On the PSA’s new COVID-19 advisory

The Office of the Principal Scientific Adviser (PSA) to the Government of India, K. VijayRaghavan, has issued a new advisory emphasising the roles of “masks, distance, sanitation and ventilation” to end the country’s COVID-19 epidemic.

Over the last few weeks, VijayRaghavan has been sharing similar messages from his official Twitter account, most recently on May 15. The advisory reflects many of his suggestions, including following COVID-appropriate behaviour, maintaining distances and ventilating rooms.

It’s noticeable that this advisory has shown up in the middle of the country’s second wave – instead of before the first wave, which began around February 2020.

What to do but not what not

The advisory begins with a recap of how the virus is transmitted: “Even one infected person showing no symptoms can release enough droplets to create a ‘viral load’ that can infect many others,” it says. “Symptoms can take up to two weeks to appear in an infected person, during which time they may continue to transmit the virus to others. Some people may never show symptoms and still transmit the virus.”

Next, it briefly discusses the mechanics of aerosol versus droplet transmission, starting with: “Aerosols and droplets are the key transmission mode (sic) of the virus.”

Both aerosols and droplets describe fluid particles; aerosols are just smaller and lighter, thus less susceptible to being pulled down by gravity and more likely to be blown around by winds. All persons release both aerosols and droplets when they breathe, talk, cough, sneeze, etc. If a person is infected with the novel coronavirus, the aerosols and droplets will contain viral particles.

Early last year, when the pandemic was just getting underway, the WHO refused to admit that particles of the novel coronavirus could be transmitted through aerosols.

Because droplets are bigger, they typically settle down to the ground within six feet, or two metres – a point that the advisory also makes. Fluid dynamics expert Ronak Gupta wrote for The Wire Science in May 2020 that this figure is based on a study conducted with tuberculosis patients in the 1930s. This is also where the suggestion to maintain a distance of six feet from people around you comes from.

The WHO didn’t change its mind until 200 scientists expressed their concerns in an “unusually public outcry”, and forced the international body to reconsider the evidence for aerosol transmission.

The advisory also reminds readers of the reality of transmission via surfaces. “Virus-laden droplets can survive on non-porous surfaces such as glass, plastic and stainless steel for a fairly long time,” it reads, and recommends that people regularly clean surfaces they touch often, like door-knobs and light switches, with bleach or phenyl.

Note that the US Centres for Disease Control (CDC) said last month that the chance of a person getting infected after touching surfaces is “1 in 10,000”. The PSA’s advisory doesn’t mention the relative unlikelihood of this mode of transmission, suggesting that it is as equally likely as the other two (droplets and aerosols).

The advisory also doesn’t advise against unnecessarily disinfecting certain surfaces. For example, Sumi Krishna has written about civic officials in Bengaluru spraying bleach on trees, roads and vehicle tyres, echoing reports of similar activities in other parts of the country. In the face of uncertainty about what to do, people have often done whatever they can – leading to what some have called ‘hygiene theatre’.

In one infamous incident in March last year, municipal officers in Bareilly forced a group of migrant workers to squat on the road and hosed them with a sodium hypochlorite solution.

Masking strategies

Next, the advisory discusses masks and the risks of different masking strategies in different situations.

Wear a surgical mask, then wear another tight fitting cloth mask over it. If you do not have a surgical mask, wear two cotton masks together. Ideally surgical mask should be used only once, but when pairing, you can use it up to 5 times by leaving it in a dry place for 7 days after one use (ideally give it some sun exposure) and then reuse as double layer.

The next five pages are devoted to ventilation. It describes having windows and doors shut as “poor ventilation”, having doors and windows open as “good ventilation” and doors/windows open with an exhaust system as “ideal ventilation”. Second, it describes what people living in hutments can do to improve ventilation, including requesting gram panchayats to install small windows to improve air flow.

Its recommendation for work spaces is the same as in the first case, with the addition of air conditioners, thus ensuring both directed inflow and directed outflow.

Fourth, the advisory recommends “offices, auditoriums, shopping malls, etc.” install “roof ventilators and HEPA/regular filters” and that the people in charge be mindful of the filters’ service lives and replacement schedules. High-efficiency particular air (HEPA) filters are filters designed to remove at least 99.95% of particles that are 0.3 µm wide.

