign that included fear-mongering pseudoscience and misinformation is disagreeable. But we also need to ask whether some actors resorted to these courses of action because others had been denied them, in the past if not in the immediate present — or potentially risk the prospects of a different science experiment in future.

Physics is often far removed from the precepts of behavioural science and social justice but public healthcare is closer. There is an important parallel between the scientists’ attempts to garner public support for the project and ASHA workers’ efforts during the COVID-19 pandemic to vaccinate people in remote rural areas. These latter people were distrustful of the public healthcare system: it had neglected them for several years but then it was suddenly on their doorstep, expecting them to take a supposedly miraculous drug that would cut their chances of dying of the viral disease. ASHA workers changed these people’s minds by visiting them again and again, going door to door, and enrolling members of the same community to convince people they were safe. Their efficacy is higher if they are from the same community themselves because they can strike up conversations with people that draw on shared experiences. Compare this with the INO collaboration’s belief that a press release from the DAE had changed people’s minds about the project.

Today the INO stares at a bleak future rendered more uncertain by a near-complete lack of political support.

This post benefited from Thomas Manuel’s feedback.

Justice delayed but a ton of bricks await

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From ‘SC declines Ramdev, Patanjali apology; expresses concern over FMCGs taking gullible consumers ‘up and down the garden path’’, The Hindu, April 10, 2024:

The Supreme Court has refused to accept the unconditional apology from Patanjali co-founder Baba Ramdev and managing director Acharya Balkrishna for advertising medical products in violation of giving an undertaking in the apex court in November 2023 prohibiting the self-styled yoga guru. … Justices Hima Kohli and Ahsanuddin Amanullah told senior advocate Mukul Rohatgi that Mr. Ramdev has apologised only after being caught on the back foot. His violations of the undertaking to the court was deliberate and willful, they said. The SC recorded its dissatisfaction with the apology tendered by proposed contemnors Patanjali, Mr. Balkrishna and Mr. Ramdev, and posted the contempt of court case on April 16.

… The Bench also turned its ire on the Uttarakhand State Licensing Authority for “twiddling their thumbs” and doing nothing to prevent the publications and advertisements. “Why should we not come down like a ton of bricks on your officers? They have been fillibustering,” Justice Kohli said. The court said the assurances of the State Licensing Authority and the apology of the proposed contemnors are not worth the paper they are written on.

A very emotionally gratifying turn of events, but perhaps not as gratifying as they might have been had they transpired at the government’s hands when Patanjali was issuing its advertisements of pseudoscience-backed COVID-19 cures during the pandemic. Or if the Supreme Court had proceeded to actually hold the men in contempt instead of making a slew of observations and setting a date for another hearing. Still, something to cheer for and occasion to reserve some hope for the April 16 session.

But in matters involving Ramdev and Patanjali Ayurved, many ministers of the current government ought to be pulled up as well, including former Union health minister Harsh Vardhan, Union micro, small, and medium enterprises minister Nitin Gadkari, and Prime Minister Narendra Modi. Modi’s governance and policies both written and unwritten enabled Patanjali’s charlatanry while messrs Vardhan and Gadkari were present at an event in February 2021 when Patanjali launched a product it claimed could cure COVID-19, with Vardhan – who was health minister then – speaking in favour of people buying and using the unproven thing.

I think the Supreme Court’s inclination to hold Ramdev et al. in contempt should extend to Vardhan as well because his presence at the event conferred a sheen of legitimacy on the product but also because of a specific bit of theatrics he pulled in May the same year involving Ramdev and former Prime Minister Manmohan Singh. Ramdev apologising because that’s more politically convenient rather than because he thinks he screwed up isn’t new. In that May, he’d called evidence-based medicine “stupid” and alleged such medicine had killed more people than the virus itself. After some virulent public backlash, Vardhan wrote a really polite letter to Ramdev asking him to apologise, and Ramdev obliged.

But just the previous month, in April 2021, Manmohan Singh had written a letter to Modi suggesting a few courses of action to improve India’s response to the virus’s spread. Its contents were perfectly reasonable, yet Vardhan responded to it accusing Singh of spreading “vaccine hesitancy” and alleging Congress-ruled states were responsible for fanning India’s deadly second wave of COVID-19 infections (in 2021). These were all ridiculous assertions. But equally importantly, his lashing out stood in stark contrast to his letter to Ramdev: respect for the self-styled godman and businessman whose company was attempting to corner the market for COVID-19 cures with untested, pseudo-Ayurvedic froth versus unhinged rhetoric for a well-regarded economist and statesman.

For this alone, Vardhan deserves the “ton of bricks” the Supreme Court is waiting with.

Hot in Ballia

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More than half of the deaths reported during the heatwave in Uttar Pradesh and Bihar this week were reported from just one district in the former, called Ballia. On (or around) June 17, the medical superintendent of the Ballia district hospital was transferred away after he attributed the deaths (until then) to the heat. He was replaced with someone else.

The state government also dispatched a team of two experts to the district to assess the local situation (as they say). One of them was director of the Uttar Pradesh health department for communicable diseases, A.K. Singh. In one of his first interactions with the press, Singh indicated that they weren’t inclined to believe the Ballia deaths were due to the heat and that the team was also considering alternative explanations, like the local water source being contaminated. I think something fishy could be going on here.

First, Hindustan Times reported Singh saying “the deaths at the hospital were primarily due to comorbidity and old age and not heatstroke”, erratic power in the area, and the time taken to reach the hospital — in effect, everything except the heat. Yet all these factors only worsen a condition; they don’t cause it. What was the condition?

Second, a reporter from The Hindu who visited Ballia learnt that it will take “more than seven days” to issue the medical certificates of the cause of death (MCCDs), so the official cause of death — i.e. what the state records the cause of each death in this period and circumstance to be — won’t be clear until then.

Aside: During the COVID-19 pandemic, the Indian Council of Medical Research issued guidelines that asked healthcare workers to not list comorbidities as the underlying cause of death for people who die with COVID-19. This didn’t stop workers from doing just this in many parts of the country. I’m not sure but I don’t think similar guidelines exist for when the underlying cause could be heat. The guidelines also specified the ICD-10 codes to be used for COVID-19; such codes already exist for heat-related deaths.

Third: Do the district authorities, and by extension the Uttar Pradesh state government, have complete knowledge of the situation in Ballia? There was the unfortunate superintendent who said there was a link between the heat and the deaths. Anonymous paramedic staff at the Ballia hospital also told The Hindu that “some of the deaths were heat-related”. Yet the new superintendent says the matter is “under investigation” even as one member of the expert team says it’s yet to find “any convincing evidence to link the deaths with heatstroke”.

I really don’t know what to make of this except that there’s a non-zero chance that a cover-up is taking shape. This is supported by the fourth issue: According to The Hindu, “the [Uttar Pradesh] State Health Department has asked the Chief Medical Officers of districts and the Chief Medical Superintendents of district hospitals to issue statements in coordination with the concerned District Magistrate only during ‘crucial situations'” — a move reminiscent of the National Disaster Management Authority’s response to the Joshimath disaster.

For now, this is as far as the facts (as I know them) will take us. I think we’ll be able to take a big stride when the hospital issues the MCCDs.

On the lab-leak hypothesis

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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.

Broken clocks during the pandemic

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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…”.

The problems with one-shot Covishield

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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

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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.