 Hello and welcome to People's Dispatch and Newsclick and today we are going to look at the COVID-19 situation in India. We've been regularly tracking this and it's the weekly update. We are with us, Praveer Gurkaisar of Newsclick. Praveer, thank you so much for joining us. So, to start with, we see that the number of cases has crossed as of today morning. That's Wednesday morning's numbers. The number of cases has crossed 276,000. The number of deaths is around 7,700 just about that. And more alarmingly, we see that the number of new cases daily is very close to the 10,000 mark. And this has been happening over the past couple of days. And we see that the increase in numbers has been drastic, especially in the past one to two weeks. So, India's situation is a bit unlike some of the other countries where the curve has been flattening and there have been talks about reopening. So, how do you evaluate the progress of the disease or the trajectory of the disease in India, especially in an international context when we consider some of the other countries? You know, if we look at the numbers that you've talked about, what I think is disturbing at the moment is that these numbers, the increase of these numbers have taken place after the prolonged lockdown. So, we have had four phases of lockdown and these numbers are still going up at a rate which for some of the states like Delhi and Maharashtra, where the maximum numbers at the moment are coming from, the doubling rate in Delhi is about, say, 12 to 14 days. Maharashtra is right now between 18 to 20 days. So, Maharashtra seems to have slowed down a bit. But there are other states which are showing 12 to 14 days of doubling rates. So, this is not a good sign. The other disturbing sign is the number of deaths. If you see at the moment in terms of new infections, you have already said India is pretty much near the top of the world in the sense that it's only countries ahead of it at the moment are the United States and Brazil. So, India is virtually having at the moment, along with Russia. Today we are a little ahead of Russia. Yesterday we are a little behind Russia. We are really joint third, shall we say, in terms of new infections, as you can see from the Worldometer chart. But if you see the death figures, that is also disturbing. India is just behind the UK in the number of deaths, since the deaths lagged the number of infection figures quite a bit. So, this is the figure which is likely to go up further as the infections increase, the infection rate grows as it is now growing. So, what you are likely to see is the number of deaths starting to climb further. And that would put India, again, at the moment, fourth highest to probably the third highest. So, it's not a good position to be in, just behind the United States and Brazil in these two parameters, because they show you the current speed at which the epidemic is moving. And that also brings up the second question in the epidemic, that after all you had about more than two months up during the lockdowns to prepare. You had at least two months to prepare before that. So, what is the preparation you now have to handle the increased number of patients you are starting to see, particularly in the metropolitan centers like Delhi and Mumbai, where the major numbers we are seeing are now. But these are things which will probably spread to Chennai, which is already spreading Madras and also to Calcutta or Polkata as it is now called. So, these are the figures that are worrying, because they seem to indicate that we are going to see a surge. And the number of deaths indicate that our health system may not be able to cope with the numbers we are seeing. So, yes, I would say the picture is not good. And it does show that the body government, which it started with when it introduced a lockdown, there were only about 600 odd cases in India. So, from that time to now, the lockdown has not successfully done what it was supposed to, because you have dealt with it in a completely police with a police approach and not a public health approach, which is why we did slow down the spread of the epidemic. That's true. That's something that we really did do, but we didn't do what is next required to do, which is bring it down. So, those rates, which in almost all countries where lockdowns have been imposed, you have seen the infection rates fall after some time. That's not happening. In fact, the infection rate is either constant or going up. And that, I think, is what is the crisis we are now going to see. Could you elaborate a bit more on what you mentioned about the necessary steps were not taken, because like you pointed out in most countries, what we have seen is there have been lockdowns of considerable severity and it has had a good result. In India, the lockdown was considered one of the most severe in the world and it was accepted by the people at large too. So, what really did not work as far as the lockdown was concerned? So, let's look at first the rates. Now, if you see the period from the last, say, 50 odd days, you will see that after the initial 10-15 days, the rates are all constant. That means we did slow it down initially somewhat, but after that, the rate of rise is constant, which means it is an exponential rise, but a slower exponential rise, which means the numbers are going to only grow up a bit slowly. So, this is the basic crisis that we have. And as you know, if the reproduction, reproductive rate of, in fact, basically the people who infect, one person, how many people do they infect? If it is more than one, the infections will only increase, the number of patients will only increase over the period of time. So, that's what we see here, that yes, continuously the figures are going up and Maharashtra is now overtaking many countries in the world. Delhi is, of course, not the same population as Maharashtra, but still it is ahead of many countries, most countries. So, if you look at all of this, and we also have Tamil Nadu, we have Gujarat, all of them are figures are large. You will see that the rate of increase somewhat less or a little more, but still steady. So, what are the figures, as you said, what are the steps that should have been taken? One step is, of course, the testing, which we have talked about earlier also, that India's testing is still, in terms of 1,000 people, still low. If you look at the Worldometer site, which gives you testing that different countries are doing, then you will find India has a test rate of 3.5 per thousand. These figures are per million. So, you have to divide by thousand to get the figures. And even if you take countries like Iran, which are not very dissimilar in capacity that India, in fact, I would say India should have a larger capacity. After all, Iran is under brutal sanctions by the United States at the moment. You will see they are 13.5. And we can go on to compare it to other countries. And you will see, for instance, countries like Thailand have much better test figures. Malaysia has much better test figures. So, our testing figures are not very encouraging. And this is bought out also by the kind of testing that we are doing per day, that yesterday our testing was 150,000. If you're adding about 10,000 per day, then 150,000 tests are low. You really need to test at least five times more than what we are testing today. So, you really need to ramp up your testing to about 100,000 per day or 50,000 per day if you're not going to ramp it up that fast. So, what you are seeing is actually a low ramping up of the testing system. And the second part of it, which is that you need to do also contact tracing on a