Finally, it makes similar recommendations for people travelling in crowded vehicles, that passengers should have as many opportunities as possible for fresh air to flow in a direction away from them.

The last part of the advisory deals with “community-level testing and isolation” in rural and semi-urban areas.

Get rapid antigen testing done for people entering the area. ASHA/anganwadi/health workers must be trained and protected for conducting the rapid antigen test. These health workers must be given a certified N95 mask even if they are vaccinated. ASHA/anganwadi/health workers to also be provided oximeters to monitor infected person (sic).

It also asks that “every person who tests positive should be given a certified N95 mask, or a surgical mask if this is not feasible, and advised isolated (sic) as per ICMR guidelines.”

Other communication events

Many behavioural economists have said that clear, simple and authoritative communication that encourages good behaviour vis-à-vis controlling the epidemic is always welcome. The Office of the PSA also released an advisory early last year stressing the importance of wearing masks, including a widely appreciated guidance (PDF) on how to stitch one’s own masks.

This said, the advisory’s timing is interesting because it coincides with some other significant pandemic-related communication events.

First, Tamil TV channels, especially those affiliated with the Dravida Munnetra Kazhagam, have been airing a two-minute long video in which Tamil Nadu’s new chief minister M.K. Stalin describes the proper way to wear a mask, to wash hands, the importance of staying indoors to the extent possible and of getting vaccinated as soon as possible.

Second, the CDC recently updated its guidelines to say people in the US who had received both doses of their vaccines needn’t have to wear masks in public. The update stoked some confusion among experts, but CDC director Rochelle Walensky said the agency’s decision was based on early reports that suggest the Pfizer-BioNTech and Moderna vaccines also significantly cut transmission. That is, people who have received both doses of either vaccine also become highly unlikely to be able to transmit the virus if they get infected.

However, any similar data for the vaccines in use in India – mostly Covishield and Covaxin – are lacking. We don’t know, provably at least, if Covishield and Covaxin cut down transmission and, if so, to what extent.

Conflicting aims

Third, as a document that sticks to the ‘physical’ characteristics of the epidemic, the advisory doesn’t address what people without the resources whose availability it presumes – like room enough to maintain a gap of six feet, exhaust fans that open to meaningful air-streams or clean running water – can do to avoid getting infected.

Even if this criticism can’t be laid at the PSA office’s doorstep alone, the issues make up a significant point of difference between the government’s poor communication thus far and the lived realities of many lakhs of Indians, especially in rural parts, where the second wave is expected to surge next.

By not discussing what the government could have done better, differently or not at all, the advisory gives the impression that the pandemic’s future is in the people’s hands. However, the Indian and many state governments are already out of step with many of the recommendations.

For example, the advisory spends five pages on ventilating rooms properly – but many vaccination centres and hospitals around the country have become potential sites of new infections themselves: the queues are long, the rooms often crowded; in some instances, overcrowding forced healthcare workers to accommodate two people on each bed, sharing oxygen supplies.

For another example, the advisory suggests that air-conditioned trains and buses install HEPA filters. This demand is a far cry from the conditions in which many of these vehicles, but especially buses, currently operate – with torn seat covers, broken handles and guardrails and grime covering most surfaces.

There is no indication that VijayRaghavan or his colleagues have spoken up against these shortcomings before. VijayRaghavan himself has been silent in the face of many questions about his role in the government’s actions. For example, as Karan Thapar asked: “when Assam health minister Himanta Biswa Sarma said there was no need to wear masks in his state or when Uttarakhand Chief Minister Tirath Singh Rawat said faith in god and the power of the Ganga river would protect people from COVID-19”, what did VijayRaghavan say to them?

Prem Shankar Jha has pointed out that the government has maintained “two conflicting aims”, each undermining the other, since the pandemic began: one to avert a second wave and the other to extract political mileage. The PSA is a high office in the government: articulating the bare minimum of what needs to be done is necessary to further one set of aims. But what happens when he doesn’t push back against the other?

The Wire Science
May 21, 2021

Preference for OA research by income group

Two researchers from Rwanda performed a “systematic computational analysis of the biomedical literature” and concluded in their paper that:

… papers with authors based in sub-Saharan Africa, papers with authors based in low income countries, and papers resulting from international collaboration are all much more likely to be made openly accessible than papers that don’t have these properties.

