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The COVID-19 Catastrophe in India Keeps Growing

Yves here. Even from what Americans can infer at a remove and with our sanitized reporting, Covid is a national emergency in India with international implications. The scale of the contagion and the breakdown of hospitals means the human tragedy will continue. It won’t simply decimate families and villages but will also thin the ranks of medical professionals. And so many people afflicted with an out of control contagion also means the odds of producing even more troubling and potentially vaccine-escaping variants is not trivial.

Remember that early on, India seemed to be doing something right, or perhaps simply benefitted from having a population where many people spent less time indoors than in advanced economies. But as case numbers grew, Modi imposed a lockdown which produced anticipatory mass migrations back to the countryside as low wage workers anticipated their incomes would dry up. As this article explains, Modi failed to take other basic measures to reduce transmission and death rates.

What is particularly appalling is that the US, which appears to have a vaccine surplus, is nowhere to be seen. Even if our contribution would only make a dent in this catastrophe, any help is better than none.

By Vijay Prashad, Indian historian, editor and journalist. He is a writing fellow and chief correspondent at Globetrotter. He is the chief editor of LeftWord Books and the director of Tricontinental: Institute for Social Research. He is a senior non-resident fellow at Chongyang Institute for Financial Studies, Renmin University of China. He has written more than 20 books, including The Darker Nationsand The Poorer Nations. His latest book is Washington Bullets, with an introduction by Evo Morales Ayma. Produced by Globetrotter

For Ashish Yechury (1986-2021), journalist.

It is difficult to overstate the grip of COVID-19 on India. WhatsApp bristles with messages about this or that friend and family member with the virus, while there are angry posts about how the central government has utterly failed its citizenry. This hospital is running out of beds and that hospital has no more oxygen, while there is evasion from Prime Minister Narendra Modi and his Cabinet.

Thirteen months after the World Health Organization (WHO) announced that the world was in the midst of a pandemic, the Indian government looks into the headlights like a transfixed animal, unable to move. While other countries are well advanced on their vaccination programs, the Indian government sits back and watches a second wave or a third wave land heavily on the Indian people.

On April 21, 2021, the country registered 315,000 cases in a 24-hour period. This is an extraordinarily high number. Bear in mind that in China, where the virus was first detected in late 2019, the total number of detected cases stands at less than 100,000. This spike has raised eyebrows: is this a new variant, or is this a result of failure to manage social interactions (including the 3 million pilgrims who gathered at this year’s Kumbh Mela) and to vaccinate enough people.

At the core is the total failure of the Indian government, led by PM Modi, to take this pandemic seriously.

Disregard

A glance around the world shows those governments that disregarded the WHO warnings suffered the worst ravages of COVID-19. From January 2020, the WHO had asked governments to insist on basic hygiene rules—washing hands, physical distance, mask wearing—and then later had suggested testing for COVID-19, contact tracing and social isolation. The first set of recommendations do not require immense resources. Vietnam’s government, for instance, took those recommendations very seriously and slowed the spread of the disease immediately.

India’s government moved slowly despite evidence of the dangerousness of the disease. By March 10, 2020, before the WHO declared a pandemic, the Indian government reported about 50 COVID-19 cases in India, with infections doubled in 14 days. The first major act from India’s prime minister was a 14-hour Janata Curfew, which was dramatic but not in line with the WHO recommendations. This ruthless lockdown, with four hours’ notice, sent hundreds of thousands of workers on the road to their homes, penniless, some dying by the wayside, many carrying the virus to their towns and villages. Prime Minister Modi executed this lockdown without checking with his own departments, whose advice might have warned him against such a precipitous and unnecessary act.

Prime Minister Modi took the entire pandemic lightly. He urged people to light candles and bang pots, to make noise to scare away the virus. The lockdown kept being extended, but there was nothing systematic, no national policy that one can find anywhere on the government’s websites. In May and June of 2020, the lockdown kept getting extended, although this was meaningless to the millions of working-class Indians who had to go to work to survive on their daily wages. A year into the pandemic, there are now 16 million people in India with detected infections, with 185,000 people confirmed dead from the pandemic. One has to write words like “detected” and “confirmed” because mortality data from India during this pandemic has been totally unreliable.

Consequences of Privatization

The consequences of turning over health care to the private sector and underfunding public health have been diabolical. For years now, advocates of public health care, such as the Jan Swasthya Abhiyan, have called for more government spending on public health and less reliance upon profit-driven health care. These calls fell on deaf ears.

India’s governments have spent very low amounts on health—3.5 percent of GDP in 2018, a figure that has remained the same for decades. India’s current health expenditure per capita, by purchasing power parity, was275.13 in 2018, around the figures of Kiribati, Myanmar and Sierra Leone. This is a very low number for a country with the kind of industrial capacity and wealth of India.

