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Issue 7

Road to Recovery: A Conversation on Covaxin with Prof. Gautam Menon

What exactly do clinical trials for a new vaccine involve? 

The first step after a potential vaccine is developed is to try it out on animals to check that it is not toxic and that it leads to an immune response. If this step is successful, the next stage is to move to human trials, where these preliminary trials are called phase 1 trials.

In such trials, healthy volunteers (typically 20-50 in number) are injected with one of a range of possible doses of the vaccine, to determine the optimal and safe dose, starting from very small doses. Whether the vaccine elicits an immune response is also verified. In phase 2 trials, the immune response is examined further, and questions of side effects and safety are also explored in a larger group of volunteers, typically more than 100.

Finally, phase 3 trials involve administering the vaccine to a much larger group, often tens of thousands of people, selected to be representative of the population. These trials are called “randomized control trials”. In these trials, about half the participants enrolled are given a placebo, something that is harmless to the body, while the other half is given the vaccine. No one knows, not even the doctors administering it, whether the injection contains a placebo or the real thing.

In India, emergency use authorization has been granted to two vaccines: Covishield, made by the Serum Institute of India and Covaxin, made by Bharat Biotech.

Since Covaxin didn’t complete its phase 3 trials and publish them, what can we confidently say about its efficacy? 

At the moment we can say little since there simply is no data yet. In the much smaller phase-1 and phase-2 trials, the vaccine elicited a robust immune response, making antibodies against the virus. The vaccine was also shown to be safe in appropriate doses. It is based on an inactivated whole-virus vaccine platform which is well-understood. However, it is important to understand that efficacy—whether a vaccine works well at preventing you from getting the disease under ideal conditions—is not a simple and immediate consequence of immunogenicity, the ability of a vaccine to provoke an immune response. That is why we need phase 3 trials in the first place.

Is there a broader misunderstanding of immunogenicity and efficacy? What is the difference and why is it important? 

A vaccine should certainly provoke a response from the immune system. That’s central to how vaccines function. But whether it works in preventing people from getting the disease – protective immunity – is a harder question and there are a few things that could go wrong. One extreme case is that getting vaccinated might, paradoxically, increase your chances of severe disease, through what is called ADE or antibody-dependent enhancement. Another possibility is a vaccine-associated enhanced respiratory disease, in which antibodies induced by the vaccine bind with viruses and form immune complexes that clog the lungs. These are possibilities that a phase-3 trial should rule out.

How is Covaxin going to complete phase 3 trials?

What should happen, in principle, is the following: The scientists running the trial will wait till a certain number of people, a number pre-approved in the trial protocol, within the group that received an injection, are diagnosed with COVID-19. They then go back and check whether these people belonged to the group that was administered the placebo or the actual vaccine. If there are many more cases in the placebo group than the vaccine group than can be accounted for by chance, that suggests that the vaccine works in protecting against developing the actual disease.

The problem is that it may take some time to reach this stage of having a predetermined number infected with the disease. Since most people develop no or only mild symptoms of the disease, they may not notice they have been infected.

A second problem is that phase-3 trials are being done in a background where a good number of people have already been infected in the past, so are immune to the disease for at least some time, as far as we know. These people won’t develop the disease even if they encounter an infected person.  

Finally, currently in India, all this is happening in the background of a steadily decreasing number of new cases. This makes it harder to have new infections in the trial group.

Why aren’t people given a choice on which vaccine they would prefer? 

The government, which is, after all, making these vaccines available for free at this point, may have wanted to ensure that they did not appear to be favouring one over the other when granting emergency-use approval. Perhaps there is also an element of national pride in this, in that Covaxin is a fully indigenous vaccine while Covishield is the result of a collaboration with international groups, at Oxford University and the pharmaceutical giant AstraZeneca.

What, according to you, is the biggest health concern with not having any efficacy data on Covaxin? 

Whenever one is administering a vaccine to a healthy person, one would like to know that it has been worth it. Does the vaccine, for example, provide protection against the disease to more than 50% of the population it is administered to? A phase-3 trial, precisely because it is so large and planned as a randomised control trial, is a good way to ask this question as well as to look out for possible rare but serious side-effects of being vaccinated.

