Are Journalists Above Law?

Shared lineage, heritage, possessions, religion, scriptures, faiths, beliefs, customs, social behaviour, language, literature, and cuisines interconnect people. These elements of bonding therefore are sources for an individual’s pride and vanity.  Essence of decorum of a civilised society is both tolerance and vanity of people. Any act including a threat to commit that act, which hurts the vanity of an individual is as serious as outraging the modesty of a woman. While free speech is a virtue of a tolerant society, hurting the vanity of someone under the pretext of free speech is anarchy. Physical wounds may heal but hurt caused to vanity is rarely forgotten or forgiven.

Synchronous or asynchronous utterances in media of all kinds and public gatherings need to be within reasonable restraints so as not to hurt the vanity of anyone.

The rights (a) to freedom of speech and expression (b) to assemble peaceably and without arms (c) to form associations or unions (d) to move freely throughout the territory of India (e) to reside and settle in any part of the territory of India and (f) to practise any profession, or to carry on any occupation, trade or business, all are subject to restraints imposed for preventing anarchy.

“I think, first of all, in any place around the world, it is very important that people be allowed to express themselves freely, journalists be allowed to express themselves freely and without the threat of any harassment,” Stephane Dujarric, Spokesman for the Secretary-General, said. (Quoted from https://www.financialexpress.com/india-news/journalists-should-not-be-jailed-for-what-they-write-tweet-and-say-un-spokesperson-on-zubairs-arrest/2576406/). He is wrong in advocating that the journalists are more than equal when it comes to legal, moral, social and cultural restraints.

Whenever a politician, journalist, lawyer, Chartered Accountant, Doctor or other professional is summoned by the law enforcement agencies for questioning, or detained by the Police for any inquiry, the representative clan and some of the non-representative elements of the so called civil society start making loud noises alleging falsehood and malice. While the officials unfailingly but eagerly apply their rules but rarely apply their minds, there are others in the government who rarely care for rules but aggressively apply their minds. Minds can be prejudicial. That investigators exceed their remit in the pursuit of justice or the orders of their masters is not an impossibility, but who are we to judge?

Are we willing to wait for the evidence to be presented before the judges and let the judge pass the verdict or are we going to initiate a parallel trial on social media sites and TV shows and Twitter? Are we going to support a system in which thousands of amateur judges oversee parallel trials and pronounce verdict months and even years before the real judges catch up?

Whatever the truth, most of us are not legal experts and it is beyond us to debate whether the process is fair or not. What we can and should debate is how ready we are to believe that every man and woman is fallible irrespective of his or her credentials. Are we ready to stop putting the suspect and the accused on a pedestal? Are we willing to suspend the purposive disparaging of the system of law by lobbyists?

*****

Politics of Commotion: Superficial Dialogue through Digital and Social Media

Over the last several years, we are witnessing, may be not perceiving it seriously, that political discourse in India is now getting confined to TV and Social Media and is commandeered by the scheduling consideration of these media options.

To enable the TV editors to gather participants for the debates and encapsulate content for prime time viewing, the messages are created no later than 5:00 pm. Likewise, to ensure proper rest for the media persons and the message sources, political activities, agitations, rallies, sloganeering, press-conferences, are all usually held after 10:00 am but before 2:00 pm.

The use and proliferation of digital and social media has radically changed both the way we are using language and the way we are ‘doing politics’ these days. Virtual space has now become the ‘natural habitat’ of an increasing number of individuals around the world; a space where they engage in discussions, work, shop, bank, hangout, relax, vote, find love partners, conduct their day-to-day activities, and so forth. A large proportion of day-to-day verbal and visual communication has migrated to various participatory web platforms. Social media have been hailed as either emancipatory tools contributing to a more participatory democracy, creating instant awareness about different social issues, a new public space of sorts (‘Arab Spring’ and the ‘Occupy’ movement are two widely cited examples).

A public sphere is a space of political communication and access to resources that allow citizens to participate in it. In this sense, given the exclusionary and commodified character of digital and social media, they cannot be considered as public spheres nor should they raise our hopes that revolution will be tweeted. Social and digital Media is dominated by corporations that make money by exploiting and commodifying users and this is why they can never be truly participatory. On a serious consideration, digital and social media are just another tool of control and containment, a profoundly depoliticising arena that fetishizes technology leading to a denial of a more fundamental political disempowerment.

One can realize the magnitude and impact of the medium if they consider that in the famous ‘Russia meddling,’ posts from a Russian company had reached the newsfeeds of 126 million users on Facebook during the 2016 US election and hundreds of thousands of bots posted political messages during the election on Twitter alone.

Digital and Social media is a new kind of an effective political instrument that, in the context of advanced capitalism, both dehumanizes politics and struggles and absolves people from the guilt of inertia in the face of major social and economic crises. It serves as an escape from the stress of intelligence, the pain and tension which accompany autonomous mental activity. Social Media is actually an effective anaesthesia against the mind in its socially disturbing, critical functions – leading to the knocking out of the mental agitation. Social media, as tools for producing and consuming different kinds of texts promotes a one-dimensional discourse. Consider the characteristics of Twitter’s one-dimensional discourse:

Language used in Twitter is short, fragmented and decontextualized: it is a language that tends to express and promote the immediate identification of reason and fact, truth and established truth, essence and existence, the thing and its function leaving no room for a dialogue and counter-reason. Twitter demands simplicity, promotes impulsivity, and fosters incivility.

