(1) Medical certification of cause of Death has been standardized in India way before Covid. In fact, India too follows the WHO ICD-10 codes. Its NOT correct that ICMR came up with some new rule just for Covid deaths. It has always been Immediate, Antecedent & Others ...
(2) Check out the recent ICMR guideline (which is being bandied about) and the guidelines on medical certification of cause of death from the registrar general. No difference, right? The later was published in 2018 (was the same in all previous editions as well).
(3) Did Deaths happen due to lack of Oxygen? Of course Yes - only an idiot or an insensitive person will deny that. Did the Govt refute this fact? No - the Govt was asked do you have exact numbers. Of course the Govt doesn't because our death certification never captured that.
(4) Health being a State subject, no State Govt (BJP, Cong, basically all) will voluntarily report shortages as it would be perceived as a governance failure. States even threatened to jail Hosp. Admin. & Doctors who raised the O2 shortage issue - we have all seen those reports.
(5) Long story short - the value of human lives and dignity in India is not the same as in more developed nations. This is not a recent phenomena - it has been the same since decades now. If you are not rich or influential, when push comes to shove, you will be screwed over.
(6) Its not like its all bleak. Things are improving. But with a country of our size & diversity, progress is slow. Its up to us basically. We need to focus on what is important. we need to keep pushing the Govt to deliver - irrespective of which political party is in power.
(7) And above all, we need to clearly differentiate between the Govt & the Nation. THEY ARE NOT THE SAME. Nothing & no one is above the Country & its citizens-let no one tell you otherwise! Indians died-and sadly, Indians are fighting among themselves to protect those responsible

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More from @parija_d

21 Jul
(1) Quick musing. Most traits are genetic. Environment moulds it a bit. But the core is genetic. So, if it's all a celestial lottery, why try? Because, being genetically endowed means nothing if we don't achieve our potential. Let me try and explain...
(2) Genetically, X is programmed such that he can quickly gain muscles (it's a fact) but instead of working on it he idles away in front of the telly gorging on pizzas and coke, he will become a fat slob. No amount of good genes will come to his rescue. On the other hand...
(3) Y isn't genetically lucky. Has to really slog to gain an inch of muscle. But he works real hard on himself. Exercise. Diet. The whole 9 yards. So, what will happen is, the genetically unlucky Y will any day be in a better shape than the lucky X. Right?
Read 4 tweets
13 Apr
(1) Test only symptomatics. Random tests of all will create shortages and drive down positivity

Now that we have approved most vaccines, make these available at all institutions which already are used to cold chain. Chemists. Sub centers. Maternity Homes. And so on.
(2) If they are good for one temp sensitive vaccine they are good for the Covid one as well.

(3) Focus more on beds with Oxygen and steroids. Down prioritize vague stuff like plasma etc.

(4) Enforce masks. Penalize crowds. Easier said than done but we need this urgently
(5) Don't be afraid of data transparency. Honest dashboards will help appropriate behavior

(7) Use IT to clearly inform people on where beds, O2, tests, vaccines are available. Will rationalise crowds and ease access.

(8) Unpopular one for the last....
Read 5 tweets
11 Apr
The approaches to Covid vaccines in India and the US. A thread … (Source: The Ken)
(1) May 2020, the US government made a plan - to support 7vaccine candidates simultaneously to speed up trials and the approval process and to promote ways to manufacture them at scale (Operation Warp Speed) - conceived as a partnership between the US govt and private companies.
(2) The rationale was that a vaccine would emerge faster was if pharma companies were given lots of money to fund their research. How much money? ~ over $11 billion. Given out to eight of the biggest pharmaceutical companies in the world.
Read 15 tweets
26 Mar
(1) Traditionally, politics has always been about power. Money, yes – but the whole thing has always been about power. Money was always a spin off – a by product if you will. So how does one go about achieving power. A thread …
(2) When one says power, in politics it traditionally means power over people. The ability to get people to follow you, believe in you and vote for you. But then why would people do that? This is where an understanding of the basic human nature comes in to play. Let me explain …
(3) People tend to admire someone who (1) demonstrates that s/he is there to help and support you (2) can show that there is a common enemy who is out to get you (3) and s/he is the one who can protect you against this enemy. What enemy you ask …
Read 10 tweets
25 Mar
(1) Does linking dietary practices to religion make sense? The dilemma of eating meat – a short thread …
(2) Why this concept abstaining from non-veg food on certain days of the week. Devout Hindus won’t eat non-veg (or even onion & garlic for that matter) as all tamasik food is prohibited. The religion itself is based on Satya and Ahimsa.
(3) But why then do we find mention of meat consumption in our scriptures? Ok – will try and explain what I think, but please understand that, this is purely conjecture from here on. Let’s dive in ...
Read 9 tweets
11 Mar
On good health – and why achieving it is no rocket science. A short thread …
(1) Myriad factors affect health. Genetics is one of the most important. All of us know that one person who has won the gene lottery–can eat all without weight gain, can smoke 3 packs a day. And still glow with health. However, for most, that’s not the case. So what should one do
(2) Food first. Principles are simple. Eat less than you think you should. DO NOT eat unless hungry. The need for the mandatory 2/3/4 meals based on the time of the day is a myth. Trust your body, not the clock. NEVER eat to your fill. Try not eating anything for 12-18 hours.
Read 8 tweets

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