THURSDAY, MAY 02, 2024
John Dayal
Around this time in 2021, this columnist’s 73-year-old wife lay on a stretcher in the driveway of a famous hospital in Delhi, gasping for breath and waiting her turn for a bed which had oxygen available, piped from the hospital’s storage system, or individual cylinders. Critical hours passed before influential friends could arrange a bed. She escaped with her life, though the hospital stay stretched to eleven days. And three years later, she suffers from nodules in the lungs, aggravation of arthritis, and sundry aches and pains that will not go away.
Many others, however, were not so lucky. In the national capital and across a large swath of states, the virus took its toll. It seemed there was no family which was not impacted, including high ranking politicians, officials, men of god, including a Catholic Bishop. Medical personnel, police, civil society volunteers, anyone who was out in the open, even with a mask covering the mouth and nose, was even more vulnerable. Tragically, 1600 doctors died of covid.
Three years later, the trauma has perhaps been pushed in some storage corrugation in the brain’s grey matter, no longer the substance of nightmares. It certainly seems not to be an issue to confront the government and the ruling party as it seeks re-election this summer.
But for millions of those who survived the disease, its continuing impact is a painful, daily, reality as they cough, splutter as they try to fill their lungs with fresh air, and aches in the joints or the muscles. Some report strange lapses in memory. CAT-Scans show nodules in the lungs. The rapid fatigue even after cursory work for many is further, if circumstantial, evidence.
Collectively, the symptoms have been called ‘Long Covid’. Long Covid needs deeper, more extensive and more intense research. It is sapping the common peoples’ peace of mind and their money as they struggle with the symptoms on a daily, chronic, basis.
For reasons not quite fathomable, the Indian establishment has made Covid statistics a matter of prestige, not accepting data computed by international health organisations, or adduced by both national and global non-governmental organisations.
Dr A Minhas in a report published in Statista.com on November 14, 2023 said India reported almost 45 million cases of the coronavirus (COVID-19) as of October 20, 2023, with more than 44 million recoveries and about 532 thousand fatalities.
The World Health Organization report that said the country’s death toll from COVID-19 is about 10 times higher than the official count, and the highest in the world. The WHO’s estimate includes people who died either directly from COVID-19 or indirectly through the pandemic's wider impact on health systems.
India entirely rejected the report and the WHO’s methodology saying it had not taken into account India’s large population and the “authentic” data which had been submitted by the country’s medical institutional system.
India’s own scientific community has not backed the government position. Media reports quoted Dr Gautam Menon, professor of Biology and Physics at India’s Ashoka University and a mathematical modelling expert, saying “The modelling systems used [by international experts] for these studies are fairly standard and if the Indian government had a rebuttal, they should provide their argument for rejecting them.
This official and political state of denial of data has prevented India from setting up a premier state of the art laboratory focussing just on Covid and Long covid, giving it special funding and the best personnel that can be found in interconnected disciplines in medicine, micro biology, pharmacology and public health. There is a caution in government being remiss in understanding the long-term impact and its impact on the mental health of patients and the loss to the economy.
Another study estimated that nearly 40 million people, in India alone, experienced and reported symptoms related to Long Covid. Factors associated with risk of Long Covid include biological sex (females are at greater risk), minority status, socioeconomic deprivation, smoking, and a wide range of co-morbidities including obesity, hypertension, and diabetes.
The most common symptoms of long COVID are extreme tiredness (fatigue), feeling short of breath. problems with memory and concentration ("brain fog"), heart palpitations, dizziness, joint pain and muscle aches. Published medical research papers say Long Covid is also associated with severe cognitive slowing.
A research project in Haryana by an international group of scientists was published in the January 2024 issue of the Lancet, the premier international journal of record. The project, under the auspices of the “Lancet COVID 19 Commission India Task Force”, was supported financially by the Reliance Foundation. Set up in July 2020, the commission, submitted its final report in October 2022.
The research, led by Sijia Zhao, Eva Maria Martin, and others including Masud Husain, aimed to estimate the burden of long COVID in three districts of Haryana, namely Rohtak, Gurugram, and Jhajjar. It covered over 2200 persons. This study is one of the first from India that uses a large population-based sample to examine longer term repercussions of Covid infections.
Patently Long Covid impacts the quality of life of a person, making patients even more vulnerable to other infections, or suffering cruelly in the highly polluted air of the National Capital region, for instance. Many people who could afford have shifted home to Goa, as a matter of fact, or Bangalore and other areas with air still breathable.
The high cost of medicare, the mounting charge by medical insurance companies, are national burdens which cannot be computed in money terms alone.
It is to be hoped that the new government that takes shape in June will put such medical research on its top priority list, and find money, men and women to begin research.
(John Dayal is an author, Editor, occasional documentary film maker and activist)