Would it have been a better move to rollout Covaxin after phase 3 clinical trial data was published? Why do you think it was encouraged over other alternatives? 

It would have been better to rollout Covaxin after the efficacy data became available, in my opinion. Data demonstrating good efficacy and safety, which could have taken another month or so to obtain, would have spoken for itself.

Of course, these decisions have to be made based on available information as well as projections for what might happen in the future, such as new variants that are more transmissible. There are certainly cases where granting emergency use authorisation might have been justified. This is why scientists as well as the lay public need to understand the basis on which these decisions were made.

The committee that approved Covaxin distribution may have had data that was shown to it that suggested that it was efficacious. We don’t know because neither the names of the committee members nor the minutes of their deliberations are available to us.

Transparency should always be a central consideration in such matters, especially since you will be vaccinating people who are healthy and you don’t want to compromise on safety.

Considering how the vaccination drive is going right now, do you think vaccine hesitancy is slowly eroding and that target numbers will be met? 

Yes, the numbers of those getting vaccinated each day are steadily increasing. That is a good sign. Unlike in the USA and some other developed countries, there is no strong anti-vaccination movement in this country and people are accustomed to large-scale immunization programs, such as the pulse polio campaign.

Do you think the vaccine rollout should’ve been critiqued more or less than it was by the Indian scientific community? What could have been different?

I think the sections of the scientific community that critiqued the Covaxin rollout did the right thing. Prof. Shahid Jameel of Ashoka University and Prof. Gagandeep Kang of the CMC Vellore, in particular, were sane voices in this, pointing out gently, but firmly, the need to stick to established procedure. One has to ensure that the public does not feel that they would be guinea pigs. Several fellows of the Indian Academy of Science also signed a document expressing their concern.

I was dismayed at the counter signature campaign, supporting the Covaxin rollout, from a group of 49 medical doctors and scientists. Their arguments made little sense to me.

Can anything be said about whether the current vaccine candidates can be effectively used for the new strains of the virus?

There is some encouraging news of the effectiveness of some of the international vaccines against the new strains, although perhaps not at the same level. Bharat Biotech has claimed very recently that its Covaxin was effective against the UK variant of the virus. Our understanding is rapidly evolving.

Do you think that the overall vaccine development process has changed in the course of the global effort in formulating a COVID-19 vaccine?

Absolutely. I thought, as many others did, that a period of 18 months to two years would be the minimum time required for a vaccine to be distributed. That we managed to do this in less than a year is a remarkable achievement. Without our ever-improving knowledge of both basic and applied science, this would simply have been impossible. Indeed, it would have been impossible even a decade ago.

I am, in many ways, proud of what India has achieved. The Serum Institute of India, located in Pune, is the world’s largest vaccine manufacturer. Bharat Biotech, the manufacturers of Covaxin, has a manufacturing plant that is the largest of its kind in the Asia-Pacific region. It is a respected company which exports therapeutics and vaccines across the world. India itself produces 60% of global vaccines. The Director-General of the WHO commented recently that “…the production capacity of India is one of the best assets the world has today”.

As an Indian, this does make me very happy.

Gautam Menon is Professor of Physics and Biology at Ashoka University as well as Professor of Theoretical Physics and Computational Biology at the Institute of Mathematical Sciences in Chennai. He works in biophysics as well as in, more recently, the modelling of  infectious disease.

We publish all articles under a Creative Commons Attribution-Noderivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).

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Issue 7

Pets of the Pandemic

Human beings, as one knows, are social beings; be it with a fellow human or an animal. This inherent quality along with the advancement of technology and media has facilitated the sociality of a person. In the era of the internet, we are up to date and in touch with more friends, family and acquaintances than ever before. However, the year 2020 took such a turn and brutally limited this inherent sociality to being social in a room and connected through a screen. One was not only isolated but in-person social interaction also meant putting oneself and the people around at risk.

With almost completing a year amidst the pandemic, conversations around mental health concerns have seen a significant rise that has a correlational if not causal relationship with the pandemic. It is not uncommon that the pandemic, quarantine and the lockdown harboured a lot of feelings of uncertainty, isolation and loneliness. While a person to person interaction might have been risky, a number of people turned to the companionship of a pet. 

