At times, Prime Minister Narendra Modis government hasseemed more intent on removing criticism on Twitter than trying to control theCovid-19 pandemic, medical journal The Lancet has said in an editorial.
"Modi's actions in attempting to stifle criticismand open discussion during the crisis are inexcusable," Lancet said.
The editorial published in the world's most renowned medicaljournal said the Institute for Health Metrics and Evaluation (IHME) estimatesthat India will see a staggering 1 million deaths from Covid-19 by August 1.
"If that outcome was to happen, Modi's governmentwould be responsible for presiding over a self-inflicted nationalcatastrophe," Lancet said in a scathing criticism of the government.
Lancet said India squandered its early successes incontrolling Covid-19. Until April, the government's Covid-19 taskforce had notmet in months, it said.
"The consequences of that decision are clear beforeus and India must now restructure its response while the crisis rages. Thesuccess of that effort will depend on the government owning up to its mistakes,providing responsible leadership and transparency, and implementing a publichealth response that has science at its heart," Lancet said.
In the suggested course of action, Lancet said India mustreduce SARS-CoV-2 transmission as much as possible while the vaccine is rolledout.
"As cases continue to mount, the government mustpublish accurate data in a timely manner, and forthrightly explain to thepublic what is happening and what is needed to bend the epidemic curve,including the possibility of a new federal lockdown," it said.
Genome sequencing needs to be expanded to better track,understand and control emerging and more transmissible SARS-CoV-2 variants, itsaid.
"Local governments have begun taking diseasecontainment measures, but the federal government has an essential role inexplaining to the public the necessity of masking, social distancing, haltingmass gatherings, voluntary quarantine, and testing," it added.
Lancet said the botched vaccination campaign must berationalized and implemented with all due speed. There are two immediatebottlenecks to overcome: increasing vaccine supply (some of which should comefrom abroad) and setting up a distribution campaign that can cover not justurban but also rural and poorer citizens, who constitute more than 65 percentof the population (over 800 million people) but face a desperate scarcity ofpublic health and primary care facilities, the editorial said.
The government must work with local and primaryhealthcare centres that know their communities and create an equitable distributionsystem for the vaccine, it added.
Lancet said the scenes of suffering in India are hard tocomprehend. As of May 4, more than 20.2 million cases of Covid-19 had beenreported, with a rolling average of 3,78,000 cases a day, together with more than2,22,000 deaths, which experts believe are likely to be substantialunderestimated, Lancet said.
Hospitals are overwhelmed, and health workers areexhausted and becoming infected. Social media is full of desperate people(doctors and the public) seeking medical oxygen, hospital beds, and othernecessities, it said.
Lancet said that yet before the second wave of cases ofCovid-19 began to mount in early March, Minister of Health Harsh Vardhandeclared that India was in the "endgame" of the epidemic.
The impression from the government was that India hadbeaten Covid-19 after several months of low case counts, despite repeatedwarnings of the dangers of a second wave and the emergence of a new strain, itadded.
"Despite warnings about the risks of superspreaderevents, the government allowed religious festivals to go ahead, drawingmillions of people from around the country, along with huge political rallies—conspicuous for their lack of Covid-19 mitigation measures," theeditorial said.
The message that Covid-19 was essentially over alsoslowed the start of India's Covid-19 vaccination campaign, which has vaccinatedless than 2 percent of the population, it said.
"At the federal level, India's vaccination plan soonfell apart. The government abruptly shifted course without discussing thechange in policy with states, expanding vaccination to everyone older than 18years, draining supplies and creating mass confusion and a market for vaccinedoses in which states and hospital systems competed," it added.
The crisis has not been equally distributed, with statessuch as Uttar Pradesh and Maharashtra unprepared for the sudden spike in cases,quickly running out of medical oxygen, hospital space, and overwhelming the capacity of cremation sites, and with some state governments threatening thoseasking for oxygen or a hospital bed with national security laws, Lancet said.
Others, such as Kerala and Odisha, were better prepared,and have been able to produce enough medical oxygen in this second wave to exportit to other states, it said