India

WHO Estimates of India’s Covid Deaths Are Highly Suspect

On May 5th, the World Health Organisation (WHO) issued a new report estimating global excess deaths at 14.9m for two years of the pandemic 2020-21 as the true COVID-19 mortality toll, nearly triple the official toll of 5.44m. “Excess mortality” is the difference between the number of deaths that would be expected in any time period based on data from earlier years and the number of deaths that have occurred. For countries with robust data surveillance, reporting and recording systems, this poses no real difficulty. Unfortunately, these conditions are not met in many countries. Therefore their excess mortality can only be estimated and the accuracy is a function of the reliability of the methodology and modelling used in the exercise. Given the overwhelming evidence about the flaws and deficiencies of Covid-related modelling over the last two years, and the damage caused by governments trusting modelling projections over real-world data, this should immediately throw up a forest of red flags about the WHO report.

A second reason to be sceptical is the less than stellar role of the WHO in its well-known Covid-related deference to China, the abandonment of its own summary of the state of the art science on managing pandemics from October 2019, its willingness to manipulate definitions of ‘herd immunity’ in relation to vaccines and natural immunity in order to fit with the experimental pharmaceutical and non-pharmaceutical interventions (NPIs) that came to dominate Covid policy around the world, and its self-interest in expanding its budget, authority and role in steering global health policies and management by means of a new international treaty.

WHO’s Dubious Model that Claims the Real Pandemic Death Toll is 15 Million – and 5 Million of Them Are in India

First we had the Economist claiming to be able to work out how many had really died in the pandemic, then the Lancet joined in. Now it’s the turn of the World Health Organisation. While the Economist and Lancet claim the true toll is around 18 million (though find a very different distribution across countries), the WHO goes for 15 million. Once more we find that the (massive) gaps in reported data are filled in with modelling: “The methods rely on a statistical model derived using information from countries with adequate data; the model is used to generate estimates for countries with little or no data available.”

The estimates for India are particularly inflated and have drawn sharp criticism from the Indian Government. The WHO claims that India experienced 3,400 deaths per million over the two years (note the figures quoted in most reports as WHO estimates for 2020-21 are an average of the two years), which amounts to 4.69 million total deaths – almost a third of the global total. That’s nearly 10 times more than India’s official Covid death toll.

India’s official Covid death toll in 2020 is 148,994. The Government said this week that its official estimate of additional deaths in 2020 compared to 2019 is 474,806, which is 3.2 times higher than the official Covid toll. It hasn’t yet provided its estimate for additional deaths in 2021, but we know that the official Covid death toll for 2021 is 332,492. If we assume the same degree of undercounting then the number of additional deaths in 2021 would be 1.06 million. (Note that India has around 10 million deaths each year, so this represents about a 10% excess mortality in 2021.) Adding the two together gives 1.54 million additional deaths for 2020 and 2021. The WHO’s estimate of 4.69 million is three times higher than this. No wonder the Indian Government is disputing the findings.

Indian Supreme Court Rules Vaccine Mandates Unlawful as Courts Around the World Push Back Against Pandemic State Overreach

It’s been over two years since waves of ever tightening restrictions, including wholesale house arrests, began to be placed on healthy citizens who had committed no crime. One by one, the world’s democracies buckled to the herd panic about the Covid pandemic sweeping the world and their governments increasingly took on hues of totalitarian regimes in telling people when, where, how far, how long and with whom and how many they could go out or even sleep with; what businesses could operate and under what conditions; what medications doctors could and could not prescribe irrespective of their own professional judgement and knowledge of their patients; and mandatory mask and vaccine requirements for an array of social and professional interactions.

Many directives lacked scientific basis and some were downright wacky – there really is no better word for it. The apotheosis of executive overreach came in Canada with the truckers’ Freedom Convoy in Ottawa and in the Australian state of Victoria. In both, MPs betrayed the people, the country and the constitution by putting their own careers first, the party second and the country last. The unchecked growth of the administrative state and centralisation of authority, power and decision-making in prime ministers’ and premiers’ offices fused seamlessly into the rise of the biofascist state. Complicity by the media in propagating fear porn, social media censorship of alternative voices and threats of disciplinary proceedings including dismissal and deregistration by professional governing bodies ensured there’s been a stifling conformism.