In late 2020, the Indian government admitted that it has 0.8 medical doctors for every 1,000 Indians, and it has1.7 nurses for every 1,000 Indians. No country of India’s size and wealth has such a low medical staff. It gets worse. India has only 5.3 beds for every 10,000 people, while China—for example—has 43.1 beds for the same number. India has only 2.3 critical care beds for 100,000 people (compared to 3.6 in China) and it has only 48,000 ventilators (China had 70,000 ventilators in Wuhan alone).

The weakness of medical infrastructure is wholly due to privatization, where private sector hospitals run their system on the principle of maximum capacity and have no ability to handle peak loads. The theory of optimization does not permit the system to tackle surges, since in normal times it would mean that the hospitals would have surplus capacity. No private sector is going to voluntarily develop any surplus beds or surplus ventilators. It is this that inevitably causes the crisis in a pandemic.

Low health spending means low expenditure on medical infrastructure and low wages for medical workers. This is a poor way to run a modern society.

Vaccines and Oxygen

Shortages are a normal problem in any society. But the shortages of basic medical goods in India during the pandemic have been scandalous.

India has long been known as the “pharmacy of the world,” since India’s pharmaceutical industry sector has been skillful at reverse-engineering a range of generic drugs. It is the third-largest pharmaceutical industry manufacturer. India accounts for 60 percent of global vaccine production, including 90 percent of the WHO use of measles vaccine, and India has become the largest producer of pills for the U.S. market. But none of this helped during the crisis.

Vaccines for COVID-19 are not available for Indians at the pace necessary. Vaccinations for Indians will not be complete before November 2022. The government’s new policy will allow vaccine makers to hike up prices, but not produce fast enough to cover needs (India’s public sector vaccine factories are sitting idle). No large-scale rapid procurement is on the cards. Nor is there enough medical oxygen, and promises to build capacity have been unfulfilled by the ruling party. India’s government has been exporting oxygen, even when it became clearthat domestic reserves were depleted (it has also exported precious Remdesivir injections).

On March 25, 2020, Modi said that he would win this Mahabharat—this epic battle—against COVID-19 in 18 days. Now, more than 56 weeks after that promise, India looks more like the blood-soaked fields of Kurukshetra, where thousands lay dead, with the war not even at halftime.

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92 comments

  1. PlutoniumKun

    From what I’ve read about what is happening in India, its probably much, much worse than is being reported with death rates 10x or more the official ones. So much can happen in remote rural India without ever getting officially counted. It looks like the only real hope for India is that the current wave just burns itself out quickly. The big question though is whether this is being driven by nastier variants. These have already been detected in the UK, so it may well be too late to stop them getting loose worldwide.

    The one issue I’d have with this article is the implied criticism of the Indian government for not following WHO advice. WHO is only now backing down on masks and it was WHO that refused to back flight restrictions based on terrible science. Its only now that a lot of public health scientists are belatedly acknowledging that it was ideology and politics, not science that encouraged so many to claim that international travel was not a problem (as if somehow the virus had wings and could cross oceans all by itself).

    1. curlydan

      I also think that some highly infectious variant is causing all kinds of problems in India.

      If anyone possibly needs another dose of “COVID will humble you and do so quickly”, check out this article from the New Yorker in early March. It was almost a victory lap for India, touting its low COVID rates despite high population density and low health care spending. In a mere two months, COVID is skyrocketing in India on an exponential path.

      https://www.newyorker.com/magazine/2021/03/01/why-does-the-pandemic-seem-to-be-hitting-some-countries-harder-than-others

      1. kareninca

        Maybe covid will humble you or me, but I’m confident that nothing will humble the New Yorker. They have a special variety of amnesia that prevents that.

  2. Maritimer

    “This hospital is running out of beds and that hospital has no more oxygen, while there is evasion from Prime Minister Narendra Modi and his Cabinet.”
    ***********
    I assume that India, like much of the world, if not all of it, has a startling disparity of income, power and influence. So, I also assume that the Elite, the Upper Classes are able to get health services somewhere or escape from the infection. Possibly fly/get out of the country by any means even private jet.

    So, are Prime Minister Narendra Modi and his Cabinet and supporters in any danger of a lack of health services? Are all pandemic victims treated equally?

    I would suggest that these questions should also be applied to countries in the West. I haven’t seen this question addressed by any of the experts. It seems to require an answer from the experts since “we are (supposed to be) all in this together.”

    I note also that there has been an extreme reluctance by most jurisdictions to stop international/domestic flights. I have also never seen any reporting on private plane travel and usage during this pandemic by the experts.

    1. Aaron

      Here is some interesting news. Apparently the affluent city people are the ones who are being disproportionately affected by the virus this time. In the first wave last year, people in poor households were hit more.

      https://economictimes.indiatimes.com/news/india/indias-urban-affluent-hit-by-new-virus-wave-after-dodging-first/articleshow/82228629.cms

      That would probably explain why Twitter is exploding with demands for total lockdowns. Lockdowns don’t hurt PMCs who can shelter in place, work from home and order takeout. It hurts working class more.

