Where were you on the morning of 30 January 2020?
Getting ready for another day like any other, perhaps on your way to work, college, or school?
Maybe you read in the morning papers and the news bulletins about the new virus, and how India had reported its first case of the novel Coronavirus caught your attention momentarily.
On 30 January 2020, India recorded it's first case of COVID-19—a medical student from Wuhan University in China.
However, few could have predicted the day would be the beginning of two long years of a pandemic in the country.
Two years and 3 waves late, what does all this data tell us? Can COVID data from the past 2 years help us map the future of the pandemic in India?
To make sense of the data we have, and fill in the blanks between them, FIT spoke to Dr Murad Banaji, a mathematician from Middlesex University in the UK, who has been closely mapping India's COVID-19 data since the pandemic began.
Notes on the Data: What We Know
The question, 'how has India's COVID-19 response been in this last two years?' is a tough one to tackle, and a major reason for this is a lack of consistent good quality data.
"The quality and scope of official data varies a lot. For some states and cities it is reasonable, and there have been improvements over time," says Dr Murad Banaji.
"On the other hand, data from many parts of the country is limited or of poor quality. This makes it hard to say anything meaningful about India's epidemic at national level."Dr Murad Banaji, a mathematician, Middlesex University, UK
Even so, there is much to learn from the data that we do have.
According to Dr Banaji, "we do have some hope of unravelling how disease spread, which interventions slowed the spread, where mortality was high, and so forth."
"We know from serosurvey data that while some states like Kerala and Maharashtra capture a reasonable fraction of their infections, others like UP and Bihar capture only a tiny fraction of all their infections."Dr Murad Banaji, a mathematician, Middlesex University, UK
Speaking of Kerala's consistently high case rate, he thinks a large part of it can be attributed to the state's data collection process, saying, "Kerala detects a lot more of its infections than most parts of the country (around 20-25 percent in Kerala, compared to around 3 percent nationally). We know this from serosurvey data."
"Kerala's waves have been more spread out, because there were more successful measures to slow the spread of infection in Kerala, especially during the first wave."Dr Murad Banaji, a mathematician, Middlesex University, UK
A downside of this, he says, is that "infection continued to spread in Kerala even after it wound down in many parts of the country. On the other hand, it almost certainly saved lives."
Expansion in genome sequencing labs in the country has also helped us track the spread of new variants more efficiently.
Over the course of the 2 years, the cost of getting RT-PCR tests and their turn around time have also gone down significantly, making it easier to get tested for COVID.
Interactive: 2 Years of India's Missing Data
This is just some of the data that is completely absent or inaccessible in the Indian context.
Other more granular data is missing includes,
The impact of the COVID-19 pandemic on mental health
Side effects of vaccines in the elderly, in the immunocompromised, in women, young kids, and so forth.
Data on how many elderly people have taken the 'precautionary shots', and real world data on their effectiveness.
Earlier this year, FIT spoke to experts about COVID vaccine research in pregnant women. Vaccines are now allowed and encouraged for pregnant women, and yet not much has changed in terms of clinical and real world data that we have regarding the safety of these vaccines in pregnant women.
The Hidden Numbers: COVID Deaths
Independently collected data and several reports, especially since the second wave, strongly point to the actual COVID-19 death toll being around seven to eleven times higher than the official COVID numbers.
Dissecting this disparity, Dr Banaji says, "it is crucial to understand why the recording of pandemic deaths in India has been so poor, even compared to some other low and middle income countries."
"We need to understand the role of poverty, of limited testing, of access to hospital care, and of deliberate dishonesty and data manipulation, in leading to this situation."Dr Murad Banaji, a mathematician, Middlesex University, UK
"Unfortunately, instead of trying to get to the bottom of what went wrong, the government has engaged in amateurish attempts to discredit the research papers and pre-prints estimating India's pandemic mortality," he adds.
The Uttar Pradesh Government, for instance, in December 2021, went as far as to declare that there was no data of deaths reported in the state due to a lack of oxygen in the second wave.
A Series of Missed Opportunities
A reluctance to release clinical trial results to the public domain, like in the case of Bharat Biotech's Covaxin, also lead to an undercurrent of distrust in the vaccines.
Complete data from Covaxin's clinical trials in children is still under wraps, in spite of it being the only vaccine in the country to be allowed to kids below the age of 18.
"The absence of data helped a number of naive and misleading narratives to flourish - and I believe these narratives contributed ultimately to the huge suffering and loss of life during the second wave."Dr Murad Banaji, a mathematician, Middlesex University, UK
Speaking to the Quint for a different article, scientists and doctors from across India lamented the lack of large scale data generated from real world studies in India even this far down the pandemic.
Echoing their voices, Dr Banaji says, "the size of India's population and the scale of the vaccine roll-out was, in fact, an opportunity to generate good quality data on vaccine effectiveness and safety."
"This appears to be an opportunity missed," he adds.
"A lot of interpretation analysis can be done from Indian data, and that's not being done. And that's what many experts outside government are demanding," Epidemiologist Dr Chandrakant Lahariya, told the Quint.
The Future of the Pandemic
"Available data tells us that infection spread has been very high in India, and vaccination is also decent. So India's population should have a good level of protection, at least against severe disease," says Dr Banaji.
But, if the trajectory of the pandemic in the last two years has taught us anything, it is that there are too many unknowns for us to be able to make predictions.
Two of the biggest unknowns, according to Dr Banaji, are new variants, and how long our immunity against them lasts.
"Even without new variants there could be future surges. Ultimately, trying to keep disease at the lowest possible levels is the best hope for slowing the evolution of SARS-CoV-2 and reducing the risk from new waves."Dr Murad Banaji, a mathematician, Middlesex University, UK
But the two years have also taught us ways to work around the problems.
Dr Banaji talks about the success of the COVID-19 vaccines—some of the fastest developed vaccines in history—in changing the course of the pandemic.
"Perhaps future vaccines will prove more effective at reducing transmission from new variants of the virus, but this is not yet certain."Dr Murad Banaji
He also emphasises on the importance of vaccine equality, saying, "making sure that vaccination coverage is high everywhere is important. Vaccine equity is a key issue to be addressed internationally."
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