Digital media takes the pedestal of instrumental and technological rationality and reduce audiences to the status of commodities and consumers of advertisements.  Such audience commodities that the media consumers become themselves are than sold as an audience to the advertising clients of the media.

Face-book, Twitter and other sites serve as an escape from the mechanised work process, and a breather to muster strength in order to be able to cope with the next round of work again. This allows social media to be marketed as entertainment – an entertainment that is accessible, on demand, any time and every time. For this entertainment to remain as a pleasure, it must not demand any effort of independent thinking from the audience. This constructs an involvement through inertia that creates a false sense of participation, security, homogeneity and consensus. Everyone is presumed to be a producer as well as a consumer of content, and the meaning of the messages get lost.

While there is around-the-clock exposure, constant access, and immediacy (all content is immediately available for reading and commenting), the message in the digital and social media is often decontextualized. The context is always that of-the-moment, limiting broader interpretations, connections and exploration of ramifications. Such content have a planned obsolescence, as the next programme or tweet will draw even more attention, commentary, visibility, and currency. The contents history is the here and now, as an ongoing critique of reality. Meaning loses history.

It comes, then, as no surprise that digital and social media have been serving as the ideal medium for populist parties and their leaders promoting the Politics of Commotion.  Digital and social media constitute an alternative to the mainstream media. Political campaigns started using social media as early as 2009, but it was with the 2019 General Elections that their use was taken to the next level.

Today, most political figures and parties use digital and social media platforms to disseminate their agendas and this has largely changed the way politics is conducted. This is a time when politics is ‘branded’ through social media. While democracies need liberation of the individuals from politics over which they have no effective control,  it seems that digital and social media have a firm grip on a large percentage of the our population, while people, in turn, have no control over digital and social media.

*****

First published 05 Aug 21

***

“Likes” “Follows” “Shares” and “Comments” are welcome.

We hope to see energetic, constructive and thought provoking conversations. To ensure the quality of the discussion, we may edit the comments for clarity, length, and relevance. Kindly do not force us to delete your comments by making them overly promotional, mean-spirited, or off-topic.

***

COVID Confusions

COVID-19 is a new acronym coined for Corona-Virus-Induced-Disease of the year 2019. Year 2020 made some old word or phrases suddenly very fashionable and buzzing with new meanings, and injected them into active vocabulary of people. Corona, a word hitherto associated with the Sun, novelty and SARS-Coronavirus-1 was not so much in use but became suddenly a dreaded word linked to COVID-19. Positivity, a word that was generally used for the practice of being or tendency to be positive or optimistic in attitude up until then, took on the other meaning of the presence rather than absence of a certain substance, condition, or feature, now a measure of incidence of disease.

Check out some of these words or phrases for yourself, because your inability to use them in conversations may be mistaken as your ignorance – animal-human interface, asymptomatic, carrier, clinical trials, community spread, contact tracing, Contagious, Droplets, Epidemic, flatten the curve, herd immunity, HRCT scan, incubation period, Isolation, Mask, mRNA Vaccines, Mutant, Outbreak, Oxygen-concentrator, Oximeter, Pandemic, Pathogen, patient zero, PCR test, personal protective equipment (PPE), Plasma, Quarantine, Rapid-Antigen Test, Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), Screening, self-isolate, social distancing, Super spreader, Symptomatic, Transmission, Vax, Ventilator, Viral Vector Vaccines, Zoonotic – and the list goes on.

Some proper nouns also made their way in the active vocabulary – Wuhan, AstraZeneca, Covax, Covaxin, Covishield, Sputnik5, Pfizer-BioNTech, Moderna, Johnson & Johnson’s Janssen, Novavax, Coronil, CoviSelf, Remdesivir, 2-DG, and so on; but the most conspicuous proper noun is FAUCI.

Anthony Stephen FAUCI (born December 24, 1940) is an American physician-scientist and immunologist who serves as the director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and the chief medical advisor to the president. He has acted as an advisor to every U.S. president since Ronald Reagan. From 1983 to 2002, Fauci was one of the world’s most frequently cited scientists across all scientific journals. In the early stages of the COVID-19 pandemic, The New Yorker and The New York Times described Fauci as one of the most trusted medical figures in the United States. Currently Fauci is the Chief Medical Advisor to President Joe Biden, officially appointed in 2021.

After initially declaring in April of last year that the virus was “not a major threat to the people of the United States” and that it was “not something the citizens of the United States right now should be worried about,” Fauci repeatedly urged Americans not to wear masks early in the pandemic. Later, Fauci admitted that he had believed all along that masks were effective but said he had wanted to ensure that supplies would be reserved for medical professionals. In other words, he asserted that he had the right to lie to the public for what he believed to be their own benefit. If Fauci is correct that masks effectively contain the spread, then the cost of his misinformation as the pandemic worsened may be incalculably large, for the US community. (https://www.delcotimes.com/opinion/chris-freind-dr-fauci-needs-a-dose-of-reality/article_9bce984e-7641-11eb-8c87-4f0114a8a7a2.html )

After repeatedly dismissing the theory that the COVID-19 virus escaped from the Wuhan Institute of Virology in China, Fauci now says he cannot rule out the theory.