      1. Astrid

        I wonder if the breakout is related to air conditioning usage. Pre-monsoon months of March-May tend to be the hottest times in South Asia. It makes sense that wealthy urbanites living and working in air conditioned high rises would be most at risk in this scenario.

      2. Mikel

        But I also remember the first reports in the USA often about how profile, jet-setters coming down with it before it hit those in the service industry and healthcare the hardest.
        Going with the “it started in China narrative”…the poor households in the USS aren’t really the ones booking a lot of international flights.

        1. Erelis

          In Oregon the county with Nike HQ and very large Intel facility had more early infections than Portland. Makes sense given amounts of international travel by sales people, marketing, engineering, foreign born workers returning from home, etc. Portland now has the most infections.

      3. Erelis

        Just anecdotal. I work for a company with many engineers in India. My project lead who works with many Indian groups said every group was reporting infected people or infected family members. All from the Delhi area. If the infections are reaching professional engineering classes, then bad news for many American companies. Expect lower quarterly earnings for some high tech companies. Will also effect H1B visas for employment in the United States and other countries. Might pick up more local American hiring.

        1. ObjectiveFunction

          Umm, that last may be taking ‘if life gives you lemons’ a tad far although I assume you didn’t intend it that way.

          A number of Indian colleagues have mentioned losing family members (generally older) to Covid back in India. And these aren’t the huddled masses: these are families with means.

          1. Erelis

            My last comment is simply trying to understand the effect of halting H1B visas as India is the primary source of them (I have worked with many of them). If companies are trying to expand and they need engineering help and can no longer rely on H1Bs then the logical assumption is that companies will look to hire locally within the US. Just trying to think through the implications.

            1. drumlin woodchuckles

              Do you think these companies will boycott American workers for as long as they possibly can?

            1. DG

              As an Indian reading this thread, I find the amount of cluelessness appalling and hilarious at the same time! Just wow!!

  3. The Rev Kev

    Was just watching news reports coming out of India and you can see that India is so screwed. The healthcare system is on the verge of collapse, they cannot get enough oxygen tanks to the hospitals, people are being turned away from hospitals and the crematoriums and burials cannot keep up. Cases are now running at nearly 350,000 cases a day and increasing rapidly. I heard about one crematorium that has been running non-stop and the metal is starting to fail in that crematorium due to the constant heat. An interview with a grave digger was revealing. He said that last year he was burying people 50 years old and over but this year it is mostly 20 to 50 years olds and which is also including a lot of children this time around. Having the country being run by the Bolsonaro of the subcontinent is certainly not helping but you want to know the worse? All this we are seeing is due to only 1 or 2 percent of the population falling sick so far.

    1. Eustachedesaintpierre

      Hopefully they won’t match the UK rate of 1,910 deaths per million which would result in about 25 million deaths if my ever dodgy math is correct.

      1. mary jensen

        “On April 21, 2021, the country registered 315,000 cases in a 24-hour period. This is an extraordinarily high number. Bear in mind that in China, where the virus was first detected in late 2019, the total number of detected cases stands at less than 100,000.”

        Absolutely no one believes any of the “data” which comes from China. No one.

        1. Astrid

          I don’t know Mary, a billion of them believe it enough to go about their normal lives. something that probably can’t be said for most Indians, Brazilians, Europeans, and USians today. Who cares what China reports? Their actions got Covid under control. What does your casual and unsourced anti China smear do exactly?

            1. mary jensen

              Astrid and witters:

              “China smear”, “projective hate-fest”. What the hell?

              No one believes China’s reports. Period. You know that yourselves. It’s no “smear”. “A billion of them believe it enough to go about their normal lives.” It seems to me you are awfully casual and unsourced to make such a statement.

              I don’t live in the US and I didn’t vote for Trump and I follow all the protocols where I do live and I am scheduled for a first vaccine this week. My doctor, a virologist, would be amazed to read what the two of you have written to me, as am I.

              1. kareninca

                We have no grounds whatsoever for trusting any data out of China. It’s not a smear; it’s reality.

        2. Taurus

          Why data which comes out of China is different than data which comes out of the US. Please note, this is about methodology, not ideology :)

          Chinese statistics is broadcast out into the world by aggregators who are affiliated with the Chinese government. Here is an example:

          http://www.wanfangdata.com/about/about.asp

          The corollary to this is that the Chinese government can at any point reach into the master database and tweak the numbers as needed for political reasons. I have no proof that they do this. But they can if they want to.

          In the US by contrast, COVID data is gathered locally and then it is aggregated independently by several academic institutions. The most popular is the John Hopkins one but it is not the only one. Dartmouth TDI also has an effort like this that I am aware of. Most likely the other Ivies as well (they are highly competitive- the alphas in those places:)

          Said academic institutions talk to each other and they represent a check on the aggregate in a public forum.