They analysed 547,404 papers indexed in PubMed, which is:

… a free resource developed and maintained by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM). PubMed PubMed provides free access to MEDLINE, NLM’s database of citations and abstracts in the fields of medicine, nursing, dentistry, veterinary medicine, health care systems, and preclinical sciences.

Source

The researchers also found that after scientists from low-income countries, those in high-income countries exhibited the next highest preference for publishing in open-access (OA) journals and that scientists from lower and upper middle-income countries – such as India – came last. It is important to acknowledge here that while there exists a marked (inverse) correlation between GDP per capita and number of publications in OA journals, a causation might be harder to pin down because GDP figures are influenced by a large array of factors.

At the same time, given the strength of the correlation, their conclusion – about scientists from middle-income countries being associated with the fewest OA papers in their sample – seems curious. The article processing charge (APC) levied by some journals to make a paper openly accessible immediately after publishing is only marginally more affordable in middle-income countries than it is in low-income countries. However, the effects of technology and initiative seem to allay some of this confusion.

There are two popular ways, or routes, to publish OA papers. In the ‘gold’ route, the authors of a paper pay the APC to the journal, which in turn makes the paper openly accessible once it is published. A common example is PLOS One, whose APC is at the lower end, $1,595 (Rs 1.13 lakh). On the other hand Nature Communications charges a stunning EUR 4,290 (Rs 3.4 lakh) per paper for submissions from India. In the ‘green route’, the authors or publishers upload the paper to a publicly accessible repository apart from formally publishing it; common example: the arXiv preprints server, which is moderated by volunteers.

There is also ‘hybrid’ OA, whereby a part of the journal’s contents are openly available and the rest is behind a paywall. In one review published in February 2018, researchers also pointed out a ‘bronze’ route: “articles made free-to-read on the publisher website” but “without an explicit [OA] license”.

The authors of the current paper reason that researchers from high-income countries might be ranking higher in their preference for OA papers because the “‘green’ route of OA has been encouraged by an enormous growth in the number of OA repositories, particularly in Europe and North America”; they also note that Africa was home to only 4% of such repositories in 2018. In the same vein, they continue, “the vast majority of funding organizations with OA policies as of 2018 were based in Europe and North America, with less than 3% of total OA policies originating from organizations based in Africa”.

Additionally, many journals frequently waive APCs for submissions from authors in low-income countries, whereas those from lower- and upper-middle income countries – again, including India – do not qualify as frequently to have their papers published without a fee. A very conservative, back-of-the-envelope estimate suggests India spends at least Rs 600 crore every year as APCs.

It was to reduce this burden that K. VijayRaghavan, the principal scientific adviser to the Government of India, announced earlier this year that India was joining the Plan S coalition of research-funders, which aims to have all research funded by them openly accessible to the public by 2021. As a result, researchers funded by Plan S members will have to submit to journals that offer gold/green routes and/or journals will have to make exceptions for publishing research funded by Plan S members.

This is going to take a bit of hammering out because the Plan S concept has many problems. Perhaps the most frustrating among them is its Eurocentric priorities. Other commentators have acknowledged that this limits Plan S’s ability to serve meaningfully the interests of researchers from South/Southeast Asia, Africa and Latin America. In July, two Argentinian researchers lambasted just this aspect and accused Plan S of ignoring “the reality of Latin America”. They wrote that Plan S views “scientific publishing and scholarly publications … as a commodity prone to commercialization” whereas in Latin America, they “are conceived as the community sharing of public goods”.

The latter is more in line with the interests of the developing world as well as with the spirit of knowledge-sharing more generally. At present, a little over 50% of research articles are not openly accessible, although this is changing thanks to the increasing recognition of OA’s merits, including the debatable citation advantage. Research-funders devised Plan S to “accelerate this transition”, as Jon Tennant wrote, but its implementation guidelines need tweaking.

