Government

Full Text | 'Govt Should Have Evaluated, Acted Upon INSACOG Warning': Rakesh Mishra

The INSACOG expert's interview to Karan Thapar reveals several truths on India's initial handling of the crisis and why the best method of controlling COVID-19 is human behaviour.

Dr Rakesh Mishra, one of India’s foremost scientists and a member of the Indian SARS-CoV-2 Genome Sequencing Consortia (INSACOG), told The Wire that in early March, the expert advisory panel of which he is a part had formally warned the government of its “high concern” that new and more contagious variants of coronavirus were taking hold of the country.

Mishra’s video interview to Karan Thapar reveals several truths on India’s handling of the crisis at a time when it was in a comparatively nascent stage. 

Below is the transcript of the interview.

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Karan Thapar: Hello and welcome to a special interview for The Wire. On Saturday, Reuters released a story about how a consortium of national laboratories tasked with genome sequencing or INSACOG had forewarned the government in early March that they have high concerns about variant strains of coronavirus that were particularly contagious and were in danger of taking over the country, and that report Reuters claimed has either been ignored by the government or at least not properly acted upon. So today we ask was such a warning given by INSACOG to the government and how did the government respondent?

Joining me to answer those questions is a member of INSACOG, the committee that gave that warning and the director of the Centre for Cellular and Molecular Biology of Hyderabad, Rakesh Mishra. Dr. Mishra, let’s start with that report released by Reuters on Saturday which sadly has been largely ignored by the Indian media with just one or two exceptions. The report says that as far back as early March, INSACOG had forewarned the government that they had high concerns about various strains of coronavirus that were highly contagious and were in danger of taking over the country. As a member of INSACOG can you confirm was such a warning given to the government in early March?

Dr. Rakesh Mishra: So Karan, INSACOG is a consortium of ten government labs and the nodal lab is NCDC which is related to health ministry and this consortium is funded by DBT so this is all a government thing. We have meetings every alternative day, where we discuss what is happening and we submit data every day and try to make sense out of it. These meetings are attended by everybody, DBT representatives, NCDC, all the ten labs. So 20-30 people attend these meetings, everybody is in loop on a constant basis. Then these meetings’ gist is conveyed through the NCDC to the Ministry of Health to whom they actually are reporting. So I understand that there is a continuous flow of information on a daily basis from INSACOG to the government sources.

KT: Can I interrupt sir? Can you confirm that in early March INSACOG communicated to the government a warning that you had high concerns about variant strains of coronavirus that were highly contagious and were in danger of taking over the country? Was such a warning given by INSACOG in early March?

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RM: This concern was raised when we were detecting new variants. We were detecting UK variants in the airport and some in the community. I understand that these minutes are seen by appropriate or relevant people in the health ministry. Now I can’t say that we have sent in writing – where I am signatory – of warning. But our finding of the variants is really a kind of warning that we are heading towards a worse situation because these are new variants…and we don’t know them.

KT: I am interrupting again because I think its very important that the audience should be clear about what you are saying. You said this concern was raised. You also said you are not aware whether a formal letter was written because you weren’t a signatory. But you added that this concern was kind of a warning, in other words INSACOG did raise this concern in early March and in raising this concern, it was a kind of warning.     

RM: Yes yes, you have understood correctly. In fact, we should appreciate that INSACOG was formed only for this purpose…that look at the genome and do the surveillance of genome if there is anything of concern. That’s why we are reporting on a daily basis. In fact, we never said that situation is comfortable.

KT: Can I ask you this Dr. Mishra, when this concern was raised, who was it raised with, the Health Secretary Dr. V.K. Paul, the Health Minister?

RM: See, because the meeting content is conveyed to the government through NCDC so I think Dr. Sujit Singh must be conveying as whatever is the protocol. All the press notes…they have a system to follow, so I think there’s a channel and I think it must be going through the Secretary, Health, but I may be wrong on that point.

KT: Okay, you are very clear again. The concern was raised to the National Centre for Disease Control whose Director is Dr. Sujit Kumar Singh and you believe that he would have raised it in turn with the Health Secretary. Do you think this concern would have also reached the Prime Minister?

RM: I would think so. I think Prime Minister is very receptive and he has very strong communication system so I’ll be surprised if this doesn’t reach. After all the INSACOG is designed to raise these concerns and depict the information and do the analysis and convey to the government and he being the top in the government should be told. I have no way of knowing whether he was told or not, but I assume he should have been told.

