Written by VT Padmanabhan and Joseph Makkoli

The second wave of Covid-19 that began in Jan 2021 is on the decline, as epidemiologists expect that the infection rates would reach the nadir in a month or so.  The second wave can also be called as India wave as the pandemic grew much faster here.  It can also be called as the Delta Wave, as this is being driven by virus variant by that name.  During the five months of the Delta wave, India added 17.8 million new cases, as against 10.3 million during the ten months of last year.  The second wave impacted Lakshadweep, an island in the Arabian Sea, a union territory of India with greater intensity.  During the first wave, not a single case was reported in the island and the first few cases were reported on 18 Jan 2021.  As of 31 May, the island has the highest infection rate in India, its infection is five times larger than India and it is higher than that of the US. This paper shows that the island was pushed into this crisis by the decisions of administration, disregarding the scientific opinion and the ignoring the opposition and protests of the communities.

Data source:  The covid-19 data for India used in this paper has been downloaded from https://api.covid19india.org/csv/latest/state_wise_daily.csv.  This dataset has daily numbers of new infections, recoveries and death for 38 States and Union Territories of India since 20 January 20.  We have used the data up to 31 May 2021. This GitHub initiative sources its data from the Government and from media reports also.  The data for other countries are from the Humanitarian Data Exchange (HDX), an open data platform managed by the United Nations’ Office for the Coordination of Humanitarian Affairs (OCHA).

Infection Rates

The only way to compare the trajectory of the pandemic in different spaces and times is to convert the data on cases to infection rates- which is the number of infected persons per thousand or million population.  In this article, we will use the rate of infection as cases per 1000 people.

 Infection Rates in Indian States

Infection rate in India as on 31 May 21 was 20.5/per 1000. The highest infection rate of 110 per 1000 has been reported in Lakshadweep Islands, a union territory in the Arabian Sea with a population of 73,183.   Five states and territories- Goa, Puducherry, Chandigarh, Ladakh and Kerala have rates between 50 -95 per 1000.  This is the range seen in middle covid countries in Europe. Bihar and Uttar Pradesh have rates around 7 per 1000, which is the rates reported from majority of the Asian-African countries.

The infection rate in the US is 103/100, which is lower than Lakshadweep’s.  There are only 9 countries in the world with rates higher than Lakshadweep’s.  (See Figure 1).

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Figure-1 : Top Ten Corona Empires of the World

History of Pandemic in the island

Until 17 Jan 21, no case of Covid-19 was reported in Lakshadweep. On 18 Jan 2021, the island reported 14 cases, all among the servicemen and family members of the India Reserve Battalion (IRBn), stationed at Kavaratthi.  The Camp and the housing complex were declared as containment zones on the same day. There were 87 cases during the second half of Jan 21, and 4650 new cases during 16 – 31 May 2021.  During the four and a half months there were 8077 cases and 33 deaths.  Half-monthly data of cases, deaths and recoveries are given in table 1.

co lak table

Trajectories of pandemic in the US and Lakshadweep

The trajectories of the pandemic during March 2020- May 2021 in the US and Lakshadweep can be seen in figure 2.  The vertical axis shows half-monthly infection rates.    In the Us, the first case was reported on 20 Jan 2020, the current caseload is 34 million and the  population is 333 million.   There the virus had to work patiently and persistently throught out the entire duration of the pandemic, and the half-monthly infection rate has been below 12 during the 17 months.  In just four and a half months, the virus could build a bigger empire in the island.

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Figure 2- Trajectories of Pandemic in the US and Lakshadweep

Half monthly infection rates in Lakshadweepo, India and the US during the Delta Wave are given in Table -2.  The last two rows are the ratios of LD with India and US.  The infection rate in the island was 15 times that of India during 1-15 Feb and 45 times that of US during 16-31 Mar 2021.  These rates could overwhelm the public health system in any country in the world.

Delta Wave

The Delta strain was first seen in a patient from India and three strains in this sub-species- (B.1.617.1, B.1.617.2 and B.1.617.3) are in circulation now.  The contribution of these strains to the pandemic in India is not known.  Quoting the UK Health Secretary, Matt Hancock, the BBC reported on 27 May 2021 that “the latest estimates are that more than half and potentially as many as three-quarters of all new cases are now of this variant.  According to the UK health secretary, the Delta strains are behind about three-fourth of the new cases being reported from UK during the recent weeks. 

How it Happened?

During the first year of the pandemic, the island remained a safe haven owing to its strict non-pharmacological interventions.  As of 22 December 2020, the Standard Operating Procedure (SOP) required 10 days’ quarantine at Kochi and a negative RT PCR test before embarcation and 7 days quarantine in the island.  On 22 December, the Administration intended “to open up more economic and livelihood activities for the local population by relaxing the prevailing SOP and to permit the movement of men and material into its territory”.  Now anyone could travel without quatantine.