Another problem with Plan S is that it keeps the focus on the ‘gold’ OA route and does little to address many researchers’ bias against less prestigious, but no less credible, journals. For example, while Plan S specifies that it will have gold-OA journals cap their APCs, scientists have said that this would be unenforceable. So, as I wrote in February:

… if Plan S has to work, researcher-funders also have to help reform scientists’ and administrators’ attitude towards notions like prestige. A top-down mandate to publish only in certain journals won’t work if the institutions aren’t equipped, for example, to evaluate research based on factors other than ‘prestige’.

To this end, the study by the researchers in Rwanda offers a useful suggestion: that the presence or absence of policies might not be the real problem.

There was no clear relationship between the number of open access policies in a region and the percentage of open access publications in that region. … The finding that open access publication rates are highest in sub-Saharan Africa and low income countries suggests that factors other than open access policy strongly influence authors’ decisions to make their work openly accessible.

The March for Science, ed. 2018

K. VijayRaghavan, India’s new principal scientific advisor to the Government of India, has brought a lot of hope with him into the role as a result of his illustrious career as a biologist and former secretaryship with the Department of Biotechnology. Many stakeholders of the scientific establishment are already looking to him for positive changes in S&T policy, funding and administration in India under a government that, on matters of research and education, has focused on applications, translational research and actively ignored the spread of superstitious ideas in society.

In a recent interview, VijayRaghavan was asked about R&D funding in India. His response is worth noting against the backdrop of a ‘March for Science’ planned across India on April 14. As the interviewer reminds the reader, the 2018 Economic Survey bluntly acknowledged that India was underspending on research. This has also been one of the principal focus areas of the ‘March for Science’ organisers and participants: they have demanded that the Centre hike R&D spending to 3% and education spending to 10%, both as fractions of the GDP, apart from asking the government to stop the spread of superstitious beliefs.

Q: Getting funding for research is widely considered to be a prickly issue. The 2018 Economic Survey stated that India underspends on R&D. Is this a concern at the administration level?

A: These are wrongly posed questions, because it says that should magically the amount of funding go up, then science’s problems would be solved. Or that this is the key impediment. There’s no questions that there’s a correlation between increased R&D funding and innovation in many economies. South Korea is a striking example how high-tech R&D has resulted in transformation in their industries… Have we analysed, bottom-up, what Korea’s spending goes into and what we can learn from that and do afresh? Have we analysed our contest and learnt? …

Now interestingly, top-down this analysis has been done long ago. We as scientists, individuals and as journalists need to see that. The DST, and the DBT, the CSIR, the ICMR all have their plans should they get more resources. You can’t have a top-down articulation of how the resources can come and be used, unless that is also dynamically connected bottom-up.

When I look at 100 cases of why fund-flow is gridlocked, in about 70 cases, it’s poor institutional processes.

March for more than science

After the first Indian ‘March for Science’ happened in August 2017, the government showed no signs of having heard the participants’ claims, or even acknowledged the event. This was obviously jarring but it also prompted conversations about whether the march’s demands were entirely reasonable. Most news reports, include The Wire‘s, had focused on how this was the first outpouring of scientists, school-teachers and students, particularly at this scale. Scrutinising it deeply was taboo because there was some anxiety about jeopardising the need for such a march itself. However, ahead of the second march planned for April 14, it’s worth revisiting.

Sundar Sarukkai, the philosopher, had penned an oped the day after the 2017 march, asking scientists whether they had thought to climb down from their ivory towers and consider that the spread of superstitions in society under the Narendra Modi government may have been because of sociological and cultural reasons, and wasn’t simply a matter of spending more on R&D. Following a rebuttal from Rahul Siddharthan, Sarukkai clarified in The Wire:

Whenever ideal images are constructed (like ideal of woman, ideal of nation, etc.), one should be wary, since any such act is often driven by considerations of power. This ideal image of science too is used to establish science as a powerful agent within modern societies. The use of this ideal image to solve social problems related to caste, religion or hatred of any kind is a red herring. It is like using a hammer to fix a bulb. When we do that, it only means that we are not really interested in solving the problem (fixing the bulb) but more invested in using the method (the hammer) – irrespective of whether it is suitable for the task or not.

The terrible cases of lynching, hatred, oppression and misuse of religion must be unequivocally opposed. For those who are serious about that task, the solution is more important than the method used to achieve it. The categories of the ideal notion of science are applicable primarily to non-human systems. So even if they work well within such systems, there is no reason why they should do so within human systems.