Historically, humans have always been a part of a culture of integrating animals within their lifestyle as both parties have been present in close physical proximity. Traditionally, animals such as horses, cows, dogs, etc. were domesticated to acquire goods such as dairy, meat, security etc; thus, they had a use-value. While these animals were resourceful, over time, this culture of domestication branched out into what a layperson would see as keeping a ‘pet’ in present times. One could see the emergence of keeping pets for companionship, comfort and support. A variety of research sheds light on the human-animal interaction, and one such research explores this bond through the Pet Effect. This effect addresses the impact of the symbiotic relationship of love, affection that the pet and owner share, that significantly contributes to each parties’ physical, emotional and mental well-being. A survey was conducted in 2016, which reported that 74% of the 2000 pet owners, felt that there was a significant improvement in their mental and social well-being once they acquired a pet.

Hence, to seek comfort in these unprecedented times, various individuals who could afford to, adopted a pet. If one would’ve stepped into a park in May, one would have noticed a good deal of what are called the ‘Pets of the Pandemic’. With the lockdown pushing work culture from in-office to a work from home format, not only did a pet provide companionship but also a positive and meaningful presence within the home environment. Owners could now fully distract themselves from the uncertainty and invest in attending to their pet and also indulging in physical exercise by taking them out for walks.

While pets may have been the solution to our loneliness, many have chosen to ignore the  impact of the pandemic on our four-legged companions? Research suggests that for newly born and adopted pets, socialisation is crucial within their first three months. The environment that a pet spends time in plays an essential role in their development. However, due to the pandemic, various pets like dogs and cats have spent a large portion of their initial months indoors. This leads to exposing pets to two pertinent issues: difficulty in adjusting to new environments and socialising and developing separation anxiety. 

Gradual exposure to society and socialization is an important part of taking care of and training pets, especially for a puppy. This training ensures that the puppy grows to be a dog that is comfortable with other people, animals and new environments and does not develop unnecessary fears and phobias. 

Furthermore, stemming from the same environment is the issue of separation anxiety. Separation anxiety is often noticed in dogs and is described as the dog displaying distressed behaviour when its’ guardian is about to leave the house. Distressed behaviour could look different for each dog, however, some common indicators are agitation, being upset, uneasy or restless and seeming depressed. Dogs suffering from separation anxiety bark and howl when they are left alone or cause destruction in the house, often causing self-injury and in some cases, make an attempt to escape. 

When we are experiencing distressed, often restoring to a pet for comfort is extremely normal. With owners spending 24×7 time with their pets, the latter have become a coping mechanism for many. The line between this mutually beneficial relationship and co-dependency has blurred during the pandemic. So the most important question to raise is what happens once the guardians move back to their 9-5 in-office lifestyle? How does the pet respond to getting all the constant attention for almost 11 months to transitioning back to the time when they were not? How does the owner resort to separating themselves from their pet, and find other mechanisms to cope with stress?

These are questions that one is yet to answer. 

Vanishree is currently pursuing Psychology and Sociology at Ashoka University. Vani enjoys cooking in her free time. 

Picture Credits: Sunehra Bhatura

We publish all articles under a Creative Commons Attribution-Noderivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).

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Issue 7

Arnabgate, TRPs and What you need to know about the ‘Business’ of Journalism

Journalism, despite its claim to honesty, is not always about unbiased, neutral news coverage. What we see as news and the way it is presented and moulded into a narrative is often a product of a larger nexus of debates, deliberations, requests, and often political and social leanings. With sensational journalism and ideologically driven news becoming increasingly common, why the ‘business’ of news reporting needs to be understood today is more important than ever. Arnab Goswami and the Republic media’s TRP scandal is an important marker in understanding how this ‘business’ functions and affects news viewership, content and revenue from advertisements. 

Television Rating Point (TRP) is the primary mechanism that keeps track of the popularity of specific programmes and channels on the television. How the TRP works and the policies for survey and measurement of these points differ for each country. In India, however, BARC (Broadcasting Audience Rating Council) is responsible for installing 44,000 bar-o-meters to represent the program choices of over 2 lakh Indians. BARC thus, is supposed to be an independent, transparent body, vested with significant authority to understand television consumer behaviour within the country. However, despite the sample size of survey by these meters being too small for a country with over 2 crore television sets, another problem with the way the system is its ability to to manipulate these meters and their ratings by paying individuals or households to view particular channels or programmes. Several such instances would thus provide faulty samples and result in something that we see happening today with news agencies like the Republic. The question then arises,

Why do TRPs matter?

