 Hello and welcome to NewsClick. Today we have with us Professor Satyitharath. We are going to discuss as we do on Monday the COVID-19 epidemic, pandemic, whatever we want to call it, its progression as we see it even now with increased numbers of vaccines being given, both in India and in a number of other countries. So of course, it is still very meager in, for instance, in Africa, lots of other places, including large parts of India. So we are not out of the woods. The government recently has said that certain North Eastern states numbers are increasing rapidly, but they've also said, and of course it doesn't correlate to this, that the R numbers, the reproduction rate of the infection is also increasing. It has come now from x, I think 0.7 something as it had been brought down to, it's now 0.88. If it goes above 1, as you know, it will start increasing rapidly. Satyith, what do we have to say about these numbers? Because if we see, look at the new these numbers the government is talking about and what is happening on the ground, we see actually the numbers which are rising in terms of what is the R numbers are really old places, not North East, which is a very small contribution, but really places like Maharatra, Pune for example, Tiruvananthapuram in Kerala for example. So the correlation is really not North East and R, it's really something else, isn't it? Well, it's a number of things. So the first thing that we have to keep in mind that any plain assertion that our numbers are right has to be treated with a dose of healthy skepticism with matters like this where we don't have universal data where everything is based on sampling. The bold faced claim that our numbers are right simply cannot be made. All of us have to be cautious and careful about the many possible confoundings, the many possible difficulties with how the sampling is done and therefore what the data do and don't represent. That said, let's look at two or three issues. Firstly, after a period of weeks, months almost of fairly stringent Braconian lockdown, over the past few weeks we have been variously emerging from lockdown. We have been doing what everybody is referring to as the unlockdown and it's unsurprising that in this phase we have an upsurge of what's called COVID inappropriate behavior. We have people who've been anxious going out and feeling de-represed and therefore crowding, therefore not necessarily masking as well as they should and so on and so forth. And there are two components to this. One is, as we've been saying consistently, community participation where citizens and communities are active decision making partners in epidemic control policies have been conspicuously lacking for the past year and therefore a general law and order kind of lockdown when it is lifted is almost certain to give rise to COVID inappropriate behavior. While I am not denying that citizens are certainly responsible for the behavior, the role of government, of governance and of policies in leaving this lacuna where community participation and partnership in epidemic control policies has not been taken on board cannot be denied. That's one issue. A second issue is that we need to keep in mind that there are far more transmissible variants around today. There is Alpha, there is Beta, there is Delta, there are other variants that are beginning to crop up, all of which as we keep pointing out are characterized by the ability to be transmitted more efficiently. What exactly the mechanisms of that more efficient transmission are is a matter of detailed biology but the fact is that they're all capable of being transmitted more efficiently. What that means is that even one step lowering of the COVID appropriate behavior guard is likely to lead to much greater spread this year than it would have done last year. That's an unfortunate fact of biological life and again because we haven't been treating communities as partners, this I don't think has been assimilated by communities to the extent that it needed to have been. A third factor in this is that we have been and in all of these criticisms I don't mean to criticize only the government of India because to a greater or lesser extent governments across the world and certainly state governments and the union government included in India have been remiss in many of these matters. But both the government of India and governments across the world have been triumphalist in the interpretation of their vaccination coverage so far. They've been converting from putting their best foot forward optimistically in vaccination policies and strategies to pretending that there is much more better and more uniform vaccination than is really the case and as a result there is a great deal of excessive expectation of vaccination media to protection in communities that's actually not supported by reality and all of these factors put together are beginning to have their effects and the effects are threefold. Firstly as you point out there are 10-15% of the districts across the country where cases have never really come down. They've played toward but not come down, they've kept going up. Many of these are in the northeast and the union government keeps pointing out that those are small numbers and so on and so forth and I'm unwilling to acknowledge the issue of small numbers if in geographical, socio geographical areas the epidemic is continuing to smolder unchecked. That's a global problem, that's not just a local problem and it can't be dismissed simply as a matter of small numbers. The second issue is that we now have compared to last year a far more decentralized epidemic transmission. We have not just urban India, we have rural India, we have very widespread pockets of smoldering infection and as a result with more transmissible variants with emerging COVID inappropriate behavior, the likelihood of local outbreaks is quite substantial and I don't think any of this is being taken either by communities or by governments as seriously as we should be taking. Of course as you know there was also the proposal for a Char Dham Yatra after what we saw in the Kumbh Mela. So now hopefully it will not take place. Hopefully let's see what happens really but obviously the COVID inappropriate behavior is not only the people but it's also the governments as we saw earlier. You have also talked about the vaccine path. Now here is the Indian vaccine rate is relatively still in terms of what needs to be done, no and also very patchy. It's there in certain pockets, it's not there in other pockets, it shoots up when the government wants to create an atmosphere that's suddenly ramped up because central government is taken over by essentially holding vaccines and then shooting it off one particular day to create a large number than falling off again. Reality is that two shots, small number still in percentage terms and a single shot not