KT: Absolutely, he is the head of the government. INSACOG was created for the very purpose of giving the government this sort of advice. You would be very surprised if the Prime Minister was not told of your warning. In other words, we must logically assume he knew, he was informed. I have been told that the language used by INSACOG was “high concern”, those were the words, “high concern”. Reuters actually quotes those words. But I am also told that at the level of either the Health Secretary or the Cabinet Secretary, those words were diluted and watered down and something much more mild was further conveyed. Is that correct?

RM: I don’t know what was conveyed. It was a high concern, there’s no doubt about it. Now how it got translated into mild concern…We had seen the disasters in UK by then and cases were rising, and we were very concerned, and we were almost dreading that something bad will come because of the very reason that new variants not only cause more infections. New variants come with new kinds of threats, they can lead to more severity of disease, they can threaten our vaccine programme. Luckily, none of that has happened so far but that doesn’t mean we are safe.

KT: Can I stop you there? As you said and I am quoting your words, “We were very very concerned something dreadful could happen.” Can you spell out what were your fears, what were your concerns in early March when this warning was communicated by INSACOG to the government. What were your fears and concerns at the time?

RM: The disease was spread all over the country in small numbers so this was not like the first wave which was going from one direction or from the airport. Now we have the infection all over the country at low level during those period. Second thing is lots of people are having sero-positivity that means they have protection and virus would try to break through that protection. Vaccine programme is starting and some people are partially vaccinated. Again, the virus will try to break through that protection. Virus always tries to infect as many people and we have shown that this virus mutates efficiently. When we analysed some 6,000 Indian genomes in January, we had reported that there are 7,500 variants. Which means variants are very prolific, which means we are always looking at new problems.

KT: So in a nutshell, can I sum it up like this, after you had examined some 7,500 genome sequences you found that the variants were very, very prolific. So in a nutshell, your fear in early March was that this disease would begin to spread and increase exponentially and cases would go up exponentially, that was your fear?

RM: It’s not only that. It can be more dangerous, cause more mortality and my main concern is vaccine programme. If we let the virus play in very large number, that means we have a huge reservoir of the virus in our country. The huge reservoir means more mutants would form and although almost all of them would be a failure but a few that would be successful would be a big trouble for us and that’s how virus evolves.

FILE PHOTO: Volunteers and relatives prepare to cremate the bodies of people who died due to the coronavirus disease (COVID-19), at a crematorium ground in Giddenahalli village on the outskirts of Bengaluru, India, May 2, 2021. Photo: Reuters/Samuel Rajkumar

KT: Absolutely, so can I ask you this then? Given that your fear in early March was that the disease would begin to spread exponentially that in turn would be making the disease more dangerous, there would be more mortality and if the disease spreads there would be more mutants and that in itself would be a danger. If that was your fear, did you give the government suggestions or advice about what they must urgently do? Did INSACOG also recommend a course of action?

RM: I am not sure if INSACOG is mandated to give a course of action, for that there are strategy groups and experts, epidemiologists and physicians. There are groups for the government. We are a research institution, our expertise is to do the biology, do the genomics of this and figure out what is happening and pass on this information. We are not equipped actually to tell what to do.

KT: I understand, sir, it is not part of the mandate of the INSACOG to tell the government what to do, to advise the government on course of action. Your mandate is to actually examine genome sequences and tell the government that the position is becoming worrying and threatening and that is what you did. However, the Reuters report released on [Monday] quotes Dr. Sujeet Kumar Singh, the director of the National Centre for Disease Control who as you say was the person to whom INSACOG communicated this warning and Dr. Sujeet Kumar Singh is quoted saying he told the government urgent action was needed otherwise the situation would become dire. The exact words Dr. Sujeet Kumar Singh used according to Reuters are the following: “It was highlighted very, very clearly that unless drastic measures are taken now, it will be too late to prevent the mortality which we are going to see. In other words, Dr. Sujeet Kumar Singh clearly told the government urgent actions is needed otherwise we will have huge deaths.”

RM: Dr. Sujeet Kumar is very sincere, knowledgeable and I must say conservative man. I’ve worked with him, so I will go by his analysis. Because he is also an epidemiologist so we give him genome information and he then can extrapolate that to population scale and disease context.

