Wednesday, July 29, 2020

AIPSN AIDWA JOINT STATEMENT E

Science, not superstition, will help us tackle Covid-19.

Background note for a nation-wide AIDWA- AIPSN  campaign

 

Read here the campaign note in English , in Hindi 

Read here the Newsclick story on the joint campaign

 

On 23rd July 2020, All-India Democratic Women’s Association (AIDWA) is commemorating the eighth death anniversary of Captain Lakshmi Sahgal, the revolutionary freedom fighter and tireless campaigner for progressive ideals, democratic rights, gender justice, and an upholder of the scientific outlook throughout her life. She was one of the founding members of AIDWA in 1981, and played a crucial role in taking the organization into the Hindi heartland. As a doctor based in Kanpur, UP, her clinic was a nodal centre for the organization, attracting women seeking medical help and unable to afford it; as well as a site for interaction and meetings of activists. Fortunate were the thousands of babies delivered there, as the parents did not have to worry about becoming impoverished in the process!

The All India Peoples Science Network (AIPSN) comprising 37 OrganizatioWwAns all over India, joins AIDWA in remembering and celebrating the enormous contributions of Dr. Lakshmi Sahgal. Significantly, she played a leading role in the founding of the Network in 1987 and was a champion of the battle against obscurantism, and for promotion of scientific temper.

The life and work of Dr. Lakshmi Sahgal assumes even greater relevance during the on-going Covid-19 epidemic during which obscurantist forces are playing on the fears of the people, particularly women, to spread superstitions and pseudo-scientific beliefs. . Many traditionalist practices which have no proven impact on Covid-19 are being advocated as cures or as having preventive properties. Under cover of the epidemic, attempts are being made by the Sangh Parivar to bolster socially conservative values, communal prejudices and patriarchal notions. This must be resisted unitedly by  progressive and democratic forces.

The message of science
The Covid-19 pandemic hit India in January 2020, and presented a challenge in the early days even to public health experts, doctors and scientists who were still learning about the novel Corona Virus. The Central Government and most State Governments, with the notable exception of Kerala as recognized worldwide,  were quite late in putting together a  coherent, rational understanding and communicating it effectively to the people. A knee-jerk  and badly implemented lock down, dramatic gestures like lighting diyas, clapping, hands, etc, initiated by none other than the PM himself, did not help matters.

Not surprisingly, as people desperately sought relief and protection from Covid-19, all kinds of myths and beliefs proliferated to fill the gaps. These included a number of home remedies like drinking warm water, standing in the sun, growing certain plants at home and so on. Such untested beliefs gained considerable popularity until, under pressure from scientists and people’s organizations and movements, public messaging became more coherent and science-based. AIPSN and other organizations of scientists, doctors and public health experts have been at the forefront of informing the public about the correct do’s-and-don’ts related to Covid-19 derived from WHO and ICMR guidelines and expert opinion. A number of popular practices  and home remedies gain acceptance as remedies because in 80% of cases the disease is self-limiting and the patient recovers without much intervention. .
The challenge meanwhile is to stop obscurantist forces and vested interests from using the uncertainty which still prevails, to spread their ideology, and to make their profits. The promotion of do-it-yourself home remedies or traditionalist treatments combine with misleading messages that “no treatment is available for COVID 19” and to distract from the governments failures to provide affordable quality medical care through rapid expansion of public health services. Although there is as yet no curative allopathic medicine, the scientific and medical communities have learned much about the virus and its effects, and are applying this knowledge in testing and treatment of Covid-19, especially in hospital settings with or without oxygen or ventilator support. Further, the search for definitive treatments and vaccines for prevention continues with emphasis on scientific validation especially through clinical trials so as to ensure safety and efficacy.  This isthe scientific approach. Unfortunately, some treatments are pushed even within modern medicine, cutting short scientific procedures, by corporate interests and their supporters in positions of power or influence, motivated by greed for profits or misplaced national pride. The undue haste in pressurizing hospitals to unrealistically accelerate clinical trials of a vaccine candidate, perhaps just to enable a triumphant announcement from the red fort on Independence Day, is a case in point, thwarted only by concerted opposition by the scientific and medical communities and informed public opinion.
Countering pseudo remedies and false propaganda
Some false remedies and fake claims take the form of peddling Covid “cures” or “treatments” in the name of Ayurvedic, homeopathic or other traditional formulations. None of these have any foundation even within these traditions, nor have they been subject to any scientific trials. Yet many such claims have been allowed to propagate. Even some Ministers at the Centre and in several States have made such claims. When the Union Health Minister or leading Government spokespersons were challenged on such claims, they have shied away from outright debunking them, instead saying they may be the “personal beliefs” of those Ministers or leaders.

The atrocious and brazen claim of a supposed Ayurvedic “cure” from Baba Ramdev’s Patanjali conglomerate emerged from this trend. The formulation from the Sangh Parivar-linked, politically well-connected Baba was all set for commercial launch based on  spurious “clinical trials,” when a public outcry by scientists, doctors and informed citizens forced the  Health and AYUSH Ministries to debunk this claim and even declare readiness to invoke the law against “magical cures and remedies.” Nevertheless, many so-called immune-boosters and other concoctions to supposedly help people fight-off Covid-19 continue to be propagated, cleverly taking care only not to use the word “cure!”