          This is not dissimilar from the difference between proprietary software development and open source software development. A little bit like – would you choose WhatsApp or Signal for the private conversations you are having with your children? To make the analogy clearer, would you trust Mark Zuckerberg or a random collection of people to produce a more trustworthy resource?

          1. square coats

            I suggest that you look into nyc governor cuomo’s amazingly honest and accurate covid data reporting (just in case it doesn’t come across, I’m employing heavy sarcasm here). You might also look into how accurate & transparent (or not) is the available data on covid inside u.s. prisons.

            I don’t know what there is to smile about in what you have said and I likewise don’t find anything to smile about in my response.

  4. bwilli123

    Lack of critical vaccine inputs from the US and lack of planning from India.
    “In an April 16 post on Twitter, (Serum Institute of India CEO) Poonawalla tagged the US President and said, Respected @POTUS, if we are to truly unite in beating this virus, on behalf of the vaccine industry outside the U.S., I humbly request you to lift the embargo of raw material exports out of the U.S. so that vaccine production can ramp up. Later, he had told The Indian Express:
    “The vaccine industry, outside the United States, needs plastic bags, filters and media solutions which are critical in the manufacturing of Covid-19 vaccine. For a month, we have been asking the US authorities, but they have not responded….We are hoping that the Biden administration takes a more global perspective than the previous administration which was looking at only America and America first, that is our hope, our umeed,” he said.

    https://indianexpress.com/article/india/to-plea-on-lifting-ban-on-vaccine-inputs-us-says-americans-first-7286601/
    https://thewire.in/health/how-the-modi-government-overestimated-indias-capacity-to-make-covid-vaccines

  5. CanChemist

    A few more important details: there is an Indian variant B1617 that is currently believed to be at least partially responsible for fueling this sudden change in trajectory. Not much is known yet about it from what I’ve seen.

    Meanwhile we’re already pushing 100 cases of it in Canada
    https://www.cbc.ca/news/health/india-b1617-variant-explainer-1.5998121

    Leading to Canada shutting down flights to India and Pakistan for 30 days.
    https://www.cbc.ca/news/politics/flight-ban-india-1.5997880

    I think the cat’s already out of the bag over here… certainly one to watch.

      1. ChrisFromGeorgia

        I thought Australia wasn’t letting any direct flights in from anywhere other than New Zealand?

        Something change recently? Airline lobby extending their dirty paws into their parliament? They were one of the stalwarts on shutting down non-domestic air travel and it was paying off for them.

        1. The Rev Kev

          We still have tens of thousands of people trapped overseas so they are bringing them home a planeload at a time and having them do a fortnight in a quarantine hotel after arrival. As you can guess, this is a slow process and India is one country where we have lots of people trying to get home from.

    1. ChiGal in Carolina

      And of course the US won’t do any restrictions. We are just dumb. Withhold vaccine and have a party.

      And bad as it is in India, when you look at the DIVOC chart comparing confirmed cases per 100k, as of 4/21:
      Czechia = 15k
      US = 10k
      India = 1k

      So far so bad and we ain’t done yet…

      1. ChiGal in Carolina

        adding
        Israel & Sweden = 9k
        Brazil & UK = 7k
        Germany = 4k
        Canada = 3k
        Norway = 2k

        and again,
        India = 1k

  6. Jokerstein

    One of my team has family in New Delhi, and he says that he’s hearing the situation is far worse than is being reported. Bodies left in the streets, some being eaten by dogs and rats.

    Also, even the UK – while not banning flights – is requiring 10-day hotel quarantine for arriving travelers. Given the incredible close link with the sub-continent and the power of the UK-based Indian population, that is telling indeed.

    1. Raymond Sim

      Bodies in the streets has already been a thing here in California. I wonder how many people know? People died in their homes, and their families, or neighbors, or law enforcement ended up putting them outside because that was better than having them rot indoors.

      In fact, if those who read this would be so kind as to respond, I would very much like to learn from you:

      1) What you know of what transpired in Imperial County during the first wave.

      2) How much you heard about it in real time.

      1. kareninca

        I live in Silicon Valley and I have seen nothing in the news at any point about people dying in their homes in Imperial County or their bodies being set outside. And I read plenty of news accounts. What I did read was that there were a lot of cases connected to meat packing plants and agricultural operations and crowded housing for immigrant laborers, and that Hispanic people have been especially hard hit.

        I have been told by someone who lives in Oakland that things got bad there several months ago, but saw little about that in the news.

        In my zip code of 15,000 people in SV, there have been 158 cases of covid so far in total (and no deaths that I know of). I know no-one at all who has had covid. I know people who know people who have covid, but that is not the same thing. It is like two worlds.

      2. Taurus

        This is the first time I have heard. Self professed news junkie, multiple news sources from various angles.