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KT: Can I ask you this? Do you have any reason to doubt Reuters’ claim that Sujeet Kumar Singh gave this clear, loud warning to the government? Do you have any reason to doubt it?

RM: No, I think these are things that we have been discussing as friends and at meetings and I am sure as a concerned citizen he will convey whatever he feels. He may be wrong sometimes, and he may be over-frightened, overconfident of certain things but he will tell what he feels.

KT: Let me then ask you this. This warning was given by INSACOG in early March to the government through the National Centre for Disease Control, you believe it would have definitely reached the health secretary, and you find it hard to believe it would have not reached the prime minister? So let me ask you, what was the response of this government after this warning reached them?

RM: The government response, I have as much access as you. The government response will be seen in public. Although, on the TV, in the advertisements, in publicity, many points we will be hearing: wear masks, take care and hygiene, go for vaccine and all those things. But I think we didn’t do enough. See there are two things. It was very, very clear that there is a danger and it is threatening us. That cases were increasing. Late February early March when cases started to increase, clearly the danger was in front of us. Either people take care of themselves and if they are not doing it themselves…

KT: Can I interrupt again? Reuters in the report released on Saturday made it clear that the government effectively ignored this warning. That is the import of the Reuters story, that the government ignored the warning, the government did nothing.

RM: I am not news gatherer. All I see is what we do in our lab in our institution and what we see is happing in society, but we knew from our research that new variants are coming and they may cause new threats and it may cause very bad situation and outside we are seeing everybody behaving as if there is nothing.

People stand in a queue outside a health centre to receive a dose of Covid-19 vaccine, amid surge in coronavirus cases, in Kolkata, Monday, April 19, 2021. Photo: PTI

KT: Absolutely, that’s the important point. Everybody continued to behave as if nothing was happening. Doesn’t that mean the government ignored your warning? People continued to behave as though there was nothing?

RM: I mean, government kept saying keep testing more, do more RTPCR tests, go for vaccination, we will vaccinate everybody. On paper and to some extent this was happening. I think the main problem has been communication and demonstrating that we have to take care. I don’t see why there should even be even 50 people allowed in a marriage, two people are enough for a marriage in these situations.

KT: I agree, sir. Let me put to you four-five questions about what actually happened after you gave this warning in early March to the government. First of all, there were multiple political rallies with tens of thousands, if not hundreds of thousands, of people right through March and in the case of Bengal right through April and these rallies were in Kerala, Assam, Tamil Nadu and as I mentioned Bengal. Secondly, there were huge shahi snans in March and again in April where two or three million people were present. Now, after INSACOG had given this warning to the government in early March, was it proper for such large gatherings to continue or was it risk and unwise?

RM: I will say, even if INSACOG did not exist, this would not be acceptable. Cases are increasing, with INSACOG we knew new kinds of dangers are coming. I think we are going through a situation where these things can be postponed, or delayed. I don’t think these things can be done with controlled numbers. I don’t know the way out, elections may be necessary. If there is something new, once can do that. But as a common man, I think any gathering in this situation is not acceptable, certainly not what we expected to happen in our country. We have been pushed to really…

KT: Let me give you another example Dr. Mishra. INSACOG gave this warning to the government in early March. Shortly thereafter, the health minister, please note my words, the health minister of Assam publicly said that there was no need to wear a mask in Assam. Then the CM of Uttarakhand said that faith in God and the power of mother Ganga would keep bathers at the shahi snans safe. Now after your warning, what do you make of this sort of advice from ministers and chief ministers?

RM: I mean I can only say that the same god has given us a brain and to do what is appropriate. Ministers saying don’t wear masks, I don’t think is acceptable. I just cannot imagine anybody on a public platform can say don’t wear a mask whereas that is the only thing that can save us. How much damage will be caused by this pandemic will depend on how well we use masks, nothing else is as important today.

KT: One more question. As late as April the 17th, when coronavirus cases were increasing in the country by over 260,000 a day, the Prime Minister told a rally in Asansol in West Bengal, “I have never seen so many people before.” He was actually congratulating the crowd for the large numbers that had turned up, and there they were on television without masks, without social distancing, after your warning to the government. What do you make of the prime minister revelling in the size of the crowd he has attracted?