Fauci has now backtracked on his comments about the National Institutes of Health (NIH) funding for the Chinese lab under his leadership, that funding was not for “gain of function” research, a laboratory technique that intentionally makes pathogens more dangerous and transmissible. Gain of function research in Wuhan was indeed funded through one of Fauci’s grants.

Late last week, COVID policies stated that fully vaccinated individuals do not need to wear masks indoors or outdoors, any longer. Defending the policy, Fauci declared that the abolition of mask mandates was not a contradiction of previous policy but instead followed “evolving science” on the virus; although no examples of this supposedly new scientific evidence were forthcoming. Fauci then added to the confusion by declaring, apparently on his own authority, that young children would still be required to wear masks in school. Then, just a gay later, Fauci suggested that it was “reasonable” for businesses to maintain mask mandates even for vaccinated Americans, in blatant defiance of the CDC’s recent guidance. Whichever way one looks at it, Fauci has become a key player in the current controversy, which completes his transformation from an independent doctor into a political football, at the age of 80 years.

Fauci has also steadily moved the goalposts on the percentage of the population that will need to be vaccinated to achieve herd immunity. Earlier this year, he said herd immunity would be achieved when 60% were vaccinated; in recent interviews, he has spewed out numbers as high as 85%. At the very least, the top infectious diseases expert of the US and chief medical adviser to Biden is loose with the facts and is prone to changing his mind. To be fair, the pandemic caught a lot of people unaware, but the thing about Fauci is that he always is so sure of himself. (https://nypost.com/2021/01/24/dr-fauci-needs-to-be-held-responsible-for-mistakes-devine/ ).

India has done well in vaccinating the armed forces personnel with 90% of them having already received both doses of vaccine. India did not listen to the US guidelines (CDC) on reopening of schools, which is now being associated with untold misery that followed in Texas.

Luckily, Indian policy-makers do listen to Dr. Anthony Fauci but do not blindly subscribe to all his utterances. Good, is not it, that while being open to all the information, suggestions, knowledge and advice coming from everywhere, we have a mind of our own. When it comes to inconsistent and improvisational COVID messaging, no one can surpass Dr. Anthony Fauci.

**

First published 24 May 21

**

“Likes” “Follows” “Shares” and “Comments” are welcome.

We hope to see energetic, constructive and thought provoking conversations. To ensure the quality of the discussion, we may edit the comments for clarity, length, and relevance. Kindly do not force us to delete your comments by making them overly promotional, mean-spirited, or off-topic.

**

See Behind the Curtain of QS World University Rankings 2022

I will begin on a lighter note because what follows is serious and may be tough, harsh and unsavoury for quite a few learned people.

There is a joke about a man asking his son about his result in the school, which is narrated nearly in all parts of the country. Rendered in local dilect with local nuances and cultural flavour, the outcome is always hilarious.  This joke goes something like this –

Man (to his son Ramu) – tell me, whether you passed this time or have failed the exams once again

Ramu (replying to his father) – I have stood fourth in the class

Man – very good Ramu, but did you pass

Ramu – Gopal (Head master’s son) has stood sixth in the class, I have done better than Gopal

Man – Poor Gopal, he remained behind you, but did he pass or not

Ramu – only Dheeru and Golu passed, they stood first and second. Don’t get angry with me, I am better than 36 in my class. Only 3 are better than me.

Man (in angry and abusive tone) – Idiot, you failed again

Clearly, the result was only 5% (2 out of 40) pass rate.

Let us now look at the QS World University Rankings 2022. India has celebrated that three of our institutions – IIT Bombay (shared rank 177), IIT Delhi (rank 185) and IISc Bangalore (shared rank 186) continue to remain in the top 200 ranked Universities of the World even in 2022. The Prime Minister (https://twitter.com/narendramodi/status/1402628065474203650) and the Education Minister (https://twitter.com/DrRPNishank/status/1402559433259962371) also congratulated these institutions, and rightly so, rankings do give us a sense of achievement. We need to be careful however, if our euphoria (https://timesofindia.indiatimes.com/india/india-emerging-a-vishvaguru-says-ramesh-pokhriyal-after-3-indian-institutes-figure-in-top-200-qs-world-university-rankings/articleshow/83373333.cms ) is like that of a Ramu or a Golu?

QS World University Rankings 2022 feature 1,300 universities from around the world. There are 35 Indian Universities in this list of 1300. (https://www.topuniversities.com/university-rankings/world-university-rankings/2022 )

Universities were evaluated according to a weighted average of the six metrics – Academic Reputation (40%), Employer Reputation (10%), Faculty/Student Ratio (20%), Citations per faculty (20%), International Faculty Ratio (5%), and International Student Ratio (5%).

The matrices are reported as measurements on an analogue interval scale (0-100) which are then aggregated into an overall score (weighted average). The overall score is therefore on an analogue interval scale (0-100).

The overall score was then ordered from high to low and discreet ranks awarded as 1, 2, 3, and 4 and so on. Universities tied at same overall score share the same rank and the next rank is then skipped to account for double cases at same rank. In such ranking, among the top 200 ranks, three institutions from India figured.

Let us try to see beneath the veil of these ranks.

