Skip to main content

Lancet editorial 'lacks' scientific robustness in calling India's Covid data untrustworthy

Dr Amitav Banerjee, MD*  

The editorial, "India's ascendency: leadership demands integrity," published in Lancet, Vol 401, May 6, 2023 (click here for Counterview report) is a half baked political commentary more in the nature of an armchair exercise missing the finer nuances of the political situation on the ground. Regrettably, the editorial also alleges that the Covid-19 data from India is untrustworthy. These are sweeping statements which are speculative on the political issues and bad science as well as the estimates of Covid-19 deaths by World Health Organization (WHO) are inferred from dubious mathematical models rather than hard population level data. Before elaborating how the editorial is wide off the mark on both politics and science it would be relevant to discuss whether political commentaries should find a place in medical journals.
The association between politics and pandemics was first emphasized by Rudolf Virchow in 1848. His observations while investigating the pandemic of typhus in Europe in the nineteenth century drove a paradigm shift in understanding human disease at the population level. 
Beyond the narrow concept of pathogen as the sole cause of pandemics, Virchow stressed the importance of social and economic conditions such as poverty, poor civil services, ignorance, illiteracy, and other socioeconomic factors. These observations, all of which called for political action made him sum up with the famous words, "Medicine is a social science, and politics is nothing but medicine on a large scale.”
Against this background it may be relevant for political commentaries to find a place in medical journals. Having said this, it is important to consider who is competent to write these in an objective and unbiased manner. Even in scientific papers, Richard Horton, the editor of Lancet had conceded that the choice of papers in Western medical journals has a racist bias, giving the diseases of poverty a lower preference. This renders the contents, both scientific and political, of the Lancet highly unrepresentative and biased. They tend to be amateurish with shallow insights ignoring different perspectives.
What is more dismaying is that the editorial lacks scientific robustness in calling the Covid-19 data "wholly untrustworthy." It states that the official government figures place deaths at 530000 while WHO excess death estimates are near 4.7 million. It conveniently overlooks that the WHO figures are based on dubious mathematical models rather than ground level robust data.
For example, estimates of number of deaths in India from Covid-19 based on serosurvey data from the field reassures us that the Indian government figures are authentic. Ioannides, early in the pandemic, based on population level serosurveys inferred that the infection fatality rate (IFR), for persons below 70 years was in the range of 0.03% to 0.04%. Majority of the Indian population, over 97% are below 70 years of age. 
Estimates of number of deaths from Covid-19 based on serosurvey data from the field reassures us that Indian government figures are authentic
As a rule of thumb if we apply the 0.04% IFR and extrapolate the rate to the total Indian population (around 1400000000), the total estimated deaths is 560000, very near to the official Indian figure of 530000 mentioned in the Lancet editorial. In fact, deaths in India may be still lower due to its much lower obesity rates compared to Western populations.
It is evident that the Lancet and other leading journals from the West need a course correction by encouraging diverse views on complex political situations, the nuances of which will be missed by Western authors. Surprisingly, it is getting the science wrong too, as illustrated by the Covid-19 inflated death rates in its commentary. Such lapses call for more diligent homework on the part of leading medical journals before being judgmental and using derogatory terms like “wholly untrustworthy."
A more balanced view, in case the Lancet wanted to discuss politics in relation to health would have been to stress the negative influence of politics & corruption in suppressing science leading to huge collateral harms and economic setbacks. A BMJ editorial poignantly states that when good science is suppressed by politics and corruption, people die. Draconian measures which were adopted in Western countries killed people in poor countries due to the immense collateral harm. 
The papers published in leading Western medical journals, under the influence of politics and corruption, misguided the world in adopting the same measures in their own countries with different epidemiology. The biggest price was paid by the poor in all countries. 
The Lancet itself has been responsible for the biggest publishing scam in recent history when it published a paper based on fake data to tarnish the image of a cheap drug like hydroxychloroquine in early treatment of Covid-19. Later the paper had to be retracted. Now, who is “wholly untrustworthy?”
*Post doctoral in epidemiology who was a field epidemiologist for over two decades in the Indian Armed Forces. He also led the mobile epidemic investigation team at the Armed Forces Medical College, Pune, India from 2000 to 2004. During this period he investigated a number of outbreaks in different parts of the country. He was awarded for his work on Tribal Malaria and Viral Hepatitis E. He presently is a Professor in a Medical College in Pune