      3. Susan the other

        There was a lot of news out of California last Christmas and into January. It was clear they were having a new wave of Covid. My kids drove down thru it all, wearing masks and using lots of hand sanitizer. They said everyone they encountered (gas, groceries, etc.) was masked and careful. No reports of bodies in the streets. But Gavin Newsome was borderline hysterical, I do remember that. If India is like California, they will be over the peak in about 4 months (November thru March for freaking out in California). But I really don’t think India is that predictable. The new wave didn’t seem to hit other neighboring states like it did California. Here in northern Utah we did hit a new peak of cases, but the hospitals handled it. I’m sure the medical system anywhere is overwhelmed if the population is clearly over its capacity. It’s a no brainer. If pandemics are our future we need to look for mobile capacity.

        1. Laura in So Cal

          I know a dozen people personally who had COVID between November & January last year + my workplace (critical industry) was reporting 5-6 cases/week (out of maybe 400 people who were in the plant). I live in Los Angeles County. Of the dozen people I know personally, 1 person was tested and none went to the doctor. Worst case was a co-worker who is in his 60’s who spent about a week in bed at home. Mostly it seemed like one person would catch it at work etc. and then bring it home and share it with the rest of their family including kids (who were still totally on-line in schools at that time).
          I saw no stories about Imperial County although I did hear stories of hospital overload etc. here in Los Angeles County.

  7. semiconscious

    perspective: india’s population is 1.366 billion. 1.215% of that total number (16.6 million) have tested positive (which is not, btw, the same thing as ‘falling sick’). 0.0139% of that total number (190k) have died…

    either that, or we can’t trust the numbers & it’s all anecdotal &/or guesswork…

    also, regarding the state of healthcare in india:

    Agarwal noted that India has a chronic disease burden or non-communicable diseases burden of almost 20% of its population, where nearly 200 million people have some chronic disease. Of that, just diabetes and hypertension afflict some 100 million people, and that patient population is growing by 13% a year, he said. To make matters worse, the rate of patient adherence to prescribed treatments is abysmally low, he added.

    https://qrius.com/the-state-of-healthcare-in-india/

    1. skk

      While those vids of funeral pyres and people lying outside hospitals make good click-bait news and a ready cudgel to beat up on the govt, by the numbers, as per ourworldindata, India’s 7 day average daily confirmed Covid-19 fatalities/per million as of April 23 2021 is 1.44, the USA is higher at 2.13.

      https://ourworldindata.org/coronavirus/country/india#daily-confirmed-deaths-how-do-they-compare-to-other-countries

      Separately, thanks a lot for that article – it gives an interesting developmental point-of-view, a capital raising, deployment, return on investment point of view, an investment in infrastructure view on investment in health infrastructure- the investment coming from people with money, as well as the govt tax based money.

      For myself, people in India should not, at this time in the evolution of the country, care who’s money goes into building the hospital, so long as the hospitals are built ( at a proportionate ROI ). Later on they can switch to tax-based, MMT based even(perhaps), investment.

      They’ll have the example of how it works out in the USA to learn from !

      1. semiconscious

        you’re welcome! my take-away from the article?: when it comes to india & health-related catastrophes, covid-19’s just gonna have to get in an already long-existent line…

  8. fumo

    Leading to Canada shutting down flights to India and Pakistan for 30 days.
    https://www.cbc.ca/news/politics/flight-ban-india-1.5997880

    It astonishes me that international air travel into Canada is still possible. The land border with the US has essentially been sealed for something like a year. US residents in the nearby Point Roberts enclave are basically cut off from both the US and Canada. Maybe air passengers constitute a higher-class contagion risk. Or something.

    1. CanChemist

      The truth is a little more gray. There are actually thousands of people crossing the border every day because of how intertwined our supply chains are, food, materials, etc etc. Shutting that down would be catastrophic. These crossers are all labelled ‘essential workers’. The border is shut to leisure travellers or transit that doesn’t meet essential requirements.

      As for air passengers from India, it’s important to recognize that we have large communities of Indian-Canadians going back generations. It’s likely that a significant fraction of the people on those airplanes are actually Canadian citizens. So it’s hard to know how to balance risk vs citizen travel / repatriation.

      It goes without saying that border crossing in general is very contentious here at the moment, but it’s hard for the reasons above to know where to draw lines.

      1. Eyan Nemus

        Agree, as far as the US Canada border goes. For example, think about all the people who live in Windsor, Ontario and work in Detroit, Michigan.

        The border almost certainly isn’t as sealed as we’d like to think. At least not equally at all border crossings.

  9. Raymond Sim

    I’ve spent the past couple months trying to persuade members of my family that what we’re now seeing in India (and South Africa, and South America, and Turkey/Iraq/Iran, and British Columbia) was coming, i.e. a Pandemic of the Variants, causing more severe disease in younger people.