  • MIT, which ranks first has an overall score of 100 (rounded up) composed of Academic Reputation (40% of 100), Employer Reputation (10% of 100), Faculty/Student Ratio (20% of 100), Citations per faculty (20% of 100), International Faculty Ratio (5% of 100), and International Student Ratio (5% of 91.4).
  • The overall scores are thus some kind of ratings for the Universities. Interestingly, as we go down the ranking list, the overall score drops very fast – Carnegie Mellon University, Pittsburgh United States scores less than 75% but ranks at 53; Hanyang University, Seoul South Korea scores less than 50% but ranks at 156; Maastricht University, Maastricht Netherlands scores less than 50% but ranks at 156; and University of Missouri, Columbia United States scores less than 25% but ranks at 476.
  • Overall Scores for Universities ranked at 501 or lower are nor reported (they scored 24 or less out of 100)

Let us revert to performance by the institutions from India. There are 35 institutions from India in the list of 1300 ranked institutions, of which 3 are in top-200, 5 more are in the 201-500 group, another 14 are in the next 500 ranks while the remaining 13 are in the last 300 ranks. The top-3 institutions from India are rated and ranked as under:

  • IIT Bombay (Academic Reputation -51.3, Employer Reputation -79.6, Faculty/Student Ratio- 32.5, Citations per faculty -55.5, International Faculty Ratio – 1.5, International Student Ratio – 1.6; Overall score – 46.4; rank-177),
  • IIT Delhi (Academic Reputation -45.8, Employer Reputation -70.8, Faculty/Student Ratio- 30.9, Citations per faculty -70.0, International Faculty Ratio – 1.2, International Student Ratio – 1.7; Overall score – 45.9; rank 185)

and

  • IISc Bangalore (Academic Reputation -34.2, Employer Reputation -19.2, Faculty/Student Ratio- 48.8, Citations per faculty -100.0, International Faculty Ratio – 1.2, International Student Ratio – 1.8; Overall score – 45.7; rank 186)

The next 5 ranked institutions are:

  • IIT Madras (Overall score – 38.1, rank 255),
  • IIT Kanpur (Overall score – 36.4, rank 277),
  • IIT Kharagpur (Overall score – 36.3, rank 280),
  • IIT Guwahati (Overall score – 28.3, rank 395) and
  • IIT Roorkee (Overall score – 28.0, rank 400).

Here is what the rating data displays:

  • Only the public institutions of technology and science are able to find a place in the top-500 club. These are deemed to be universities but not a university in the real sense of the term. A university is multi-disciplinary, spanning across humanities, science, commerce and social sciences rather than being confined to a very narrow focus on technology.
  • There is no real Indian University in the top-500 ranks. South Africa has 4 real universities in the top-500 club.
  • As against 8 institutions from India in the top-500 club, Europe has 212 institutions, United States has 87 institutions while Rest of Asia has 117 institutions (includes 26 from mainland China, 16 from Japan).
  • These 8 institutions do not account for even 1% of the total university enrolment in India.
  • The best of best in India scores only 46% marks as compared to the best in the world score of 100%.
  • There are large variances in the scores for Academic Reputation, Employer Reputation, Faculty/Student Ratio and Citations per faculty within the top 3 whose ranks are spread over only 9 ranks.
  • Employer reputation seems to exceed Academic Reputation for the high ranked institutions in India. IISc turns out to be an exception in reputation as well as in its Citation score.

Makeup is used as a beauty aid to help build up the self-esteem and confidence of an individual. Like NIRF Rankings (https://www.researchgate.net/publication/350354434_NIRF%27s_India_Rankings_Are_Ludicrous) QS World University Rankings 2022 are a makeup for educational institutions. This makeup conceals the ugly pockmarks on the face of Universities in India. It is unfortunate that the Education Minister has utilized this makeup to beat the harsh lights and the glare of camera flashes which would expose the rot in education system.

By calling these rankings as a testimony for India’s “leap in the field of Education & Research and is emerging as a VISHVAGURU” Education Minister is only proving his lack of understanding and literateness. Surely, he remembers well – “Parde Mein Rehne Do Parda Na Uthao, Parda Jo Uth Gaya To Bhedh Khul Jayega, Allah Meri Tauba – Allah Meri Tauba” (परदे में रहने दो पर्दा न उठाओ, पर्दा जो उठ गया तो भेद खुल जायेगा, अल्लाह मेरी तौबा – अल्लाह मेरी तौबा) keep the curtain on, don’t lift the curtain, If the curtain is lifted, then the secret will be revealed, Allah is my repentance – Allah is my repentance.

**

First published 12 June 2021

***

“Likes” “Follows” “Shares” and “Comments” are welcome.

We hope to see energetic, constructive and thought provoking conversations. To ensure the quality of the discussion, we may edit the comments for clarity, length, and relevance. Kindly do not force us to delete your comments by making them overly promotional, mean-spirited, or off-topic.

***

Are You Joking Dr. Lele?

Evidence-Based Medicine is a hot topic ever since the unpleasant and acrimonious spat between Swami Ramdev, also known as Baba Ramdev, of Patanjali and Dr. Jayesh Lele, MBBS, general secretary of the country’s largest lobby of allopathic doctors, the Indian Medical Association, or IMA was aired on 25 May 2021.

Lele seem to claim that COVID-19 treatment being undertaken in India by the allopathic doctors is Evidence-Based Medicine, which Ramdev was unwilling to accept due to very frequent and recurring changes in the allopathic treatment-protocols being practised, the preceding ones being abandoned citing lack of evidence while the succeeding ones being merely new conjectures.  Following the dictum that ‘absence of evidence’ is not the ‘evidence of presence’ let us dispassionately and objectively examine Lele’s claim.

