Task-force scientists say Delhi’s serological survey results delayed pending MHA approval

As India crosses one million COVID-19 cases and twenty-five thousand deaths, political struggles appear to impair India’s preparedness and response. From 27 June to 5 July, the Delhi government and the National Centre for Disease Control had jointly conducted a serological survey across Delhi, to determine the prevalence of the novel coronavirus in the capital. But the NCDC, which functions under the health ministry and is reviewing the survey data, has not yet released its findings to the Delhi government. On 16 July, the NCDC informed the Delhi High Court that it was still reviewing the data and would take one more week to declare the preliminary results of the survey. But according to three members of a national task force of scientists, which was constituted to advise the central government on its pandemic response, the report has been held up because it is being reviewed by the home ministry.

The three members, all speaking on the condition of anonymity, said that the NCDC had not involved the task force in its survey or examination of the results. Even the Indian Council of Medical Research—the country premier’s medical-research institution, which has been at the forefront of preparing India’s COVID-19 strategy, did not have access to the serological survey. During a press briefing on 15 July, a journalist posed a question about the release of the survey results, and Rajesh Bhushan, an officer on special duty in the health ministry, admitted—perhaps unwittingly—that the report had not yet been shared with the ICMR. “These are complex exercises,” Bhushan responded. “They take time. Delhi serosurvey was finished on July 5. After it’s reviewed internally and shared with ICMR, we’ll share.”

According to one task-force member, Balram Bhargava, the ICMR’s director general, informed him on 11 July that the results were pending clearance from Rajeev Gauba—the cabinet secretary, who reports to the prime minister—and from Preeti Sudan, the health secretary. A second member told me that Sujeet Singh, the NCDC’s director, had said the organisation was awaiting MHA approval. “Our COVID response is now under the home ministry, and so is being implemented as a police intervention and not a health intervention,” the member added. With the spike in coronavirus infections pushing several states back into lockdowns, the Narendra Modi administration appears to have elbowed out the scientists and handed the reins to the ministry of home affairs.

It is unclear why the home ministry would review the results instead of the Delhi government—or the ICMR and the health ministry. Serological tests measure the antibodies produced to resist the virus in the surveyed blood samples, and the survey included a total of 22,823 samples from across Delhi. By determining the prevalence of antibodies against the novel coronavirus, the survey would aid scientists and policy makers to understand the scale of the infection, and the pace at which it is likely to spread. It would highlight the effectiveness of the measures taken to combat the pandemic so far and indicate whether Delhi’s residents remain susceptible to infection. It is critical information that would form the bedrock of a strategy to prepare and fight against COVID-19. “We have been asking the NCDC to share this data with us so we can take informed decisions,” a Delhi government official, who is familiar with the case told me on the condition of anonymity.

The three members of the task force said they did not have any information about the study design, which would explain how nearly twenty-three thousand residents of Delhi were selected for the survey. They said that they learnt of the survey from news reports. One member said that the task force had met in the third week of June, but it was neither discussed during the meeting nor listed in its agenda.

A member of one of eleven empowered groups constituted by the ICMR in response to COVID-19 emphasised on the importance of keeping scientists and the ICMR involved in this process, even if the condition in the capital has improved. “During a crisis like this pandemic, robust democracies have relied on established institutional processes,” the member said, who requested not to be identified. “This is a novel disease, and the government requires scientists to process new data, correctly interpret new science about this virus.  Bureaucrats do not have the knowledge to parse this information. When the established norms are sidelined, or new norms created, it may be effective in the short term, but in the long run it will destabilise institutions.”

“We’ve already seen that the contact-tracing operations are mainly run by security agencies,” the member of the empowered group continued. “That a security institution is looking at sero-survey data is incredibly problematic.” A second member of the task force echoed these concerns. “Pandemic control has been taken over by the politicians, in consultation with the police and the administration,” he said. “So it has transformed into more of a law-and-order control programme, not really an epidemic-control exercise.”

At a point when none of these bodies had received the results of the survey, on 8 July, The Hindu reported that the initial results of the survey showed that at least 15 percent of Delhi’s population “have developed antibodies against the virus, according to officials.” The task-force members I spoke to expressed their displeasure that the media had learnt details about this crucial survey before India’s leading scientists. The Delhi government official emphasised that the results ought to have been shared with them. “Health is a state subject,” the official said. “We have the right to this information.”

However, the home ministry denied involvement with the serological survey. In an emailed response to queries about the survey, the home ministry’s unit of the Press Information Bureau responded, “The subject matter of Delhi serological survey does not relate to MHA.” The email response contradicted the ministry’s posts on Twitter. On 26 June, the ministry’s spokesperson announced Delhi’s serological survey, tweeting, “As per the directives of HM @AmitShah, discussion was done on the serological survey in Delhi, which will be carried out jointly by NCDC and Delhi Government.” The MHA spokesperson’s email neither confirmed nor denied that the report was held up by the ministry.