    I’m not a magical genius, and I’m certainly not the only one who’s foreseen this, I’m just a guy who knows a little math and makes a point of rexamining all his assumptions in the light of the available evidence.

    What we’re seeing now will continue, with ever increasing severity, in all those countries that insist on leaving the handle on the cholera pump. It will go on and on and on, til the virus uses up its whole bag of tricks.

    You think you know when that will happen? You must be an expert on bat viruses! And bat immunolgy! And human immunology! And zoonosis! I sit at your feet awaiting pearls of wisdom.

    How does a smartass like me know severity will increase? Because it’s fighting its way through preexisting immunity ffs! Inflammation will follow.

    Fun fact: You know who just doesn’t hardly ever do that inflammation thing? Yes!!! Bats!

    We don’t even know how long SARS-CoV-2 can go on with its current main tactic of intensifying ACE-2 affinity. Thermodynamically it seems it still has some slack to work with.

    At this point it can be said with confidence that vaccine-induced immunity is almost certainly superior to that acquired from infection, but it’s not magic. With the current rates of transmission we’re giving the virus exactly the environment it needs in order to mutate its way into vaccine escape.

    So next year the scramble will be to roll out the boosters, while twice as many people die in each successive wave. If you’re inclined to dismiss that possibility, well, I’d like to know what you were saying in October last year.

    1. Jason

      At this point it can be said with confidence that vaccine-induced immunity is almost certainly superior to that acquired from infection, but it’s not magic.

      Frankly, with so many qualifiers, you may as well not make this statement at all. It comes across as trying too hard.

      With all the vaccine hesitancy* we’re witnessing, good luck getting most people to eagerly line up for 2 shots and regular boosters.

      *vaccine hesitant, while definitionally true (I am – I feel quite rationally based on the information I have to this point – hesitant to take this vaccine), is also every bit as much a subtly shameful pejorative.

      I’ve created my own descriptor, which has both literal and whatever other meanings come to be associated with it: the vaccine enthused.

      1. Raymond Sim

        Trying hard to do what? Describe reality?

        There’s nothing, well almost nothing, 100% certain in all of this, hence the qualifiers. I am 100% certain you might be stupid though. And 90% certain you’re disingenuous.

        And natch the angle you come at it from is vaccines.

      2. kareninca

        I don’t understand. I didn’t get the impression at all that Raymond Sim was saying that the vaccines would help in the long term. Why do you think that he is shaming people who don’t want to be vaccinated? He seems to be saying that the virus will out mutate whatever we come up with. I agree with that.

        I am in no hurry at all to be vaccinated, so I am attuned to people who are pushing vaccination.

        I’ll admit that I don’t know what he thinks would take the handle off the cholera pump. I guess it is possible that that is a push for vaccination, but I don’t see how, given that he admits that this this virus will mutate on and on.

        I think you may have misread his post, and that he may have been irritable due to too much coffee.

        1. Raymond Sim

          By “leaving the handle on the cholera pump” I mean forgoing necessary public health measures. It’s a reference to the London cholera epidemic whose source was, according to public health legend, finally discovered when the handle was taken off a certain public water pump.

          I don’t blame anyone for not wanting to take any of the damned vaccines. I’m not happy about doing it myself. But I’ve lost all patience with people who want to pretend this isn’t a serious disease, or that there are any easy ways out.

          1. kareninca

            Yes, I knew what you were referring to; this is NC; we know about the London cholera epidemic here; you can assume that sort of thing. I meant that I didn’t know what you would count as removing the handle.

            I think finding good treatments is the most important thing at this point. I guess that is a public health measure. I think that is our only real hope; the vaccines will at best be a patch and at worst – well, that doesn’t bear thinking about.

        2. Jason

          I didn’t say that Raymond Sim is intentionally shaming people. I said that the term “vaccine hesitant” has come to be a subtly shameful pejorative.

          Raymond Sim made a statement that had so many qualifiers that the statement itself has no meaning. This is not an accusation or a dig at Raymond; it’s the truth. I suppose Raymond took said truth as a personal affront and immediately labeled me “stupid” and “disingenuous” (well, he’s only 90% certain about the latter).

          That’s what happened here.

      3. ChiGal in Carolina

        vaccine adherent is more like it—a lot of us are taking it because it seems the benefits outweigh the risks but speaking for myself and my peeps we get that there are known unknowns, and probably unknown unknowns too. It misses the mark to call us enthused though it may suit your purposes.

        1. Raymond Sim

          I guess you could call me a vaccine adherent.

          But I saw an electronmicrograph of the AZ adenovirus adhering to a platelet. No adherent vaccines please!

        2. Jason

          Fair enough, though the “suit my purposes” is entirely unnecessary and obviously intended to suggest I have “purposes” which are in some way nefarious.

      1. Raymond Sim

        I’m not spotting the relevant passage. Could you point me to it?