Pseudo-scientific claims have got validated because the party in power and supporting social forces have gone along with such notions. The Prime Minister’s calls for people to come to balconies or doorsteps and clang vessels, and later to shine torches or light lamps, to express support for doctors and health workers, were followed by twitter storms and social media posts claiming that India’s anti-Covid lamps were seen from space by NASA, or that “powerful radiations” or “vibrations” from these public displays would destroy the Corona Virus! No efforts were made by any Government or Sangh Parivar leader to contradict any of these fantastic claims. (Suffice it to say that the virus continues to spread alarmingly!) These kind of claims are being used not just to magnify the PM’s “superpowers,” but also to undermine the influence of science, rationality and critical thinking in society.
The Sangh Parivar and linked forces have also used the Covid19 pandemic to spread communal poison. One highly regrettable mass religious gathering in Nizamuddin, which acted as a superspreader, was used systematically over several months to demonize a particular religious minority as the major cause behind the pandemic. This was carried forward to stigmatize the entire community by spreading false rumours that positive cases from this gathering were deliberately spitting on others to spread the virus, or that buying vegetables from vendors belonging to this community was dangerous etc. The simple fact is, as science teaches us, that it is not the religion that matters but that there was a large gathering, with no physical distancing or other precautions being taken. Indeed, a recent occurrence at arguably the most popular temple in the country where large numbers of priests and devotees have been infected, sharply underlines this fact.

The Sangh parivar and linked forces have been utilizing social media to propagate superstitions, communal, traditionalist and obscurantist beliefs in a big way, which have to be countered, through powerful media campaigns of our own based on science.

Unmasking the use of religion to reinforce patriarchy. 
The other dangerous development is the invocation of supposed religious beliefs to reinforce obscurantist views and customs, especially by giving it a gender twist, with the virus being personized as an angry goddess. Observations made by AIDWA activists from different states provide some disturbing instances of this growing trend.
In Rajasthan, some well-known temples were surreptitiously opened despite the government’s ban on opening places of worship, by spreading rumours that the doors of the temple had opened “by themselves” and people, especially women, should offer prayers there to “placate the Corona virus.” Women have been told to dip their hands in kumkum water, or in cow dung in UP, and put their imprints on the walls of their homes to pacify “Corona Mai (Devi).”        In parts of Bihar, women are being prompted to go to nearby rivers, dress up and carry sindoor, bindi, sweets etc and take a dip just as they would during Chhat Puja, to appease an angry “Corona mai.” In some places, women get “possessed” and exhort “Corona mai” to go away. Unfortunately, it is observed that women from Dalit and OBC families are especially influenced to act in this manner. The idea of an angry “Corona goddess” is also being propagated in Uttarakhand and West Bengal.
Such notions of an angry or dangerous Goddess who must be appeased have been witnessed earlier too in India. Small pox was associated with female Goddesses, for example Mariamma in Tamil Nadu, and the pox itself was known as “Mata/ Amma/Ammai etc,” as chicken pox, measles etc are often termed even today. Part of this derives from ancient quasi-religious beliefs but also stem from deep-rooted patriarchal culture and ideologies ascribing evil, dangerous and power-hungry characteristics to women as witches, daayin etc.
In Telangana, pro-Sangh Parivar forces, often led by women, are leading “prabhat pheris” or dawn marches, propagating the idea that the Covid epidemic has struck because women have stopped performing pujas and other sanskari or traditional practices, and calling on them to restart them so as to drive away the Corona Virus. The intention is clearly to reinforce traditional patriarchal culture with a subservient role chalked out for women within the lakshman rekha drawn around the home.
In Odisha, pro-Sangh Parivar outfits have been campaigning that temples should not have been closed, and that the Supreme Court did not permit the Rath Yatra because it is pro-Muslim and pro-Christian! In fact, places of worship of almost all religious denominations have been kept closed by the respective religious institutions themselves and by government guidelines.  Where this has not happened, or has happened without observance of physical distancing and hand-hygiene, it has resulted in Covid positive cases spreading from such gatherings. Any rational and unbiased person would understand that the problem is not with the particular religion, but with the practices adopted. Here obscurantist forces are deliberately fanning and spreading communal prejudice, while at the same time devaluing science and rational thought and distracting everyone from governments’ responsibility to provide quality medical care.
In this context, AIDWA and AIPSN would launch joint campaigns starting from 23 July 2020 to combat propagation of superstitions and irrational beliefs by obscurantist forces. We will take inspiration from great fighters like Captain Lakshmi Sahgal, to arm people with science as against superstition, and to demand that the scientific temper enshrined in the Constitution be widely promoted. The campaign would resist attempts by the government and obscurantist forces to take us backwards , and instead uphold the values of secularism, gender justice, critical thinking and scientific temper, all of which are essential for building a forward-looking, democratic society.