RM: It is very unfortunate that these kind of things are happening, elections and rallies. In fact, later rallies were called off. This should have been done earlier and its very unfortunate that we have seen these kind of things and we will be seeing more trouble coming because of these rallies. The result of this exposure will come after a couple of weeks.

KT: So the prime minister’s comments in Asansol on the 17th of April when coronavirus cases were increasing by 260,000 a day was unfortunate. It was an unfortunate thing for the prime minister to say particularly if the warning from INSACOG had been made clear and remember that warning happened five or six weeks earlier.

A BJP rally at Illambazar in Birbhum district, Saturday, April 17, 2021. Photo: PTI

RM: I mean, what I mean is that election rally and gathering of people was unfortunate. This in any situation, one can say many things but I think it’s very simple. I keep repeating, INSACOG warning was one thing, but when the cases are rising at this number, you just mentioned, two-three lakh cases, I think he should have just frozen everything because that’s the only way.

KT: You know, your advice that rallies should have been shut down, that it is impossible to hold rallies without people intermingling unsafely, that advice fell on deaf ears. Let me tell you what the home minister said. He was asked a question: Are rallies fuelling the virus? He said he doesn’t believe there is a connection between large political rallies and the spread of the virus. His example was, look at Maharashtra, the cases are growing hugely in Maharashtra, there are no political rallies in Maharashtra. But in Bengal, he said, where he was at the time, there was no problem. How do you, as a member of INSACOG, respond to that answer from the home minister.

RM: I think he was not given proper feedback and information because virus doesn’t care whether its election rally or religious rally or marriage rally or bar or restaurant. Wherever there are people, where there is somebody infected virus will jump from one to other through the aerosol, that’s how it happens. There is no question that virus will not spread in election rally and virus will spread only in mall or in cinema halls. Maharashtra has gone through multiple simultaneous things like local elections, opening of local trains, marriage parties. There have been cases where everybody, 50, 100, 500 attending a marriage were infected. We knew there is more infectious bug around and to come together in clusters you are going to then spread it. We opened the schools and children got affected so much.

KT: Opening schools was a mistake?

RM: This is a very delicate question. To me, it is a difficult question you ask. Children are at home, in the apartments for more than a year. They are getting psychologically affected. But you open the schools, they are not adults, even adults don’t follow the COVID-appropriate behaviour. They play, they even exchange masks for friendship. So its very difficult to control children. Opening schools is a thing if you could manage, but we have not been able to manage. Schools are crowded, teachers bring in infection, children bring infection home. That was in retrospect a bad idea but at the time I wouldn’t have said. I kept saying the same thing, opening the schools is important but whether its safe…

KT: We have reached a situation Dr. Mishra where three days ago coronavirus cases grew by 408,000 cases a day. We have epidemiological forecasts being made by experts like Bhramar Mukherjee in Michigan or Gautam Menon here in our own country and they are saying that when we peak in mid May or the third week of May, we could touch 5 or 6 lakh cases a day. Bhramar Mukherjee says the range could be higher at 8 or 10 lakh cases. My question is a simple one. The BJP has announced that tomorrow, the 5th of May, they would be holding a nationwide dharna. In these circumstances, is it sensible to hold a nationwide dharna or is it playing with the country’s health?

RM: I am not aware, but if dharna means clustering together, that shouldn’t be done, it is as simple as that, whatever may be the cause because we have already caused miseries to people by not being able to control the rate of infection. We cannot convert the whole city, the whole country into hospitals. I think we’ve got saturation there. The only way now is to stop the spread of the virus, break the chain of the virus and all out we should go for that like a war. There shouldn’t be anything else happening, the only thing should be how to stop the virus. Everybody should work towards that. I think any other political thing, any other avoidable thing can be postponed. We can settle our scores later, but at this time we have to save people because we have seen such an unfortunate thing happening. People dying for oxygen. We are not trivial, primitive country, we send our satellites to the moon, and our things to Mars. But if we cannot save people by giving oxygen, which is a trivial thing in a normal situation, that means we are caught off guard and the scale of thing has just inundated us.