A physicist said something similar to me around the time: that the old uncle preaching the benefits of homeopathy in his living room is doing so not because he doesn’t have access to scientific knowledge. That may be true but what’s more conspicuous by absence is someone in the same room challenging his views, communicating to him without being intimidating or patronising and having a discussion with him about what’s right, what’s wrong and the methods we use to tell the difference. Instead, focusing on making it easier for scientists to become and remain scientists alone will not take us closer to achieving the outcomes the ‘March for Science’ desires.

Sarukkai echoed this point in a comment to The Print: that scientists who march only for science are not doing anything useful, and that they must march against casteism and sexism as well (and social ills outside their labs). Without real change in these social contexts, it’s going to be near-impossible for those deemed less powerful by structures in place in these contexts to challenge the beliefs of those afforded more social authority. Ultimately, effecting such change is not going to be all about money – just as much as more money alone won’t solve anything, just as much as imploring the government to “fix” all these issues by itself will not work either.

This is where VijayRaghavan’s comments about R&D spending fit in. Before we throw more money in the general direction of supporting R&D, its Augean stables will have to be cleaned out and inefficiencies eliminated. One example, apropos VijayRaghavan’s comment about 70% of funds being gridlocked due to “poor institutional processes”, comes immediately to mind.

Sunil Mukhi, a theoretical physicist, wrote in 2008 that when he had been a member of the faculty at the Tata Institute of Fundamental Research, Mumbai, his station afford him a variety of privileges even as there was “no clear statement of our responsibility or duty to perform, and no consequences for failing to do so”. While he has since acknowledged a potential flaw in his suggested solution, the fact remains that many researchers often laze in prized research positions at well-funded institutes instead of also having to grapple with the teaching and mentorship load prevalent at state universities and colleges.

Additionally, though most people have directed their ire at the government for underfunding R&D, 55% of our R&D expenditure is from the public kitty. Among the ‘superpowers’, China is a distant second at less than 20%. So the marches for science should also ask the private sector to cough up more.

One for all

When the government pulled the financial carpet out from under the feet of the Council of Scientific and Industrial Research in 2014 and asked its 38 labs to “go fund themselves”, many scientists were aghast that the council was being handicapped even as more money was being funnelled into pseudo-research on cow urine. But there were also many other scientists who said that the CSIR had it coming, that – as a network of labs set up to facilitate applied and translational research – it was bloated, sluggish and ripe for a pruning. Perhaps similar audits, though with ample stakeholder consultations (not the RSS) and without drastic consequences, are due for the national scientific establishment as a whole.

As a corollary, it is also true that every march, protest or agitation undertaken against casteism, sexism, patriarchy, bigotry and zealotry can work in favour of the scientific establishment since what ‘they’ are fighting against is also what scientists, and science journalists, should be fighting against. Access to bonafide scientific ideas should not be solely through textbooks, news articles and freewheeling chats on Twitter. Instead, and irrespective of whether they become available, they should have the option to be availed through the many day-to-day interactions in which we confront structures of caste and class.

For example, there is no reason the person who cleans your toilet should not also cook your dinner. To institute this dumb restriction is to perpetuate caste/class divisions as well as to reject science in the form of hand-wash fluids. For another, there is no reason an employer shouldn’t let their domestic help use the toilet when they need to. However, the practice of expecting those who work in our homes to use separate toilets or be fired still persists, even in a society as ostensibly post-caste as West Bengal’s, demonstrating “the extent to which employer relations with domestic workers continue to be flavoured by caste” – as well as the extent to which we falsely attribute different human bodies with irrational biological threats.

These problems are also relevant to scientists, and must be solved before we can confront the bigger, and more nebulous, order of scientific temper in the country. However, such problems can’t be fixed by scientists and science alone.

It is worth reiterating that the ‘March for Science’ tomorrow is not a lost cause; far from it, in fact. The demand that 3% of GDP be spent on R&D is entirely valid – but it also needs to be accompanied by structural reforms to be completely meaningful. So the march, in effect, is an opportunity to examine the checks and balances of science’s administration in the country, the place of science in society, and introspect on our responsibility to confront a protean problem and not back down in the face of easy solutions. If the solution was as easy as ramping up spending on R&D and education, the problem would have been solved long ago.