Emailed queries sent to Singh and Bhargava, the NCDC and ICMR’s respective chiefs, had not been answered by the time this story was published. It will be updated as and when they respond.

The serological survey is hardly the first instance of the home ministry’s involvement in Delhi’s COVID-19 response. In early June, as Delhi began witnessing a dramatic surge in the number of daily cases, the Aam Aadmi Party government announced a decision to reserve the national capital’s hospital beds for its residents alone. But it was promptly overturned by Anil Bajaj, the lieutenant governor, who issued a press statement noting, “It is unfortunate that any responsible government should attempt to discriminate amongst patients on grounds of residence.”

The irony of the statement was not missed within India’s public-health circles and particularly among those working on tuberculosis. They pointed to a cruel litigation in which a teenager diagnosed with tuberculosis sued the Narendra Modi government to access a new drug, bedaquiline. She was denied the drug on the grounds that only Delhi residents were eligible to receive it. In January 2017, the Delhi High Court ruled that “domicile or residence of the patient” was not a sufficient reason to deny her the drug. She finally received bedaquiline, but the delay proved to be fatal. By the time she began taking this hard-won new treatment, she was dependent on oxygen with virtually no independent lung capacity. She died on 9 October 2018. She was 19 years old.

But the centre’s previous contrary position was not pointed out as the lieutenant governor swept in and overturned the previous order. The centre’s involvement grew more pronounced as the situation in the capital worsened. On 14 and 15 June, Amit Shah, the home minister, held a meeting with top Delhi government officials including the chief minister, Arvind Kejriwal, about the capital’s COVID-19 response. The next day, any doubts about the MHA’s involvement were put to rest when Shah made a surprise visit to the Lok Nayak Jai Prakash Narayan hospital, Delhi’s largest dedicated COVID-19 facility.

After his visit, an anonymous Delhi government official told the Indian Express, “The Centre has indicated that with cases rising, it wants to be involved in the day-to-day decision-making … The Delhi government has given its full support to the Centre, considering the rate of spread, and the speed at which facilities need to be prepared.” An Outlook report on the centre’s involvement stated, “As Shah spelt out a multi-pronged strategy for Delhi, it exposed AAP government’s weakness in the public healthcare system, something it had showcased as its biggest achievement. And then the image of Shah visiting the LNJP hospital, run by Delhi government, showed that he was in-charge.”

It is undeniable that in the past month, the daily rise of reported coronavirus cases in the capital have reduced drastically from nearly 4,000 per day to 1,500 per day approximately. Delhi appears to have passed a peak of the virus, as even the number of deaths per day has dropped significantly.

It is also undeniable is that politicians have largely muzzled the scientific voice. The three task force members, as well as the member of the empowered group,  informed me that they had found out about India’s COVID-19 vaccine, which was to be ready for public-health use by 15 August, from the news. After the announcement, the Indian Academy of Scientists—one of the top organisation of scientists in the country—was prompt to dismiss the deadline as “unreasonable and without precedent.” In the face of criticism about politics guiding scientific decisions, Bhargava sought to justify the deadline by claiming that the vaccine was sought to be fast-tracked to cut out “unnecessary red tape.” But not before causing international embarrassment. In an interview to The Wire about the vaccine, Dr Soumya Swaminathan, the World Health Organisation’s chief scientist and a former ICMR director general, stressed on importance of  maintaining “scientific and ethical standards” while developing the vaccine.

While the crisis in Delhi improves, the pandemic has spiralled across India, placing the country among the top three nations with the highest number of cases, after the United States and Brazil—both led by heads of state whose disregard for science has been well documented.  Simultaneously, information has become scant and the once daily media briefings by the centre have now become rare—there have been only two briefings in July. Lav Agarwal, who had become the face of India’s pandemic response as the health ministry’s representative, is now absent from the briefings. Raman Gangakhedkar, who was the ICMR’s lead epidemiologist, has retired. Vinod Paul, a member of NITI Aayog and the chairperson of the task force, who famously predicted the end of pandemic by 16 May, has also become absent from the press briefings.

As of 8 am on 17 July, the health ministry had recorded a total of 10,03,832 confirmed cases and 25,602 deaths. As India becomes only the third country to record over a million cases, the Modi administration’s decision to respond to the pandemic as a law-and-order issue leaves the nation’s health security vulnerable to a rapidly spiralling outbreak.

Correction: An earlier version of this article incorrectly stated that the cabinet secretary reports to the home ministry, instead of the prime minister. The Caravan regrets the error.