KT: Dr. Mishra, very important thing about the dharna the BJP plans to hold nationwide tomorrow, May the 5th. You said, at this time, our prime and first and only duty is to save people and their lives and you added, “We can settle our scores later.” That is a very important thing you have said because the dharna is being held in protest for what the BJP claims or alleges is violence done by the TMC. Your reply is, save lives now, that’s the most important thing and settle your scores later. Let me go one step further. In early March, when INSACOG warned the government that cases would increase exponentially, you were also telling them that when that happens, hospitalisations will increase hugely, mortality will increase hugely. So at that time, could the government also not have made plans to expand hospitals, to increase ICUs, to add considerably to ventilators and most importantly of all, estimate how much oxygen would be needed and ensure you had enough. What were steps the government should have taken in early March when you told them cases are likely to exponentially increase?

RM: You are right that we should have improved our infrastructure but the scale in which we have entered, I don’t think any level of infrastructure would have worked. Our focus should have been to go for the kill, when the virus was down. Don’t let it come back. Again and again, all of us have been saying virus is down but not out and it can come back with vengeance because it will come with new variants.

A crowded Covid-19 ward at a hospital in Varanasi, Monday, May 3, 2021. Photo: PTI

KT: I take your point that no one could have anticipated the size and scale of the second surge. No one could have anticipated we would be growing at 400,000 cases a day. But what the government did in February and March was to dismantle the facilities that had been created to handle the first wave. The DRDO centre and the Satsang Beas centre in Delhi were dismantled. The jumbo facilities in Mumbai were dismantled. Surely, dismantling facilities was the wrong thing to do particularly when INSACOG was advising you that there is a real danger that cases are going to increase exponentially. So the very act of dismantling was a terrible mistake.

RM: I think that was a miscalculation. Not only our warning, we have seen what had happened in UK. They had to go through national lockdown and they could manage with difficulty and imagine they have got a much more efficient infrastructure and resources and so on. Its not only the government who was actually dismantling, even private hospitals that were treating COVID patients, but the numbers started to go down. And remember, other diseases had not reduced. Other medical care that’s required have not gone away. Those were waiting and waiting. People started turning towards that. So that was a miscalculation.

KT: I really apologise for the number of times I have interrupted you. You see, there is a big difference between the government dismantling the facilities they created and the private sector doing so. The government has access to what INSACOG is telling them, and the government defied the warnings from INSACOG when it dismantled facilities rather than building them up. Private sector doesn’t have access to what INSACOG is saying. The private sector will go by what they can see and if they see cases coming down then they will say we don’t need to keep so many beds. This brings me to the key question. The government deliberately did not share with the people of India the warning INSACOG had given it. Perhaps they didn’t do so because they didn’t want the country to panic, but by keeping the country in the dark of the enormous danger lurking on the horizon the government also ensured that people would behave irresponsibly. Not wear masks, gather in large numbers and not socially distance. Now, do you believe that the government’s failure to share your warning with the people of India was understandable or was it another mistake? Should the government have warned the people, treated them as adults and told them look, this is the danger, we are warning you, please act safely. They didn’t do that, was it a mistake?

RM: See, conveying correct information in effective ways is very important and that has a long lasting effect. If we don’t convey properly, then first and most damaging thing is loss of credibility which I believe is more damaging. Of course, later something comes immediately there is a protest, there is a confrontation because we have got into an environment of what to trust and what not to trust. That’s why the government to go over in an excessive manner to communicate is effectively.

KT: It’s not just that the government did not communicate effectively. The truth is, a) it didn’t convey your warning at all but more importantly, b) it didn’t take your warning seriously. Its own behaviour in terms of allowing shahi snans to continue, political rallies to continue, health ministers in Assam saying you don’t need masks, home minister of the country saying I don’t believe political rallies have an impact on the spread of the virus. All of that shows that the government was in denial. It had advice, it had warnings from its own scientists; refused to accept them. It, in fact, denied them. It did exactly the opposite of what was required. I am going to ask you a question, and I know it is difficult for you to answer because you are a member of INSACOG. Did the government behave irresponsibly in not accepting your advice and in the way it behaved?