Peoples Resistances

There were widespread opposition and protests by the people against the unilateral decision without the people’s consent.  B Hassan, the President-cum-Chief Counsellor of Lakshadweep District Panchayat requested the administrator to “withdraw or keep in abeyance the revised SOP with a larger interest of safe guarding the life of the people”.

A meeting of the elected representatives of Androth Panchayat on 26 Dec 20 resolved:

 

Such meetings were held in all the Panchayats.

The New Variant and the Warning from Government of India

The new SOP came into force on 28 December.  On the same day, the Home Secretary Government of India, wrote to the Administrator that “keeping in view the fresh surge in cases globally and emergence of new variant of virus in United Kingdom, there is a need for maintaining caution and strict surveillance to prevent any fresh surge in cases in wake of upcoming New year celebrations and ongoing winter season which are favourable for the spread of the virus”.

Lakshadweep – A Backgrounder

The density of population in Lakshadweep is 2,149/sq km; it ranks third in the country, next only to Delhi and Chandigarh. Besides, there are more members per household in the island.  The average size is 6 persons per household; a third of the households have seven or more members.  The houses are also smaller due to the limited landholdings, resource crunch, geography and geology of the islands. These conditions created a fertile ground for the seeds sown.

Lakshadweep, a group of coral islands in the Arabian Sea, about 280 km to 480 km off Kerala coast consists of 12 atolls, three reefs and submerged sand banks. The underwater view is kaleidoscopic and breathtaking with pristine beauty, crystal clear water and shallow lagoons.  Of the 27 islands, only 11 are inhabited. The coral atolls have the average elevation of half a meter.

Livelihood

Coconut, cultivated in 2700 hectares, is the only major crop with a production of 55 million nuts per year. The Lakshadweep coconut has 82% oil content, the highest in the world and is branded as an organic product. The sea around Lakshadweep is rich in fishery resources. The estimated fishery potential resources are about one lakh tonnes of tuna and shark. The “Pole and Line” fishing is only found in Lakshadweep in the Indian continent. The present annual production is about 12,000 tonnes, which is hardly 5% of the total potential. Skip Jack tuna contributes about 80% of the total landings, and 60% of the landing dried.  More than half the catch is exported.

The First People

Lakshadweep has the highest proportion of Aadivasi (95%) in India.  It has the second highest literacy rate and the lowest crime rate in India. The age and sex distribution of the people is given in Figure-3.

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Figure 3:  Age Structure and Sex of Lakshadweep

In the Honourable High Court of Kerala

The tribals also went to the Honourable High Court of Kerala, praying for intervention on the revision of SOP.   Two writ petition and one writ appeal were admitted and dismissed.  The learned judges however, characterised the relaxation of quarantine protocol as improper and unscientific.  The first petition filed by Shafeeque Rahman was dismissed on 18 Jan 21, few hours before the administration of the island received the RTPCR results of 14 posistive cases.  Quote from the judgment:

When petitioners apprehend immediate spread of Covid 19 on account of withdrawal of institutional quarantine for travelling to the islands and point out the inadequacy of facilities to contain the spread of Covid 19, contention of the respondents is that they have taken all measures to contain the same.

The petition was dismissed on the ground that the revision of SOP “does not warrant interference of this court under Article 226, as it is issued in implementation of the policy decision taken by the Lakshadweep Administration, in order to protect the interest of all concerned, which is very well within its authority”.

The Appeal and Another Fresh Petition

On 28 May 2021, a Division Bench of  learned judges S. Manikumar and  Shaji P. Chaly dismissed Shafeeque’ s appeal and the second writ petition filed by Akbar MK (mentioned below).  Dismissing the appeal the Bench stated that “the catastrophic effect feared by the inhabitants of Lakshadweep, on account of the improper and unscientific relaxation of quarantine protocol, is not proven to be correct, with Covid -19 positive cases being identified in the islands.”  (Emphasis ours.)

On 28 May 2021, the day of the judgment, Lakshadweep had a cumulative caseload of about 6,000, as against more than 2 million in Kerala and 25 million in India. If one were depending on raw data, the catastrophic effect in the island will be invisible, even if its entire population were infected. What if the Bar and the Bench had knowledge of the infection rates?

In his petition,  Akbar MK  sibmitted that “a policy matter by the Government which infringes upon the fundamental right of a citizen is liable to be quashed and therefore, as a necessary corollary, the relevant part of SOP is liable to be quashed.”  Dismissing the petition, the learned judges said: “We are also of the view that the SOP is issued considering the advises rendered by the experts in the various fields and such aspects cannot be given a go-bye, by a writ court normally and ordinarily, which is a well accepted proposition in law”. (Emphasis ours).