Savarkar 'criminally betrayed' Netaji and his INA by siding with the British rulers

By Shamsul Islam* RSS-BJP rulers of India have been trying to show off as great fans of Netaji. But Indians must know what role ideological parents of today's RSS/BJP played against Netaji and Indian National Army (INA). The Hindu Mahasabha and RSS which always had prominent lawyers on their rolls made no attempt to defend the INA accused at Red Fort trials.

Delhi HC rules in favour of retired Air Force officer 'overcharged' for Covid treatment

By Rosamma Thomas*  In a decision of May 22, 2023, the Delhi High Court ruled in favour of petitioner Group Captain Suresh Khanna who was under treatment at CK Birla Hospital, Gurugram, between April 28 and May 5, 2021, for a period of eight days, for Covid-19 pneumonia. The petitioner had to pay Rs 3,55,286 as treatment costs, but the Ex-Servicemen Contributory Health Scheme (ECHS) only reimbursed him for Rs 1,83,748, on the basis of government-approved rates. 

'Enough evidence' in Indian tradition to support legal basis for same-sex marriage

By Iyce Malhotra, Joseph Mathai, Sandeep Chachra*  The ongoing hearing in the Supreme Court on same-sex marriage provides space for much-needed conversations on issues that have hitherto remained “invisible” or engaged with patriarchal locker room humour. We must recognize that people with diverse sexualities and complex gender identities have faced discrimination, stigma and decades of oppression. Their issues have mainly remained buried in dominant social discourse, and many view them with deep insecurities.

Religious divide 'kept alive' with low intensity communalism in Gujarat's cultural capital

By Rajiv Shah  A fact-finding report, prepared by the Mumbai-based non-profit, Centre for Study of Society and Secularism (CSSS), has cited the Vadodara Ram Navami violence of March 30 as yet another example of how, after the BJP consolidating its hold on political power in Gujarat post-2002 riots and at the Centre in 2014, the nature of communal riots has changed, underlining, as opposed to high-intensity violence earlier, now riots have become “more sub-radar and at a smaller scale, more localized”.

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Urgency for next pandemic? But Mr Health Secretary, you're barking up wrong tree

By Dr Amitav Banerjee, MD*  The Union Health Secretary, Mr Rajesh Bhushan addressing the Health Working Group of G20 India, at Hyderabad on 05 June 2023, cautioned that the next pandemic would not wait for us to make global treaties and called on countries to work together.

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

76% Odisha govt school infrastructure in dilapidated state, 'undermine' RTE norms

By Our Representative  As many as 75.86% (5,421) elementary schools in Odisha do not possess a playground, depriving students of physical activity opportunities. Also, 75.68% (5,408) of schools require minor or major repairing, undermining the norms and standards stipulated in the Right to Education (RTE) Act.

Why continued obsession with adding more 'water guzzling' coal, nuclear power plants?

By Shankar Sharma*  The true concerns over water inefficiency in coal power plants have been known and have been highlighted many times in the past. A highly relevant study report by Prayas Energy Group had highlighted this fast looming threat to our society many years ago. But our authorities have been acting as though there can be no issue with water supply, and that additional coal power plants can be added indefinitely; even without any true relevance to climate change.

Caste, impact on Ayodhya area 'halting' BJP rulers to act against Brij Bhushan Singh

By Vidya Bhushan Rawat*  Finally, the #WrestlersProtest has got international attention. The United World Wrestling (UWW),  condemning the treatment and detention of wrestlers and expressing its disappointment over the lack of results of the investigations against Brij Bhushan Singh, accused of sexually harassing women wrestlers, has urged the "relevant authorities to conduct a thorough and impartial investigation."