RM: I would say differently, that whether government conveyed or not the warning, I don’t think the government needs to convey the warning but the government can take a leaf from there and plan the action and that is what is expected. The government is not just a post office to pass one letter to the other, INSACOG to public. That I don’t mind if the same thing is not published but it should be acted upon and evaluated. I think, you can see many experts saying that the system failed to imagine that the problem would be this high. Nobody ever denied, with some exceptions, that corona has gone and will not come back. That is why we are doing the vaccine, that was obvious. But I think to translate this information…

KT: Can I interrupt? You’re saying that the system failed to imagine the problem would be so high, so big. I am going to ask you bluntly one more time, the warning that cases would increase exponentially, that hospitalisations and mortality would increase was communicated you believe to the health secretary and you cannot believe it was not brought to the attention of the prime minister. Yet, political rallies continued, shahi snans continued, health ministers said you don’t need to wear masks, the home minister said there’s no impact of rallies on the spread of the virus. The prime minister himself on the 17th of April was revelling at the size of the crowd. Was this irresponsible of India’s politicians?

Devotees gather to offer prayers during the third Shahi Snan of the Kumbh Mela 2021, at Har ki Pauri Ghat in Haridwar, Wednesday, April 14, 2021. Photo: PTI

RM: I am not in a position to judge the government and politicians but I can tell that if we have seen how New York, Italy and Spain have gone through being so advanced. Every time we were telling that if cases increase, we will have difficulty, we don’t want crowds. Virus is not that dangerous, mortality is less. But if you have thousands and thousands of people, people will not die because of the virus, they will die because of oxygen because they will have not have access to it. And that is what is happening. We should have controlled that. Whether people take matters in their own hands and take care, they have been told many times or whether there should be lockdown or whether there should be army on the road.

KT: I have pushed this question about whether the government was irresponsible in not responding to the warning two or three times I will leave it there, let the audience judge for themselves. This is a democracy, people have the right to hear questions, they have a right to hear the answers. Every Indian has a right to come to its own conclusion. Let the Indian people decide whether government paid heed to your warnings, responded adequately or was it in denial and in being in denial endangered the country’s health and behaved irresponsibly, let people decide that. Let me, before I end this interview, come to the variants that are threatening the country. There are two. First, there is the UK variant which I believe was first detected in January. Do you believe today it is the dominant source of the spread in Punjab and a major factor in Delhi as well?

RM: Yes, you are right. So in Punjab most of the infections are, there are estimates from our INSACOG data that maybe 80-90% of the cases are from the “UK” variant, that is 3.1.1.7. In fact, that is how genomic research tells us how this variant came from UK via travellers in certain groups. Its not only the variant, the genome data can be traced back its spread to some people. These people had congregations, whether it was marriage, whether it was a farmer thing, or whether it was a political thing. We can’t tell that. And then those participants of the congregations are clustering and going to districts. So you can see one, two, three steps of spread.

KT: So in Punjab the “UK variant” is 80-90% the cause of the spread? What about Delhi? Is the UK variant a major factor in Delhi as well.

RM: Delhi also, I think it is 40%. These numbers keep charging, and projections based on how many we can see, we can’t sequence all. It was avoidable this I can tell you, because in Hyderabad, everybody who comes from abroad, they are tested and if they are positive their sample is sent for sequencing and unless we know which variant it is they are not allowed to leave the airport. And in Andhra Pradesh and Telangana, even today, UK variant is very minimal because hundreds of people have been detained at the airport because they were UK variant positive.

KT: Very important point you are making Dr. Mishra. Andhra and Telangana and Hyderabad have a large number of people coming from the UK just as Punjab and Delhi do but Andhra, Telangana and Hyderabad were cautious and meticulous in ensuring that the UK variant did not spread. Clearly, Delhi and Punjab did not show the same sense of caution and concern which is why the UK variant has spread 80-90% levels in Punjab and 40% levels in Delhi. Let’s now come to the double mutant as it’s called, although that’s a misnomer, it was first detected I believe in December. It became a cause of concern early this year. Newspaper reports say that it is both more easily transmissible and possibly more resistant to vaccines. Are those reports correct?

A man carrying wood walks past the funeral pyres of those who died from the coronavirus disease (COVID-19), during a mass cremation, at a crematorium in New Delhi, India April 26, 2021. Photo: Reuters/Adnan Abidi

RM: So, the 3.1.6.7 that you are referring to, the Indian variant, it was first detected actually in October. But the sample was collected in October and that means it had been around for some time and because of the control and many other factors it was not encouraged by people to spread so much. It was around but it was not spreading. Later, in February and March when we opened and lots of interaction took place, the virus got the chance to spread. Please remember that the virus, no matter how dangerous or infectious they are, they can do nothing unless we help them.

KT: But what about my two points?