The updated (revised and improved) definition of Evidence-Based Medicine is a systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values. (David L. Sackett, Sharon E. Straus, W. Scott Richardson, William Rosenberg, and R. Brian Haynes. Evidence-Based Medicine: How To Practice And Teach EBM. 2nd edition, London: Churchill-Livingstone, 2000)

Speaking at the MLA 2010 Annual Conference, held in Washington DC, Mark Ebell, MD, MS, Associate Professor at the University of Georgia, and Editor-in-Chief, Essential Evidence Plus  defined Evidence-Based Practice as, “Making a conscientious effort to base clinical decisions on research that is most likely to be free from bias, and using interventions most likely to improve how long or well patients live.” (https://youtu.be/XWi7vNv2nos)

Evidence-based medicine includes three key components (see Figure): research-based evidence, clinical expertise (i.e., the clinician’s accumulated experience, knowledge, and clinical skills), and the patient’s values and preferences.

Practicing evidence-based medicine is advocated on the promise of improved quality, improved patient satisfaction, and reduced costs.

The EBM Pyramid (see figure) explains the knowledge types and the reliability of such evidence. Evidence in Level I is considered the gold standard of medical knowledge. Evidence in Level II comes from Controlled trials without randomization or Cohort or case-control analytic studies or multiple time series studies. It is often true that the best evidence available to clinicians is their own observed aggregate data. Evidence in Level III is based on expert opinion from experts who have narrowed their focus as much as possible about a complex area. Evidence in Level IV is based on personal experience. This is the least desirable source of evidence and lacks any statistical validity.

There is good evidence (e.g., from RCTs) and there is bad evidence (e.g., from personal experience). Then there’s evidence that falls in the grey area—neither clearly defined as good nor bad. It can be difficult for clinicians to know whether to use evidence in the grey area. To determine the validity of evidence, a team of clinicians with several years of experience in evidence-appraisal should review the knowledge in question. The team can then determine if the evidence is valid (i.e., accurate) and applicable (i.e., useful for the situation or population being considered).

COVID-19 is a fast moving epidemic with many uncertain parameters. In view of the lack of prior knowledge and urgency of the situation to have some understanding, clinicians and researchers worldwide are reporting rapid results in the form of Level III and Level IV evidence. There is no evidence at Level II or Level I about any treatment protocols at this time. These rapidly reported results are continuously changing as new insights on the SARS-CoV-2 virus and COVID-19 emerge.

The treatment protocols adopted by allopathy for treatment of COVID-19 have therefore been non- standardized, non-evidence-based protocols. They have been based on near real-time data, mostly of level IV and level III, to make care decisions with the sole objective of improving outcomes of treatment. Given the urgency for action, transparency, accountability, quality of care and value of care have expectedly taken a back seat.

Numerous preventative strategies and non-pharmaceutical interventions have been employed to mitigate the spread of disease including careful infection control, the isolation of patients, and social distancing. Management is predominantly focused on the provision of supportive care, with oxygen therapy representing the major treatment intervention. Medical therapy involving corticosteroids and antivirals have also been encouraged as part of critical management schemes.

The COVID-19 Treatment Guidelines have been developed by National Institutes of Health of the Government of the United States, to provide clinicians with guidance on how to care for patients with COVID-19. As per the official website these treatment guidelines were last updated on 27 May 2021. (https://www.covid19treatmentguidelines.nih.gov/introduction/ accessed on 06 June 2021). The recommendations in these Guidelines are based on scientific evidence and expert opinion. Each recommendation includes two ratings: an uppercase letter (A, B, or C) that indicates the strength of the recommendation [Rating of Recommendations: A = Strong; B = Moderate; C = Optional] and a Roman numeral with or without a lowercase letter (I, IIa, IIb, or III) that indicates the quality of the evidence that supports the recommendation [Rating of Evidence: I = One or more randomized trials without major limitations; IIa = other randomized trials or subgroup analyses of randomized trials; IIb = Nonrandomized trials or observational cohort studies; III = Expert opinion].

As on date, there is only one recommendation rated ‘AI’ for Managing Outpatients with COVID-19 while the most reliable of recommendations for Managing Patients in an Ambulatory Care Setting have not bettered the ‘AIII’ rating. Critical Care recommendations are still at rating B. Recommendations for managing hospitalised patients with varying severities of disease are still at ‘BIIa’ rating.

These guidelines have a clear disclaimer, “Rated treatment recommendations in these Guidelines should not be considered mandates. The choice of what to do or not to do for an individual patient is ultimately decided by the patient and their provider.”

The above facts clearly indicate that there is no evidence-based-practice or evidence-based-protocol for treatment of COVID-19 in the allopathic system. Based on frugal, confusing, rapidly changing and often low-quality data, clinicians are using and recommending their best educated guesses for treating COVID-19. It is true that an educated guessing is better than no guessing until such time that research becomes available but there is no evidence to show that an educated guess is any better than an uneducated guess.

Surely you are joking Dr. Jayesh Lele when you say that the treatment-protocols being practiced for treatment of COVID-19 is evidence-based-medicine. There is no harm however in your and your fellow members of IMA at least hearing C. Miller when he tells us, “why the practice of medicine is not science.” (Miller C. “Medicine Is Not Science: Guessing The Future, Predicting The Past” Journal of Evaluation in Clinical Practice, 2014, Vol 20, Issue 6, pp. 865-71).