adequate at the moment as it seems even that number is not very large. So if we look at it the vaccine issue also is going to bite us at the moment because unless we spend at least another six to nine months vaccinating the people and really getting about 75% of the people vaccinated, we are not going to see that as a major contributor to lowering the numbers. And if we look at what we are seeing in terms of the vaccine production, we are not seeing the spike the government had promised, maybe we'll take that up another what are the detailed vaccines that are coming out supposed to be coming out where they are in the production stage, how much has been the production, how much production has been ramped up, that's a different issue. But you did talk about the other issue that even in countries which have relatively more stronger vaccine programs like it is said the European Union, the United Kingdom and the United States, they're still patchy because a large number of people who have not been vaccinated were not even being counted because they're supposed to be illegal immigrants and they are now acting as large vectors or reservoirs of people who are completely unprotected and therefore right for the vaccine for the virus to spend. So absolutely the fundamental completely unsurprising and depressing truth is that existing inequities are exacerbated in epidemic times. They are exacerbated because people are not counted as you point out. They are exacerbated because marginalized communities are correctly skeptical of the state and therefore show vaccine hesitancy that is derived from a completely different source than that in affluent anti-science communities and because their vaccine supply and their vaccine delivery systems are much less reliable and far more patchy and therefore single dose vaccination is likely to be far more common amongst those communities, the marginalized, the undocumented, the disempowered communities and as we pointed out the emerging more transmissible variants even though single doses might well provide for protection against severe illness and death do not provide for particularly good protection against infection and transmission and all of this together is creating what we said a few months ago as the situation where there are large communities in which the virus is spreading a butting vaccinated communities in which virus variants that are being generated in this pool are being tested against the vaccinated communities so to say. We are inviting the emergence of true vaccine escape variants as a consequence of iniquitous vaccination. Well, that's an interesting point because what we then seem to be inviting as you were saying is that a condition where the viruses or the virus strains will emerge which will defeat the vaccine at least to some extent and therefore it will also show that we need a new generation of vaccines already they're talking about third dose of vaccines in the United States in Israel they are arguing that they need a third dose all this is already happening. So back to the old formulation which you have said either everybody wins or all of us lose that's the unfortunate vaccine that we have to follow which unfortunately the rich both in terms of countries and the people don't seem to be following. Satyajit while all this is true what you said there is also the other part of it both in the United States and the United Kingdom which we seem to know more about because of our colonial past and English being the language which is common to the educated elite in India as well as the whatever we call them in the ex-colonial or settler colonial states of United States and United Kingdom. The there is now from both the government and including the CDC the argument that people who have been vaccinated have to see two shots don't have to wear masks what does it actually indicate because don't you think that asking some people to wear masks not others in fact is in going to invite a more COVID inappropriate behavior by everybody. I must confess that while I see this so-called scientific rationale in the sense simply that the vaccinated are much less likely to be productively infected I am deeply, deeply skeptical of this advice for withdrawing completely from epidemic appropriate behavior. It is one thing to begin to open up both the economy and culture at large it is another to begin to create a situation where there are two classes of people the vaccinated who have privileges that the unvaccinated don't this is particularly important because the unvaccinated are not at all necessarily unvaccinated by choice especially they are not necessarily unvaccinated as a result of some anti science anti-vaxxer perspective but simply as a consequence of not having had access not having had structured not having had opportunity or being justly suspicious of the state under these circumstances to create effectively two classes of privileges is an invitation to worsening inequities I think it is therefore deeply improper for such advice to include this complete opening up I can imagine that under some very restrictive and specific circumstances a permission for the vaccinated and not for the unvaccinated such as Wimbledon tennis tournaments such as football matches all of this I say with less than serious tone but I can imagine that there are situations where one might allow a vaccination certificate to give some small privilege but these are policies that need to be extremely careful extremely graded extremely specific and extremely nuanced if they are not to translate into massive exacerbated inequities which we might start to see the United States and the United Kingdom again because it does see the numbers are going up again over there and we know that successive COVID infections do take place it is a gap of 68 months and it is a new variant so given that what you are saying is that of course we are still talking about countries who have vaccines there is an Africa large parts of Asia large parts of Latin America we still don't have vaccines for majority of its people so this is perhaps not the signal that we should be discussing here but the reason of discussing is unfortunately what we see in the United States and the United Kingdom particularly in countries like India and the Indian then we try to follow them and this is therefore something which can have dangerous consequences in India as well thank you very much Satyajit for being with us sharing with us as usual your insights into a rather complex and difficult problem because it is not a problem of science not a problem of biology it is a problem of also society and of course ultimate issue which is all what seems to be what the ruling parties governments classes look for the question of money who benefits who loses this is all the time we have for NewsClick today do keep watching NewsClick and do visit our website