Omicron: The Phantom Covid Wave

In most countries, reported infections have hit record highs during the Omicron wave, smashing previous records.

Fortunately, the variant has turned out to be up to 90% milder than the previous Delta variant, so the large outbreaks have not led to overwhelmed hospitals or heavy death tolls. Nonetheless, many countries have seen substantial waves of Covid deaths, notably Denmark, but also South Africa (where the deaths have continued to climb despite reported infections dropping off since mid-December), Austria, Germany, Switzerland and Norway (among others, including America).

Indian Researchers Find that Natural Immunity Protects Better Against Infection than the AstraZeneca Vaccine

I’ve already covered three studies that found natural immunity protects better against infection than the vaccines. These comprise two from Israel, and one from Denmark. In each case, individuals who’d already had Covid were much less likely to become infected than those who’d been vaccinated.

Now a fourth study has come to my attention; this time from India. (The study was published as a preprint back in August.)

Malathi Murugesan and colleagues monitored infections in a cohort of healthcare workers between April and June of this year, during the country’s second wave. They compared four groups, corresponding to the different combinations of previously infected or not, and vaccinated or not.

Note: the vast majority of participants had received the AstraZeneca vaccine. This is in contrast to the Israeli and Danish studies, where most individuals had received another vaccine (mainly Pfizer).

Among those who hadn’t been previously infected or vaccinated, the cumulative infection rate was 14.9%. It was slightly lower among those’d been vaccinated but not previously infected, namely 11.1%. And it was dramatically lower among those who’d been previously infected: 2.1% among those who hadn’t been vaccinated, and 1.4% among those who had.

To check these results were robust, the authors ran a statistical model controlling for age, sex, type of work, and the daily incidence of Covid in the surrounding area (the city of Vellore in Southern India).

They estimated the protective effect of natural immunity to be 86% (which is consistent with a recent systematic review). By contrast, vaccine effectiveness was only 32%. As expected, the protective effect of hybrid immunity was 91% – slightly better than that of natural immunity alone.

There are now four separate studies all showing the same thing: several months after the corresponding event, natural immunity provides substantially better protection against infection than the vaccines.

“Vaccination efforts,” the Indian researchers note, “should be optimised by directing vaccination towards the areas where individuals are non-immune.” In other words, there was no need to vaccinate healthy people who’d already had Covid; those vaccines should have gone to the clinically vulnerable in poor countries.

Why Are Sweden and India Not Seeing a Covid Surge?

Why are some countries surging this autumn but others aren’t, at least not yet? Much of Europe is now seeing sharp rises in reported infections. In some it appears to be a delayed Delta surge, but in others like France, Netherlands, Norway and Finland it comes after an earlier summer Delta ripple that looked like it had gone away. Yet India, which had (quite literally) the mother of Delta surges, has not seen any new rise despite only 29% of its population being double-vaccinated, and despite the festivals of Diwali and Durga Puja, widely warned about as a transmission risk, taking place in the autumn.

Sweden, meanwhile, has somehow so far managed to avoid Delta surges altogether, after being hit relatively hard in spring 2020 and winter 2020-21. The country famously imposed only light restrictions (no stay-at-home orders, school or business closures or mask mandates at any point). Similarly, few restrictions were imposed in India in 2021, and there is also doubt about how far Indian citizens have followed any restrictions that were brought in; in any case, high population antibody rates were subsequently reported. Are India and Sweden benefitting from a more robust immunity owing to greater exposure prior to this autumn? What happens this winter will help to clarify this question.

The U.K. meanwhile is experiencing a strangely drawn-out Delta epidemic. Beginning in June, it has now been simmering away at around about the same level for five months, neither exploding as the models predicted, nor dropping off again back to low levels, as earlier waves have done.

India Confounds the Modellers

What happened to India’s summer and autumn waves? After suffering a large surge with the emergent Indian variant (i.e., Delta) in the spring, India has defied modellers’ predictions by remaining very quiet since.

In August, Rajib Dasgupta, Chair of the Centre of Social Medicine and Community Health at Jawaharlal Nehru University, wrote for the Conversation about the “likely” imminent new autumn surge.

