India's COVID-19 response: science first

The Editorial¹ about India's COVID-19 emergency was disappointing to read and does not behove a venerated journal such as The Lancet.

Since the onset of the pandemic, media and medical literature has pursued the progress of this infection, its complications, and its social and economic implications. Some publications follow the data generated daily by various hospitals, districts, and states in India, which work together as one big machine in diagnosing, tracking, and reporting patients and their outcomes.2, 3 Other publications critique all these data. There are self-deprecatory analyses, interpretations of what could have been done, condemnations of the painstakingly built processes, and frank denigration of the health-care professionals involved in this effort.

It is sad to see that the Editors¹ are keen to give a verdict on the Indian COVID-19 emergency and the so-called botched vaccination campaign on the basis of media reports, rather than medical evidence. We do not understand why such an important scientific journal should embark on such political commentaries and arrive at prejudiced decisions.

The response of any country to a pandemic is a complex process that is guided by its existing health infra­structure, the scalability of both skilled labour and machinery to counter the infection, the rapidity in establishing vaccine immunity, and the economic feasibility of a lockdown. At this point in time, when health and economic crises cannot be separated from each other, the only way out for medical communities is to stick to what they do best: the science of preventing and treating diseases. The Indian response of testing strategies, vaccination dosing, and treatment algorithms have all been well considered by teams of doctors and health-care professionals with knowledge and understanding in both public health and infectious diseases. Many health decisions, although seemingly guided by economic policy, have existing evidence at heart.

India, as a nation, has stood firmly to manage the unprecedented challenge caused by COVID-19 infections, with both government and non-governmental support augmenting preventive and thera­peutic health-care facilities, diag­nostic and research facilities, and tracking services, to minimise the loss of human life. The management model adopted at the national and at the state level (including the largest state of Uttar Pradesh, with a population of 240 million), has been well lauded nationally and internationally during these trying times for planning and execution. The second wave has caught the nation unaware with its rapidity and magnitude. Despite this difficulty, the case fatality rate has yet to be as high as that observed in many high-income countries with the financial luxury of complete lockdowns for months on end. India has held on strong and has not witnessed a breakdown in the supply chain of health infrastructure despite the effect of the virus. India can also be proud of being a nation that has provided the same treatment to its rich and poor in this pandemic.

It is always easier to be wiser in hindsight. History will be the judge and jury for all decisions. Until then, let medical professionals work together with science in front and forget the politics of decisions.