**

First published 06 June 2021

***

“Likes” “Follows” “Shares” and “Comments” are welcome.

We hope to see energetic, constructive and thought provoking conversations. To ensure the quality of the discussion, we may edit the comments for clarity, length, and relevance. Kindly do not force us to delete your comments by making them overly promotional, mean-spirited, or off-topic.

***

We Are Not Letting the Pandemic Weaken

The actual number of people getting sick with the coronavirus is increasing. We know this because in addition to positive COVID-19 tests, the number of symptomatic people, hospitalizations and later, deaths, are following the same pattern. Thankfully, Doctors, clinics and hospitals have learnt to reduce the fatality rate amongst the COVID-19 patients but this is no reason for people to throw caution to the winds.

Human behaviour is the major factor. State and local administrations, as well as individual people, differ in their response to the pandemic. Some follow COVID-19 precautions, such as physical distancing, hand washing and mask wearing. Others are not as prescriptive in requiring these measures or in restricting certain high-risk activities.

In some states and communities, public places are closed or practicing limitations (such as how many people are allowed inside at one time); others are operating normally. Some government and community leaders have encouraged or even mandated mask wearing and physical distancing in public areas. Others have left it as a matter of personal choice. In areas where fewer people are wearing masks and more are gathering indoors to eat, drink, observe religious practices, celebrate and socialize, even with family, cases are on the rise.

As state governments began to reopen cinemas, bars, restaurants and stores during the last few months, people were understandably eager to be able to go out and resume some of their normal activities. Nevertheless, the number of people infected with the coronavirus was still high in many areas, and transmission of the virus was easily rekindled once people increased their activities and contact with each other. Unfortunately, the combination of reopening and lapses in the infection prevention efforts – social distancing, hand washing and mask wearing – has caused the number of coronavirus infections to rise again.

There is a lag between a change in policy, and the effects of this change showing up in the COVID-19 data. An increase in the number of COVID-19 cases or hospitalizations is seen as many as six to eight weeks after change in policy. When a person is exposed to the coronavirus, it can take up to two weeks before they become sick enough to go to the doctor, get tested and have their case counted in the data. It takes even more time for additional people to become ill after being exposed to that person, and so on.

Several cycles of infection must occur before a noticeable increase shows in the data that public health officials use to track the pandemic. Due to such delays, people become careless with their behaviour, and they start moving around more. If everyone continues to wear masks, wash their hands and practice social distancing, reopening will have a much lower impact on transmission of the virus than in communities where people do not continue these safety precautions on a widespread basis. Also, after many months of cancelled activities, economic challenges and stress, people are frustrated and tired of taking coronavirus precautions. All these are factors that are driving surges and spikes in COVID-19 cases.

About 70% of the population needs to be immune to this coronavirus before herd immunity can work. People might be immune from the coronavirus, at least for a while, if they have already had it, but we do not know for how long such immunity lasts. A widely available, safe and effective vaccine is still going to take months for everyone to get it.

There is an alarming spike in the number of cases and more COVID-19 surges are likely to occur. Letting the coronavirus circulate freely among the public would result in hundreds of thousands of cases and millions more people left with lasting lung, heart, and brain or kidney damage. We must all continue to practice COVID-19 precautions, such as physical distancing, hand washing and mask wearing. We must work with our government to ensure that everyone in our household is up to date on vaccines as soon as they are made available.

Let no one harbour the false attitude of denial that COVID-19 does not happen to them or that they are not the spreaders of the infection once they have survived COVID-19 or have been vaccinated for it. 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the COVID-19 disease but people are the cause of the pandemic.

*

First published 12 April 21

*

“Likes” “Follows” “Shares” and “Comments” are welcome.

We hope to see energetic, constructive and thought provoking conversations. To ensure the quality of the discussion, we may edit the comments for clarity, length, and relevance. Kindly do not force us to delete your comments by making them overly promotional, mean-spirited, or off-topic.

Online Academies and their Self-appointed Educators

The amount of ‘GYAN’ being distributed freely on about every known issue, subject and discipline on the social media –Instagram, Facebook, WhatsApp, YouTube, and the like, is unbelievable. It is very difficult if not impossible for anyone to come up with questions which have not been already answered on Quora or SlideShare; and should such questions remain, one can expect to seek answers by posting the questions on such sites.

The depth and width of ‘knowledge’ being peddled online is unmatchable by any individual subject-expert or even a University. Truly therefore, these are the NEW universities which are exclusively online and distribute ‘GYAN’ in both the modes – synchronous and asynchronous.

The only problem is that there is no accountability or responsibility taken by these academies for the GYAN which they distribute.  These academies are totally democratic and non-discriminatory. They have free and open enrolment of faculty and students, with no essentiality of any prior learning of any sort. With no entry or exit hurdles for faculty and students, they also do not directly conduct any evaluations or certifications. Credentials are certified by ‘measurable metrics’ of the kind-  ‘clicks’ ‘likes’ ‘follows’ ‘shares’ or ‘comments’ – which are a manifestation of democratic votes for an educator of these online academies.

Such manifestation imparting itself so strongly into mainstream information seems harmless. After all, it is helpful and important to be clear about the kind of world we are living in and the kind of life we desire because that clarity shapes our values, decisions, and relationships to all things material, including money.