        Also, please see my response to Anonapet below, re the nature of the superiority.

          1. Raymond Sim

            I didn’t say it was difficult, I said I didn’t see a relevant passage. Did I miss something? You can quote a sentence or two for an old guy with fading vision can’t you?

            1. flora

              I think you did miss something. Hint: It’s talking about 3 cohorts, not just 2 cohorts. Knowing that bit, the wording should make sense to you.

              1. Raymond Sim

                Quit being cute. A study which concludes:

                ‘We have also shown two vaccine doses to be as effective as prior natural infection. This could be an
                important consideration during policy development over COVID-status certification or “COVID
                passports”, and supports considering both prior PCR/serological testing and vaccination data for
                this36. …

                … Looking forward, one key question will be whether immunisation offers long-term protection against
                COVID-19. A recent study showed the rate of waning and longevity of neutralising antibodies varies
                greatly amongst individuals with prior COVID-19 infection and suggested that, if similar rates of
                waning are seen after vaccination, annual vaccine administration is likely needed37
                .
                Overall, we have shown COVID-19 vaccination to be effective in reducing the number of new SARSCoV2 infections, with the greatest benefit received after two vaccinations, and against symptomatic
                and high viral burden infections, and no difference between the Pfizer-BioNTech and OxfordAstraZeneca vaccine. ‘

                Is not endorsing natural immunity as being just as good as the vaccine, they’re saying the vaccines aren’t worse.

                If you believe your conclusion is borne out by their data, then please do show us.

                In any case they explicitly withhold judgement on the long-term prospects. And that’s where natural immunity craps out.

                1. flora

                  strawman – nowhere did I say “endorse’. I said ‘equally effective’.

                  The results you restate as:
                  “Is not endorsing natural immunity as being just as good as the vaccine, they’re saying the vaccines aren’t worse.”

                  1. Raymond Sim

                    Evasion, they’re not asserting equivalence, which you clearly implied was the case.

                    If they showed equivalence then it must be in the data. Please illuminate.

                    1. Arizona Slim

                      Not to get personal, Raymond, but I went to middle school with a guy who had the same first and last name. Are you, by chance, from Pennsylvania?

    2. Anonapet

      At this point it can be said with confidence that vaccine-induced immunity is almost certainly superior to that acquired from infection, … Raymond Sim

      Well, at least with infection acquired immunity there’s a possibility that more than just “the spike” is targeted by the immune system.

      So in theory, at least, there’s the possibility that an infection acquired immunity would be more resistant to variants than that provided by current vaccines targeting only the spike.

      The same logic would apply to vaccines consisting of whole killed or weakened viruses.

      1. Jason

        It looks like we have no chance of a traditional whole dead/weakened virus vaccine here in the U.S. They’re not even working on one now. And we know they won’t allow any of the foreign-made ones into the country.

        1. JBird4049

          Can anyone tell me why? Bacteria and viruses are always changing and it would be prudent to get as many kinds of vaccines under research and available as possible. Is it the old neoliberal reason of profit?

        2. Raymond Sim

          Some of the vaccines present the spike protein in a ‘fixed’ configuration, which has been postulated as accounting for superior performance against .B.1.351. This is apparently not doable with a whole virus vaccine.

          A while back I got a bit of a talking-to from my wife to the effect that more information isn’t necessarily more persuasive or more informative. Maybe this applies to trying to persuade the immune system to do things as well?

          That said, all areas of response except the glamour-puss vaccines seem pitifully neglected.

      2. Raymond Sim

        Unfortunately the virus cleverly attacks immune cells and disturbs formation of immune memory, doing quite a bit of damage you may or may not be able to afford in the process. As a result you don’t get the usual ‘textbook’ results when the virus stops by again in six months or so.

        1. Jason

          On the virus and immune memory?

          Raymond in his initial post: “I’m just a guy who knows a little math.”

        2. Nick Alcock

          That’s not something I heard before. This is not measles. It does interfere with the interferon response, but that’s an innate immune thing and not related to immune memory, which is (more or less) an adaptive immune thing.

          Cite?

    3. eugene

      I thought the tendency of viruses was to mutate to less severity not more severity. It’s in the virus’ interest to not kill to many of its hosts too quickly (hence Baruch Blumberg’s description of hepatitis C as the perfect disease because it spreads quietly for 30 years before it does its real damage). Just asking, but isn’t it likely that the virus will ultimately become endemic, like the common cold?

  10. Joseph DeSimone

    A recent case-controlled study by Indian Council of Medical Research (ICMR) has underlined the benefit of hydroxychloroquine (HCQ) as prophylaxis, showing that the sustained use of the anti-malaria drug along with the use of personal protective equipment (PPE) was associated with a significant decline in risk of Covid-19 infection rate by upto 80% among the health care workers. See: https://health.economictimes.indiatimes.com/news/pharma/why-icmr-continues-to-stand-firm-on-using-hydroxychloroquine-as-prophylaxis/76172274

    So despite numerous studies that prove the safety and efficacy of HCQ with zinc as a prophylaxis as well as an effective therapy if administered in the early stages of the infection, it amazes me how the WHO
    suspending the clinical trials using (HCQ) under its Solidarity Trial, and then many countries blindly follow. More bewildering is if India is protecting their health care workers with HCQ, why not the populace?