large scale, which is of course not what you're doing. So, if you're not doing contact tracing, you are not doing testing on a large scale, then obviously the first line of defense is not working. That is one. The second part of it, which is how prepared are you for the hospitals. And this is the big issue that, you know, the deaths are not avoided as it is claimed by the governments, that because of the lockdown, we've avoided deaths. If you do not crush the epidemic, what you do is have a slower rate of spread of the epidemic, in which case you can cope with the emergency that the pandemic introduces and your health system is not overwhelmed. This is what Germany did. They had a very large set of infections. But as you can see, the German death rates are much lower than Italy and France, which actually the health system got overwhelmed by the infections. The German system could cope up with it. So, what you do is have enough intensive care facilities available, enough COVID beds available in your hospital system to be able to take care of the patients that are going to turn serious. Because it's true that within the number of people you have, there is going to be a certain percentage who are going to start getting serious in terms of illnesses. And if you see the death figures, and that's where the real worry at the moment is, you will see if a Maharashtra, there will be a large number of deaths. If you take, for instance, Gujarat, again a large number of deaths. If you take Delhi, again a large number of deaths. So you can see the top three figures kind of graphs over there are death graphs that all three of them are showing rather high number of deaths per thousand of people infected and so on. And if you make this the case fatality ratio as it is being talked about. Now, government of India, for instance, is claiming of the total population of infected. These are the number of people who have died. But if you look at the fact that people who have infected in the last 10 days, 15 days, are going to turn serious. So, deaths don't take place at the same time. So, if you have say 15,000 people who have turned sick in the last five, six days, which is what the reality is that none of them would have reached that level of infection, meaning that they would not become serious. And therefore, they would die early. So, therefore, these figures are not correct if you take a moving scenario. And if you do that to really have a realistic view, you're probably infected to fatality ratios closer to 5% than 3% of the government is claiming, but certainly nowhere near 1% or 2% which is supposed to be the figure that we should really look at. The figures that, for instance, Germany has shown is less than 1%. So, you can control it if you are able to maintain the hospital system and cater to it, but that's not what we have done. We're now only now talking about increasing the temporary hospital beds, getting stadiums and other things into the act. All that should have been prepared for right in the beginning of the lockdown, not now. And therefore, your hospital should have only catered to more serious cases and not anybody who is sick. And that's the real problem that we now have, that we don't have the separation of the serious from just those who are infected with COVID. We're not able to separate them. And we are also not able to separate the people who are infected with COVID and who are not tested, who are lying at home and infecting others. And finally, probably a question about how the Indian political system, especially the government, is responding to this. So we talked about this before. There has been a transparency deficit, so to speak, unlike the examples in many of the countries. And there's also something you've been writing about, which is that the larger public health and community angle to tackling COVID-19 has not really been visible in most parts of the country, except maybe Kerala. So could you talk a bit about that? When the Home Minister starts talking about what has the opposition done, that itself is a sign of admission that he is really accepting that they did not succeed in controlling the epidemic. It's an admission in that sense of defeat from the lockdown they had imposed with all the enormous pain they've inflicted, particularly on the poor, the migrant population, the rural workers and so on. So it's a huge admission to make. So it's done in the typical combative, what about mode that this government seems to have painted. But leaving that out, the issue is this entire issue is handled under what is called the Disaster Management Act, which imposed a virtual emergency on the country and handed over all the powers to the Central Government. It still has not been withdrawn. So all our actions are still taking place under the Disaster Management Act, which really centralizes power. So therefore, from the beginning, it has been an extremely top-down approach. And apart from the Kerala government, and maybe to some extent, certain other governments, most governments have followed on that same principle of centralizing authority, which you can see in Delhi as well, that the Kejriwal government, the UP government, which came with the promise of being different from others, has basically handled it in the same mode of top-down instructions using only the government machinery. So that is not the right way to fight it, because as the WHO joint team in China, the report said, it was an all-in government, all-in people effort. And here it was not only an all-in government effort, it was an all-in central government effort for the first seven days, only now that the epidemic seems to be going out of their hands. Now they are saying, let the states handle it. So this is one part of the problem. The second part of the problem, and this is again squarely with the Central Government, that there are some medicines or treatments which seem to be at least providing some relief, some quick, faster recovery. There is a combination of basic, various antivirals, which we can go over in those figures, which are those which are succeeding. And there seems to be three, four, five of them, which seem to be working. And of course the Remdesivir, which is also quite well known, which also is from Gilead Science Successful, which has been already allowed to be used in India now. This has been officially allowed. But the question is, what is the price for these? And why is the government not issuing compulsory licensing for these cases? So that is the second thing that the government really has to do, which it is not doing. So I think there are failures of involving the people, which you already have talked about. But there are also failures of the other kind, which is not making your public health system strong and robust under conditions of a pandemic, which is really what you need to do. And also looking at the kind of medicines, which if nothing else will at least relieve the symptoms and pull people out of the really the critical phase that they are in. And that is the phrase that we really have to worry about, that that's where the deaths take place. It's not because of the infection per se. It's also the whole, the body, different systems behaving differently under the epidemic. And a lot of it is your basic immune system going out of act. So those are the kinds of things that we are not, we don't seem to be doing. And at the moment, we have now descended to what has the other side done kind of questions while you hold, the central government holds the dominant position today, both politically and administrative. So I don't think that's an escape route for them.