There is nothing that makes self-appointed educators qualified to sell the promise of a less ignorant life. It is easy for these people to step into roles of knowledge leaders on Facebook or Instagram because, now more than ever, youngsters in particular, want something meaningful to believe in and reach out for information and knowledge outside the conventional and traditional institutions. Youngsters are seemingly looking for information and community in combination.

One of the positive things about a wider array of people being able to access an audience is the kind of democratization of information and knowledge leadership, but without a collective protocol to determine whom we trust to answer life’s greatest questions, we also forget to consider the capabilities, credentials and motives of those who are answering these questions for us.

As mainstream information continues to be shaped by social media, criticism of those who profit from such ventures is fundamental to protecting not only our own well-being, but the future of truth itself. As they say, if you don’t have information, you are uninformed; if you have information, most likely, you are misinformed. The problem then manifests in your belief that you are properly informed and knowledgeable. Should we worry about expertise becoming a commodity and eluding accountability?

*

Disclaimer:

These contents of this post may qualify as ‘GYAN’ and I, as the author of this post, may as well fit the description of a ‘self-appointed educator’ as meant in this post. This posting is intended solely for those readers who are discerning and matured enough to choose what is right for them and is not an unsolicited commercial communication or spam. This content of this post is not guaranteed to be complete or error free. No liability is assumed for any errors and/or omissions in the contents of this message.

*

First published 27 November 2020

*

“Likes” “Follows” “Shares” and “Comments” welcome.

We hope the conversations that take place will be energetic, constructive, and thought-provoking. To ensure the quality of the discussion, comments may be edited for clarity, length, and relevance. Comments that are overly promotional, mean-spirited, or off-topic may be deleted.

Misinformation about COVID-19

The UN has been focusing on misinformation in connection with COVID-19, stating that misinformation is a virus. Surprisingly, there are instances where public figures such as elected officials like the presidents of Brazil and the USA have indulged in disseminating misinformation. It is difficult to understand why elected officials would circulate misinformation about a pandemic, seemingly for short-term victories or momentary political gains, when their people are becoming sick and dying. Imposing their misguided, and sometimes deadly, interpretations of the crisis on the public has been reckless and is a regrettable way of exercising power.

There is no doubt that tackling the misinformation is as relevant as mitigation and prevention of the disease when confronting an unprecedented public health crisis like the COVID-19.

India shines as an example of successful engagement with the misinformation adopting vigorous and innovative strategies to confront situations that can be described as calculated distortions of the truth perpetrated by certain opinion makers, public figures and politicians via the media, especially social media.

India has successfully contained the deadly threat of misinformation about COVID-19 and is showing the early signs of succeeding in containing the pandemic itself. The Lancet is however not too optimistic about Indian success (www.thelancet.com p. 867 Vol 396 September 26, 2020). Let us hope that ‘The Lancet’ is not propelling some misinformation about India (https://www.linkedin.com/pulse/lancets-pessimism-indias-optimism-mukul-gupta).

(First published 08 October 2020)

————————————————-

“Likes” “Follows” “Shares” and “Comments” welcome. We hope the conversations that take place will be energetic, constructive, and thought-provoking. To ensure the quality of the discussion, comments may be edited for clarity, length, and relevance. Comments that are overly promotional, mean-spirited, or off-topic may be deleted.

The LANCET’s Pessimism on India’s optimism

Both, human nature and human custom, has constraints and boundaries which keep reminding us of human imperfection and of the fragility of real communities. Pessimism is the recognition that these constraints and boundaries make impossible any planned, rational transformation of society. However, history is replete with examples where societies have been transformed through the belief that we can advance collectively to our goals by adopting a common plan, and by working towards it. Optimism is therefore the key to change and transformation while pessimism guards the hierarchy and status quo. As they say, excess of everything is bad, so is true for optimism and pessimism, which is why there is a concept of realism.

On 26 September, the Free Press Journal published a news article saying that “The renowned medical journal, Lancet, has cautioned India on the danger of presenting the current pandemic situation with too positive a spin. It not only clouds reality but also hampers vital public health initiatives.” The link can be found at https://www.freepressjournal.in/india/india-is-creating-a-false-optimism-reputed-medical-journal-lancet-on-indias-handling-of-the-pandemic.  Having carried out some forecasting for COVID-19 cases in April and May 2020, purely for academic joy, this news report intrigued me and motivated me to look up at the “THE LANCET” caution.

 “The LANCET” which began as an independent, international weekly general medical journal in 1823, claims to make science widely available so that medicine can serve, and transform society, and positively impact the lives of people.

People in general and decision makers around the world have a great regard for “The Lancet” which has over time evolved as a family of journals across various medical and health specialities.

“The LANCET” has captioned its editorial to Vol. 396, September 26, 2020, on p. 867 as “COVID-19 in India: the dangers of false optimism.”

First things first – this is an editorial opinion and not a piece of research. An editorial opinion is expressed with the purpose of influencing public opinion and public-policy and may not be taken as non-purposive or unbiased. While this editorial makes some palpable hits, it is hard to separate the wheat of philosophical wisdom from the chaff of prejudice.

Next – it is a well accepted cardinal principle that false optimism is fraught with peril. False pessimism is equally fraught with peril. If the fallacies of optimism are human universals, what is more corrupting is not the attempt to do the impossible, but the failure even to attempt it. Progressive changes, however, rarely happen by chance. History is a narrative of humans rationally and consciously transforming the world. To give up on “goal-directed policies and politics” is to give up possibilities of betterment.