The Joint AIDWA-AIPSN Campaign would be conducted throughout the country from 23rd July 2020 at least till the National Scientific Temper Day on August 20, the black day on which anti-superstition campaigner Dr.Narendra Dabholkar was murdered by right wing obscurantist forces.

Sunday, July 5, 2020

www.thelancet.com Vol 396 July 4, 2020 65

Health Policy
www.thelancet.com Vol 396 July 4, 2020 65
Wuhan from other cities, expanding nucleic acid testing
capacity to 35 000 tests per day in February, 2020. These
hospitals and laboratories helped ensure that every
suspected case could be tested, treated, and isolated,
and that their close contacts could be traced and isolated
in a timely manner.31–33
Citizen support has been essential. People not
providing essential services had to remain at home as
much as possible; everyone had to avoid gatherings and
wear masks when going out. Wuhan suspended all
transportation in and out of the city from Jan 23 to
April 8, 2020. Varying degrees of intra-area and interarea
transportation restrictions were applied throughout the
entire country, from big cities to small villages, for at
least 1 month. Many volunteers supported the community
control policies. Timeliness was stressed, with hospitals
required to report confirmed or suspected cases within
2 h, laboratories to report test results within 12 h, and
local Centers for Disease Control and Prevention to
complete case investigations within 24 h.
Modelling estimated that, had this containment effort
not been done, the number of COVID-19 cases would
have been an estimated 67-fold higher than they have
been thus far.34 According to this model, detection,
isolation, and contact tracing with quarantine was the
most effective part of the containment strategy, which was
estimated to have prevented more infections than travel
restriction and contact reductions.34 Integration with NPIs
served to strengthen and accelerate the effect of detection,
isolation, tracing, and quarantine.34 Suspending intracity
public transport, closing entertainment venues, and
prohibiting mass gatherings were also associated with
reductions in case incidence.35
Suppression
We use a suppression strategy for when an epidemic is in
multiple areas with varying degrees of outbreak and
community spread, when it is not possible or feasible to
stop spreading by confining transmission to an isolatable
geographical area. Core measures are similar to those for
containment and are summarised in table 2. Suppression
logically follows successful containment to prevent
spread from imported cases and re-establishment of
community transmission.
Suppression measures can keep transmission and
prevalence low, decreasing the effective reproduction
number (Re).36 Once Re is below 1 in a community, spread
in that community should eventually stop. However,
maintenance of strict suppression measures, particularly
physical distancing, brings a large socioeconomic burden.
As shown by scientists at Imperial College London,37
intermittent physical distancing triggered by trends in
disease surveillance can allow interventions to be relaxed
temporarily in short time windows, but measures will
need to be reintroduced if or when case numbers begin to
rebound. Therefore, a challenge for suppression is to
balance the needs of epidemic control with restoration
and maintenance of social life, choosing epidemiologically
appropriate times to relax or strengthen control.
Importantly though, during times of more relaxed
physical distancing efforts, proactive case detection and
management with contact tracing and quarantine must
be maintained, to avoid re-establishment of community
transmission and a rebound of the epidemic.
Achievability and feasibility of containment and
suppression
SARS-CoV-2 is mainly transmitted by symptomatic cases.
Analysis of nucleic acid tests in a cohort with 2147 close
contacts showed that only 17% (22 of 132) of cases were
asymptomatic among all nucleic acid test-positive cases.38
Similarly, in the Diamond Princess cruise ship outbreak,
approximately 18% of nucleic acid test-positive cases
were asymptomatic.39 Based on national surveillance data
from China, clinical manifestations of COVID-19 are
readily identifiable in most patients, with more than
half developing pneumonia, which facilitates early case
finding.21,22,40,41 Although presymptomatic and even asymptomatic
infected individuals can transmit the virus, their
ability to transmit is much lower than that of symptomatic
infected individuals.42–44 By actively identifying symptomatic
patients and expanding testing of their close
contacts, a large burden of asymptomatic infection can be
detected, and with infected individuals appropriately
isolated at an early stage, risk of transmission will be
reduced. Low transmissibility of asymptomatic cases, and
the ease with which symptomatic cases can be diagnosed
using readily available, sensitive, and specific diagnostic
tests, support the notion that transmission can be
interrupted by finding and managing cases and tracing
and quarantining their close contacts.
The core containment and suppression strategies are
worthwhile, not only in an early stage of the epidemic
but also during a later community transmission stage.
With limited community transmission, as was seen in
provinces outside Hubei in China, containment was
achieved within a month. Widespread community transmission
of SARS-CoV-2 in Hubei (population 59 million)
was stopped in less than 2 months (figure).
The most urgent and important measure of the
containment and suppression strategies is scaling up
testing of each suspected case and all close contacts of
those infected.45,46 With the increase in PCR testing
capacity in China as an example, the median time from
illness onset to diagnosis was shortened from an initial
average of 12 days in early January to only 3 days in early
February.47
After containment in China
The current situation of COVID-19
The containment strategy has largely been successful in
China. From April 1 to May 31, 2020, there have been,
on average, 54 infections reported daily by China’s
National Health Commission, which were almost all