Paragraph 5 of the judgment (Shafeeque Rahman K.K vs Collector And Chairman)  dated 18 Jan 21 mentions about an exhibit submitted by the petitioner which is reproduced below:

“(Based on) information received on 01 Jan 21 under Right to Information Act,  petitioner stated that there was no recommendation from the Director of Health Services, who is the competent authority to reduce the institutional and home quarantine”.

We could not locate any expert recommendation for the 23 December  revision of the SOP. .

Highlights

In India, the infection rates during the first and second half of May were 4.8 and 2.5 per 1000.  During the same periods, Lakshadweep had 25.7 and 46.8 per 1000 respectively. During the second half of May, infection rate in India decreased by 37% against an 82% increase in the island.

During the second half of May, the infection rate in the US was 12/1000.  The highest half-monthly infection rate registered in the world during the entire duration of Covid-19 pandemic was is 22 per 1000 in Belgium in October 2020.  Lakshadweep scored the highest infection rate per half-month in the world.

The infection rate in India has started falling since the second half May.  It looks like the island would have to wait.

DISCUSSION

The Genome sequencing in Lakshadweep

Studies show that the Delta strains of SARS-Cov 2 which are driving the second wave of the pandemic are more transmissible, 50 per cent more than the UK or Alpha variant (B.1.1.7).  Though the first sequences of B.1.617 were available in December 2020, it was identified as a cause for concern in March from samples sequenced in February. In Lakshadweep, the surges with the highest half-monthly infection rate in the world happened when Delhi and other places were also experiencing surges, which are now attributed to the Delta strain.  Genome sequencing of the virus has not been done in Lakshadweep.  A detailed study including genome sequencing in the island will be of immense in the control of the pandemic at the global level. The Indian SARS-CoV-2 Genomics Consortium (INSACOG) constituted by the Government of India in December 2020, with an ambitious plan to sequence 5% genomes of all cases may not be able to do this at this point of time.  An international effort using new technologies like the low-cost CRISPR diagnostics is among the options.

Allies of Virus amongst Us

The political, scientific and religious leadership also contributed to the success of the virus in all major covid countries.  In India for instance the National Supermodel Committee for monitoring infection,   appointed by the government of India predicted in October 2020 that the pandemic in India would end in early March. This was followed by the government’s declaration of its victory over the virus at Davos. There are also presidents and prime ministers who believed that their nations are invincible, and that the Gods are always on their side.

The Uniqueness of Lakshadweep Administration’s Virus-friendliness

All the political leaders whose actions helped the virus had the support from their expert committees.  In Lakshadweep, the administrator did not receive such recommendation to revise the SOP from any expert.  The stated objectives of the revision of SOP were related to the economy – loss of revenue due to closure of tourism and suspension of construction activities.  Shafeeque in his petition alludes to an unstated objective, which has been mentioned in paragraph 5 of the judgment:

“the reason behind (the revision) is the offshoot of ego clash of the newly appointed Administrator because his attempt to accommodate guests was objected to, pointing out that observance of quarantine protocol and guidelines by all including the member of parliament.”

This may be true or untrue.  A major modification of a highly successful protocol, at a time when the Union Government had warned about the emergence of a dangerous variant, without the backing of science and people’s consent in unheard of in this pandemic.  What happened in Lakshadweep is a  case of unethical human experimentation.

Nuremberg Code and Helsinki Declaration

Unethical human experimentation is human experimentation that violates the principles of medical ethics. In Nazi Germany, such human experiments were more extensive with a minimum of 15,754 documented victims. During the Nuremberg Trials, 23 Nazi doctors and scientists were tried for the unethical treatment of concentration camp inmates, who were often used as research subjects with fatal consequences.

 

AuschwitzFigure 4:  A group of child survivors behind a barbed wire fence at Auschwitz-Birkenau, on the day of the camp’s liberation on January 27, 1945.

 

Horrifying medical experiments on twins helped Nazis justify the Holocaust.

https://www.history.com/news/nazi-twin-experiments-mengele-eugenics

 

During the 1930s and 1940s, the British Army used hundreds of British and Indian soldiers in their experiments to compare the toxicity of mustard gas on Indian and British skin. In the Tuskegee syphilis experiment from 1932 to 1972, the United States Public Health Service conducted a long-term study of syphilis study on more than 600 African-American men, who were denied access to the known treatment of the antibiotics. The Nuremberg Code and the Helsinki Declarations developed the ethical principles for medical research involving human subjects, including research on identifiable human material and data.

For the past five months, the islandes have been turned into concentration camps where experiments were conducted on the transmission of the Delta strains of SARS Cov-2 virus. Thirty three precious lives have been lost; there is no end in sight for the plight of the people.  As more pandemics are expected in future, it must be ensured that such experiments are not repeated.

VT Padmanabhan researches and writes on environmental and food safety issues.Email:  vtpadman@gmail.com

Dr Joseph Makolil is a nano-scientist with the Cochin University for Science and Technology (CUSAT).


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