The example of DG of ICMR envisaging launching a coronavirus vaccine on Aug 15, quoted by The LANCET, is surely an optimism of “unscrupulous” form, but questioning the lower case-fatality-rate in India because it is lower than the reported rate in other (western) countries is unscientific. In order to support such unscientific opinion, The LANCET goes on to suspect the entire COVID-19 data from India and suggests that this number is a political spin.

Case-fatality-rate is the ratio of deaths to cases; and its lower value would mean lower deaths for same number of cases. It could also be lower if the reported number of cases is higher for same number of deaths. What is The LANCET alleging – is India under-reporting deaths or over-reporting cases?

A scientific mind should question previous results in face of new data rather than the reliability of the new data unless one is sure that the previous data was more reliable than the new data. Data is the message and data-reports are brought by messengers; new data should lead to questioning of results, not the message.

Is this pessimism of some “unscrupulous” kind clouding the mindset of LANCET which is unwilling to accept that India might be making headway in war against COVID-19 leaving behind the expected leaders of any such success?

How would The LANCET react if one were to say that this editorial is a political spin against India’s success to protect the world’s perception of traditional western supremacy?

Is The LANCET advocating that, rather than seeking utopian solutions, radical alternatives or bold initiatives, India should muddle through with “compromise and half measures” mindful that no ultimate solutions are up for grabs?

Is The LANCET proposing for India to be “a community without convictions” marked by irony and subservience?

The LANCET is posturing as if it is exposing the blindness and the hypocrisies of the Indian politics, but its editors seem to be notorious for never acknowledging that there might be some too in the developed west. The LANCET’s editorial calling India’s COVID-19 numbers as ‘false optimism’ lacks logical or scientific reasoning and suffers from survivorship bias of quantitative back-testing using past indices.

I am neither a leftist nor a rightist. I hold no brief for India or its political class, but I do wish to raise my voice as a citizen of India, which has held on to traditions of conservative political philosophy but, which is unwilling to shut her eyes to continued propagation of western supremacy, who have tried to make heaven on earth, and ended up making it hell.

(First published 28 Sep 2020)

—————————————–

“Likes” “Follows” “Shares” and “Comments” welcome. We hope the conversations that take place will be energetic, constructive, and thought-provoking. To ensure the quality of the discussion, comments may be edited for clarity, length, and relevance. Comments that are overly promotional, mean-spirited, or off-topic may be deleted.

Annihilation of Social Reality

Things as simple as hugging a friend, talking face-to-face, socialising freely, and travelling have been restricted. Even as social distancing measures are slowly relaxed, hesitation and anxiety remain. The situation has had a profound effect on our social relations.

Two broad and inter-related aspects of social experience are to be distinguished. First, there are our face-to-face relations with others, including particular individuals and people in general. Our interactions with other people shape our feelings, thoughts, and activities in all manner of ways: the pleasure we gain from our surroundings, whether we feel at ease or unsettled in a situation, the narratives through which we interpret our lives, how we regulate our moods, whether we anticipate the future with hope or dread. Interaction with another person can nurture a sense of comfort and hope or, by contrast, a feeling of discomfort and vulnerability. This applies even to brief, mundane interactions with strangers—whether someone smiles while walking past or glares at you with apprehension as they hurriedly cross to the other pavement. To be experienced as a potential conversational partner is quite different from being experienced as a potential source of infection.

Many dimensions of interpersonal experience have been affected by lockdowns and other social distancing measures. In some cases, the effects are more positive: some people have been brought together; friendships have been rekindled without the usual distractions; and rewarding pastimes have been discovered or rediscovered.

A strong sense of solidarity and expressions of gratitude towards front-line key workers in different sectors have also emerged. With this, questions arise of where and to what extent we have been able to adapt successfully to the new situation and what, if anything, remains missing or even irreplaceable.

We share a world with others and much of its meaning comes from this shared-ness. With social distancing, much of this background structure is changing; norms of interaction that were once taken as given are gone.

At times, there is a sense of not knowing what to do anymore, how to interpret and interact with other people. The rulebook is not only new but also strangely incomplete. There are experiences of anxious uncertainty and of absence and loss, as our habitual patterns of expectation are repeatedly challenged by socially distanced public spaces.

Various elements of pandemic experience are characterised by suspicion, uncertainty, and doubt. We may distrust the air we breathe and the surfaces we touch, while strangers suddenly seem unpredictable sources of potential danger.

This dismantling of the everyday inevitably leads to a pervasive breakdown of habits. Usual socialising in the evenings or the weekend, or the morning chaos, organised and punctuated our lives into a familiar tempo. Previous schedules have been largely removed from daily life, resulting in changes to our experience of time. The loss of norms, routines, and structure alters our sense of how time passes. Some people report that time feels like an undifferentiated flow, an experience that is disorienting and dispiriting.

COVID-19 is not just killing the ‘animal’ but also the ‘social’ in the ‘social animal’ called man. The pandemic is destroying the society as we have known and it may not be any constructive destruction but a destructive destruction.

(First published 10 August 2020)

————————————————– 

“Likes” “Follows” “Shares” and “Comments” welcome.

We hope the conversations that take place will be energetic, constructive, and thought-provoking. To ensure the quality of the discussion, comments may be edited for clarity, length, and relevance. Comments that are overly promotional, mean-spirited, or off-topic may be deleted.