The mainstream media’s reporting on the ‘COVID crisis’ in India has clearly been governed by a global approach to messaging that appears to aim at ramping up fear of ‘new variants’ and coerce compliance to vaccination during a period of increasing resistance, both in India and abroad. However, as somebody who lived in India for 8 years in total until December 2019, and as the fundraiser for a food bank in Bihar that has been alleviating the hunger caused by lockdowns , I have daily contact with people in India as well as some context for the figures being presented amidst the ongoing alarm.
Firstly, the media are presenting cases and deaths in whole numbers that sound horrendous until you convert them to percentages of India’s huge population of 1.4 billion people. The current daily death rate in India of 2,600 is equivalent to 126 deaths per day in the UK, way below our peak rate and closer to what we are experiencing now. See the graph produced by JHU below to understand the context .
Secondly, even as the alleged COVID deaths reach their peak more people die of diarrhoea every day in India and have done for years, mostly due to a lack of clean water and sanitation creating a terrain ripe for the flourishing of communicable disease .
Thirdly, Delhi, the focus of the media’s messaging, and the source of many of the media’s horrifying scenes of suffering, has the most toxic air in the world which often leads to the city having to close down due to the widespread effects on respiratory health [4, 5, 6]. This even led to Sonia Gandhi and her son Rahul having to flee the city in November 2020 until the air quality improved .
Fourth, high stake assembly elections are going on in some of India’s biggest states at present . Delhi’s toxic air has been a political football for years that neither dominant party addresses directly, preferring to call on individuals’ collective efforts to tackle the problem. Therefore, blaming the soaring respiratory problems that require oxygen on a COVID surge skilfully diverts attention from the ongoing political neglect of this urgent public health issue.
Fifth, respiratory diseases including COPD, TB, and respiratory tract infections like bronchitis leading to pneumonia are always among the top ten killers in India . These conditions are severely aggravated by air pollution and often require oxygen which can be in short supply during air pollution crises. Delhi even saw its first oxygen bar open in 2019, where wealthier residents can pay for a 15-minute blast of oxygen during toxic periods .
Finally, the Indian government’s focus on vaccine procurement risks diverting resources from tackling urgent public health issues including access to clean water, sanitation, clean air, and treatments for other communicable diseases. An article in the British Medical Journal reported on disrupted access to TB vaccinations due to lockdowns , with TB known to cause around 1.4 million death worldwide each year with around 450,000 of those deaths in India annually.
According to my contacts on the ground, people in Delhi are suffering from untreated respiratory and lung conditions that are now becoming serious. I’ve also had breathing problems there when perfectly healthy and started to mask up to keep the particulate matter out of my lungs. I used to suffer from serious chest infections twice yearly during the big changes in weather in India, usually November/December and April/May. When I reluctantly masked up that stopped. My contacts have reported that the usual seasonal bronchial infections have not been properly treated by doctors afraid of getting COVID, and due to people’s avoidance of government hospitals out of fear of getting COVID. Undoubtedly, these fears will have been fuelled by the media’s alarmist coverage of the situation. Consequently, the lack of early intervention means many respiratory conditions have developed life-threatening complications. Also, people from surrounding rural areas often travel to Delhi for treatment as it has the best healthcare facilities and people can go there for a few rupees by train. This puts pressure on Dehli’s healthcare system during respiratory virus seasons.
Until now, my contacts report that vaccine take-up among the working classes and other minority groups has been low due to widespread mistrust of government-funded vaccination camps. In the context of successive governments’ neglect of other longstanding public health problems that disproportionately affect India’s working class, the rolling news coverage of COVID and lockdowns are perceived as attempts to coerce vaccination compliance. Also, many perceive COVID as a disease more likely to affect the wealthy living in gated urban environments with air conditioning; therefore, a reluctance to comply endures. Vaccination is now being promoted over cheap early treatments that were previously widely available, and while vaccine take-up has increased, so have deaths concordantly as displayed in the graphic from John Hopkins University below . While correlation does not equal causation, most people I have spoken to do not believe this is merely a coincidence. Given the widespread availability of the data online, and anecdotal reports of adverse reactions and deaths, suspicions of the vaccination campaign remain.
When we consider the current media coverage of India’s alleged COVID crisis in the context of the multiple factors presented above, clearly people’s concerns are not unfounded, and all is not what it seems.
1. Just Giving (2020) ‘We’re Raising £3000 to Continue the Food Bank in Bodhgaya’ https://www.justgiving.com/crowdfunding/foodbankbodhgaya
3. Times of India (2021) ‘These Diseases Kill Many More Than the Coronavirus’ https://timesofindia.indiatimes.com/india/these-diseases-kill-many-more-than-coronavirus/articleshow/74670863.cms
4. DW.com (2020) ‘India: Smog Causes Health Emergency During Merkel Visit’ https://www.dw.com/en/india-smog-causes-health-emergency-during-merkel-visit/a-51083303
5. Al Jazeera (2020) ‘India’s Capital New Delhi Suffers Most Toxic Air in a Year’ https://www.aljazeera.com/news/2020/11/5/indias-capital-new-delhi-suffers-most-toxic-air-in-a-year
6. Thomas, V and Tiwari, C. (2020) ‘Delhi the World’s Most Polluted Capital Fights Back’ Brookings https://www.brookings.edu/blog/future-development/2020/11/25/delhi-the-worlds-most-air-polluted-capital-fights-back/
7. The Hindu (2020) ‘Air Pollution: Sonia Gandhi Shifts to Goa on Medical Advice’ https://www.thehindu.com/news/national/air-pollution-sonia-gandhi-shifts-to-goa-on-medical-advice/article33140498.ece
8. Indian Express (2021) ‘Assembly Elections 2021 Live Updates’ https://indianexpress.com/article/india/assembly-elections-2021-live-updates-west-bengal-kerala-tamil-nadu-puducherry-assam-7250933/
9. BBC News (2019) ‘Delhi Pollution- The Bar Selling Oxygen to Choking City.’ https://www.bbc.co.uk/news/av/world-asia-india-50502972
10. Pai, M. et al. (2020) ‘India’s Syndemic of Tuberculosis and COVID-19’ BMJ Editorial https://gh.bmj.com/content/5/11/e003979
11. John Hopkins University CSSE Covid-19 Data (2021) https://github.com/CSSEGISandData/COVID-19