    And here’s a link to an interesting article titled “Why do Asian countries use hydroxychloroquine for Covid-19 despite Western rejection?”, see https://www.ispsw.com/wp-content/uploads/2020/08/711_Lin.pdf.

    Lastly, returning stateside, curiously any person or organization attempting to demonstrate the effectiveness of HCQ is immediately smeared or canceled by big tech and the mainstream media.

      1. Joseph DeSimone

        Here’s a link to over 200 Hydroxychloroquine (HCQ) studies published as recently as 4/23/21 and as far back as 1889 (using quinine, HCQ is a synthetically manufactured drug, developed based on the chemical structure of quinine), see: https://c19hcq.com

    1. Larry Y

      How does the drug scale up to hundreds of millions, even billions, of people? And then the side affects. The side effects may be better understood compared to the vaccines, but again, have to scale that monitoring to something continuous over hundreds of millions of people.

      And frankly, right now, it seems like prophylaxis is not even a speed bump to the pandemic in India or Brazil… The only things that seem truly effective are vaccines, or measures epitomized by Taiwan and New Zealand.

  11. Tom Collins' Moscow Mule

    Remember when . . . . it was repeated over and over by some commentators that “herd immunity” was going to be the panacea and the resolution for the current crisis, that is the COVID epidemic?

    Perhaps, that thinking was apparently hastily contrived, misleading, ill founded, and incorrect.

    Because,

    “But then, over time, as people’s immunity waned, more contagious variants came along and sparked another surge. There are also signs that people who have already had COVID-19 can be reinfected more easily with this strain, Gupta wrote, especially over time, as their natural immunity wanes. These reinfections may be driving this second, explosive surge in India.”

    With the following added note, because accurate information and precision in both the use of thought and words minimizes confusion:

    “But scientifically, the term “double mutant” makes no sense, Andersen says. “‘SARS-CoV-2 mutates all the time. So there are many double mutants all over the place. The variant in India really shouldn’t be called that.” Like the other variants of concern, B.1.617 contains not just two mutations, but more than a dozen.”

    https://www.npr.org/sections/goatsandsoda/2021/04/24/988744811/people-are-talking-about-a-double-mutant-variant-in-india-what-does-that-mean

    Finally, ‘May you live in interesting times.’ There is no doubt that the curse has fallen on us.” “We move from one crisis to another. We suffer one disturbance and shock after another.”

    As it always was. As it is representative of the ebb and flow banality, or eternal recurrence that is existence.

    1. Raymond Sim

      ‘Double mutant’ was a reasonable shorthand for a variant with two particularly concerning mutations. Kristian Andersen is one of a number of oft-quoted people who worry a lot that talk of ‘scariants’ will lead people to lose faith in vaccines, or otherwise cause ‘panic’. If you ask me, we are waaay overdue for a bit of reasonable panic.

      And I don’t think anybody has done more to wreck public trust and diminish awareness of the actual danger, than the ‘You can’t handle the truth crowd.’ St. Fauci included.

      They play right into the hands of the likes of Michael Levitt, Naomi Wolf and the other AIER evil clowns.

    2. kareninca

      “But then, over time, as people’s immunity waned, more contagious variants came along and sparked another surge. ”

      People like Karl Denninger have said from day one that this thing would mutate to escape whatever we threw at it. I have assumed that from the start. I don’t know why this is a surprise. I guess there is some hope that a vaccine could cut transmission enough to tamp it out, but such vaccination does end up selecting for more transmissible strains. And the whole wide world is a big area for a vaccine to mutate in. And I’m not seeing very many truly shut borders. And the same variants pop up independently in different places, since they are how the virus is inclined to mutate.

    1. Raymond Sim

      My best guess is there’s no one variant to rule them all. Among other things competitive advantage in a given population will likely be path-dependent on the population’s previous exposure history.

      Oregon’s covid website is really great, at least as viewed from California. They have time-series displays for the main variants, so you can watch them duking it out almost in real time.

  12. Peerke

    It is high time that the WHO changed its tune regarding ivermectin and other therapeutics and prophylaxis. It is verging on if not already a crime against humanity that the WHO and others refuse to accept the data on these drugs.

  13. Dave in Austin

    On a slightly different note, for the past two years I’ve seen a stream of articles suggesting that an economically dynamic India was the obvoius counterweight to the the rapidly growing Chinese economy.

    That speculation seems to have stopped since Covid highlighted to weaknesses of the Indian model.

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