The Wire, 13 April 2018.

English as the currency of science's practice

K. VijayRaghavan, the secretary of India’s Department of Biotechnology, has written a good piece in Hindustan Times about how India must shed its “intellectual colonialism” to excel at science and tech – particularly by shedding its obsession with the English language. This, as you might notice, parallels a post I wrote recently about how English plays an overbearing role in our lives, and particularly in the lives of scientists, because it remains a language many Indians don’t have to access to get through their days. Having worked closely with the government in drafting and implementing many policies related to the conduct and funding of scientific research in the country, VijayRaghavan is able to take a more fine-grained look at what needs changing and whether that’s possible. Most hearteningly, he says it is – only if we had the will to change. As he writes:

Currently, the bulk of our college education in science and technology is notionally in English whereas the bulk of our high-school education is in the local language. Science courses in college are thus accessible largely to the urban population and even when this happens, education is effectively neither of quality in English nor communicated as translations of quality in the classroom. Starting with the Kendriya Vidyalayas and the Nayodya Vidyalayas as test-arenas, we can ensure the training of teachers so that students in high-school are simultaneously taught in both their native language and in English. This already happens informally, but it needs formalisation. The student should be free to take exams in either language or indeed use a free-flowing mix. This approach should be steadily ramped up and used in all our best educational institutions in college and then scaled to be used more widely. Public and private colleges, in STEM subjects for example, can lead and make bi-lingual professional education attractive and economically viable.

Apart from helping students become more knowledgeable about the world through a language of their choice (for the execution of which many logistical barriers spring to mind, not the least of which is finding teachers), it’s also important to fund academic journals that allow these students to express their research in their language of choice. Without this component, they will be forced to fallback to the use of English, which is bound to be counterproductive to the whole enterprise. This form of change will require material resources as well as a shift in perspective that could be harder to attain. Additionally, as VijayRaghavan mentions, there also need to be good quality translation services for research in one language to be expressed in another so that cross-disciplinary and/or cross-linguistic tie-ups are not hampered.

Featured image credit: skeeze/pixabay.

English as the currency of science’s practice

K. VijayRaghavan, the secretary of India’s Department of Biotechnology, has written a good piece in Hindustan Times about how India must shed its “intellectual colonialism” to excel at science and tech – particularly by shedding its obsession with the English language. This, as you might notice, parallels a post I wrote recently about how English plays an overbearing role in our lives, and particularly in the lives of scientists, because it remains a language many Indians don’t have to access to get through their days. Having worked closely with the government in drafting and implementing many policies related to the conduct and funding of scientific research in the country, VijayRaghavan is able to take a more fine-grained look at what needs changing and whether that’s possible. Most hearteningly, he says it is – only if we had the will to change. As he writes:

Currently, the bulk of our college education in science and technology is notionally in English whereas the bulk of our high-school education is in the local language. Science courses in college are thus accessible largely to the urban population and even when this happens, education is effectively neither of quality in English nor communicated as translations of quality in the classroom. Starting with the Kendriya Vidyalayas and the Nayodya Vidyalayas as test-arenas, we can ensure the training of teachers so that students in high-school are simultaneously taught in both their native language and in English. This already happens informally, but it needs formalisation. The student should be free to take exams in either language or indeed use a free-flowing mix. This approach should be steadily ramped up and used in all our best educational institutions in college and then scaled to be used more widely. Public and private colleges, in STEM subjects for example, can lead and make bi-lingual professional education attractive and economically viable.

Apart from helping students become more knowledgeable about the world through a language of their choice (for the execution of which many logistical barriers spring to mind, not the least of which is finding teachers), it’s also important to fund academic journals that allow these students to express their research in their language of choice. Without this component, they will be forced to fallback to the use of English, which is bound to be counterproductive to the whole enterprise. This form of change will require material resources as well as a shift in perspective that could be harder to attain. Additionally, as VijayRaghavan mentions, there also need to be good quality translation services for research in one language to be expressed in another so that cross-disciplinary and/or cross-linguistic tie-ups are not hampered.

Featured image credit: skeeze/pixabay.