With about 40,000 cases and 400 deaths each day as of mid August, a new uptick is likely in the cards. The Indian states experiencing most of these new cases are those with relatively lower sero-prevalence, ranging between 50% and 70%. The 400 million sero-negative pool – that is people who have not been infected or had the vaccine – continues to be a large vulnerable group.

Forecasting by modellers indicates a third wave beginning in August and peaking at 100,000 to 150,000 infections a day by October. An alternative projection expects the peak in cases going until November.

It’s October now and the reality, of course, is a low level of infections since June and no new surge throughout summer and autumn so far. Below is the graph showing the predictions from the modelling of Mathukumalli Vidyasagar and Manindra Agrawal of the Indian Institute of Technology that Rajib Dasgupta cites above. I have added in the line of actual ‘cases’, which shows that they have trended well below the ‘optimistic’ scenario since the moment the prediction was made.

The Role of Variants in Driving Surges is Good News for Sceptics

As an addendum to my piece yesterday on the evidence for variants driving Covid surges, a comparison between India and neighbouring Bangladesh is illuminating. Once again, the curves below are the positive test rate and they are superimposed on the graphs of variant proportions over time from the CoVariants website.

India

India has had one large surge in 2021 so far, occurring in spring and associated with the Delta variant (which was first identified there; in dark green). It has had no summer surge, and no new variant since.

Bangladesh

Bangladesh, on the other hand, has had two peaks in 2021, a spring peak associated with the Beta variant (light red) and a summer one associated with the Delta variant.

No, Minister, Vaccine Passports Are Not Necessary to End the Pandemic

Vaccines Minister Nadhim Zahawi has insisted to MPs in the Commons that vaccine passports are necessary to end the pandemic. The evidence, however, suggests otherwise.

While the U.K. has seen a spike in reported ‘cases’ in recent days, much of it is driven by the increase in testing as schools have returned. The positive rate, by contrast, shows a gentle decline.

There’s no sign here of vaccine passports being needed to prevent unmanageable spread.

What about elsewhere? Israel is a highly vaccinated country which got in there early with vaccines, so that upwards of 55% of the population has been double vaccinated since early April, and it has made extensive use of vaccine passports.

India, by contrast, is a low vaccination country which only recently broke through 10% double vaccinated.

How are they faring? Israel is currently experiencing a big surge in Delta infections, at a time when over 62% of the population is double vaccinated.

The Truth About the Covid ‘Crisis’ in India

Now that Chile is settling down a bit, the latest Covid cautionary tale is India, which never seems to be out of the news at the moment as its positive cases and deaths have rocketed in the past few weeks.

Even the usually level-headed Kate Andrews in the Spectator has been painting the situation in lurid colours.

As it happened, the UK’s worst nightmares were never realised. The Nightingale hospitals built to increase capacity were barely used. But what the British Government feared most is now taking place elsewhere. India is suffering an exponential growth in infections, with more than 349,000 cases reported yesterday, as well as nearly 3,000 deaths. Hospitals are running out of oxygen for patients and wards are overflowing. There are reports of long queues as the sick wait to be seen by medical professionals. It’s expected the situation will deteriorate further before it gets better.

Jo Nash, who lived in India until recently and still has many contacts out there, has written a very good piece for Left Lockdown Sceptics putting the current figures in context – something no mainstream outlet seems to have any interest in doing.

Jo makes the crucial point that we need to keep in mind the massive difference in scale between India and the UK. At 1.4 billion people, India is more than 20 times larger than the UK, so to compare Covid figures fairly we must divide India’s by 20. So 2,000 deaths a day is equivalent to a UK toll of 100. India’s current official total Covid deaths of approaching 200,000 is equivalent to just 10,000 in the UK.

In a country the size of India and with the huge number of health challenges faced by the population, the number of Covid deaths needs to be kept in perspective. As Sanjeev Sabhlock observes in the Times of India, 27,000 people die everyday in India. This includes 2,000 from diarrhoea and 1,200 from TB (vaccinations for which have been disrupted by the pandemic). The lack of adequate hospital provision for Covid patients may be more a reflection of the state of the health service than the severity of the disease.

Jo Nash also points out that poor air quality plays a role.

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…

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…

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 people’s avoidance of government hospitals due to 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 Delhi’s healthcare system during respiratory virus seasons.

Positive cases look like they may be peaking in many regions now.