RM: Yes, I am coming to that. So the Indian variant is more transmittable than earlier ones but probably less infectious than the UK variant because we are seeing wherever UK variant and Indian mutant variant is there, UK variant is dominating for example in Delhi, majority is UK. They can play out because as I said these viruses mutate very fast. Later, one become stronger one may become weaker. But at the moment if you ask me from whatever we understand, the UK variant is most infectious, Indian one is less infectious but more than any other. In Bengal for example, it has completely replaced the 618. More or less, 618 was the major variant a month or two back. But now, it is only the Indian variant which is 617 so it is more infectious than others and it is also spreading its footprints in Karnataka and other southern states.

KT: What about the concern that 617 is more resistant to the vaccine? Do you believe that is the case?

RM: No, we have tested that in the lab and both Covaxin and Covishield are protecting against UK variant and the mutant. Others have also tested. I understand ICMR has done and the phase III trial of Covaxin has shown that there is resistance. But to your media, I really want to convey that we should not celebrate, we should consider ourselves lucky because it can happen later a variant will come which will undermine the vaccine protection so the only thing we have to do today is to stop this virus by whatever means.

KT: This concern that you have just expressed, that we could end up with a new variant that is resistant to vaccines. The direct reason why you warned the government in early March that an exponential spread of cases is dangerous because when cases spread exponentially there is a bigger chance for mutant variations to happen and one of those mutants could end up being vaccine resistant, that is the fear that links back to the warning you gave in March. One more question about the double mutant, is it the principal cause of the spread in Maharashtra?

People queue up to receive their COVID-19 vaccine in Surat, May 1. Photo: PTI

RM: Actually not, I have a different belief that I don’t think the variant has caused. The cause is the people’s behaviour, variant is just a thing. It’s like somebody running towards you with a gun to kill you, you don’t want to ask whether it’s AK-47 or AK-48, you just have to run. Any variant is dangerous and it can give rise to a worse variant.

KT: But newspaper report quoting Dr. Shahid Jameel in today’s Business Standard, that is to say the Business Standard of the 4th of May. He believes up to 60% of the genome sequencing done in Maharashtra is of the double mutant variety. That means it has spread to a fairly extensive level in Maharashtra.

RM: No, the fact that its footprint is increasing means it is more infectious than other variants. But if it’s the cause of 60% cases, 40% cases are caused by something else. One month back, it was 20% and 80%. We are giving scope for the virus, this one is taking more advantage, others are taking less advantage. In the end, we will see this whole landscape changes. After some time, we will see one more variant will spread.

KT: Coming to the end of this interview, I have time only for one last question but I want to underline something you said earlier. You tested in laboratories and both Covishield and Covaxin are effective against the UK variant as well as against the double mutant which we know as B.1.617. In other words, both vaccines in India are effective against the two variants that are spreading, the UK virus and the double mutant. My last question, in these circumstances, we are growing at 360,000 cases a day but that may only be because testing on Sunday came down by 3 lakhs. You could find that tomorrow we will go back to 400,000. In these circumstances, do you believe we need a prolonged nationwide lockdown or is the present system of one week or two-week regional lockdown sufficient?

RM: I don’t think viruses go by weekend or week or day or night. We have to take more strict measures, I don’t know whether national lockdown is the solution because the misery it leads to. Last time, probably we were less prepared and it was heart breaking to see people walking. This time, maybe it is more heart-breaking to see people dying in hospitals for oxygen so we have to take now a call and I think something closer to a major lockdown is required. We just cannot let this happen, we cannot keep making more beds, more emergency hospitals, import more oxygen cylinders. Those are really limited things, so we must do everything possible to break the chain, break this spread. That is the only thing that will stop the number, reduce the number and we can come back.

KT: Dr. Mishra, you have been very clear and forthright and I thank you for having spoken so candidly and boldly. You believe stricter measures are necessary, as you said, something closer to a major lockdown because the virus does not respect one week or two week lockdown. But in particular, I thank you as a member of INSACOG for confirming that in early March INSACOG did warn the government that the new variants of coronavirus that were more contagious were threatening to take over the country and urgent action was needed. Thank you also for in your answers agreeing that the response from the government was a lot less than what was required. I thank you for your openness and hope that the candour with which you spoke today does not put you in any trouble. Thank you Dr. Mishra, you are an invaluable person, stay safe.

RM: Thank you.             

Watch the full interview here.