 Televised Rating Points, other than establishing what the Indian population watches, also decide who within the myriad of television channels is popular and worth investing by companies.Higher TRPs result in businesses and political parties advertising through these channels to get their product, ideology or achievements to the public. This, in turn, provides a platform for engagement between businesses, political organisations and viewers. This relationship between the three develops further as investments in these channels increases with higher increasing TRPs thus allowing for certain ideologies, products, and affiliations to thrive through advertisements and funding for the channel. 

 Why does the interaction/nexus/business matter?

When we as viewers watch these news channels, not only do we see specific advertisements for products, we also get a glimpse of promotional advertisements by political parties, the government as well as specific financial contributors to the channel, which in turn does affect our consumer behaviour and supply specific information about these products and organisations. Further, news channels may have ideological or political leanings, often stemming from the business aspect of it, or maybe projections of the organisation or editors’ opinions. These factors decide what ‘makes’ the news. Breaking news thus might be a result of deliberated pros and cons for the channel, its beliefs and is often reflected in the way news is presented on tv. What we get as news may thus reflect personal or organisational beliefs, ideologies or political leanings, owing to TRPs which increase the channel’s funding ,reach, narratives, and often holds power to affect public opinion. 

The business of news reporting is complicated and is often hard to understand. Sometimes, it might be difficult to differentiate between opinion, news and propaganda, owing to the fine line between the three. Thus, as consumers, what we can do is try to understand the industry as a business, separate and filter ideas of honesty and truth to further understand what constitutes news. 

While online media, Instagram channels and Twitter have become prominent spaces for debate, what still needs to be done is to understand and differentiate between news and organizational views we are surrounded by and subjected to every day.

Saman Fatima is an undergraduate History student who is an avid reader and poetry writer.

Picture Credits: “TV, Television and remote controller – stock photo” by espensorvik is licensed under CC BY 2.0

We publish all articles under a Creative Commons Attribution-Noderivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).

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Issue 7

Farm Bills 2020 and The Future of The Indian Economy

Thousands of farmers, mostly from Punjab, Haryana, and western Uttar Pradesh, have been protesting at several Delhi border points since the 26th of November 2020. Their demands are centred around the repealment of three recently passed farm bills. The bills are namely, Farmers’ Produce Trade and Commerce (Promotion and Facilitation) Bill, Farmers (Empowerment and Protection) Agreement on Price Assurance and Farm Services Bill, and Essential Commodities (Amendment) Bill. Unable to reach a consensus with respect to the terms of these bills, the central government has decided to postpone the implementation of the bill.

The discontent of the farmers and the inability of the government to meet their demands raises several questions about their validity and the causes for grievance. While the protests have received major media attention, this article will endeavour to shed light on the larger impact the bills could potentially have on the Indian economy.

The Indian agricultural sector has been the least efficient sector of the Indian economy. While over  42% of the country’s manpower is employed in the primary sector, it contributes to about 17% of the GDP, making it the most populated and least efficient wing of the Indian economy. Several factors contribute to the inefficiency of the industry, most of which the new farm bills aim to address. 

The Indian agricultural industry has had a grave imbalance over the last couple of years, in terms of surplus production as well as issues with Minimum Support Price (MSP). This imbalance has continued to plague the market. Farmers fear that with the three new laws, the government is signaling its movement away from the current patterns of procurement at MSP. This uncertainty and lack of trust is one the primary causes of the recent protests. 

Surplus stocks of wheat and rice have hindered the agricultural economy in India and also the environment. The continuous wheat-rice crop pattern, especially in North India, has resulted in dead and excess stock lying at FCI warehouses. Most of the surplus is mainly a result of MSP laws that have given farmers a guarantee of purchase at a fixed price. This has allowed farmers from green revolution states such as Punjab and Haryana to grow MSP crops like wheat and rice irrespective of the market demand. As per certain reports, nearly 89% of the rice produced by the farmers in Punjab and 85% in Haryana is procured by the government. Hence, farmers in Punjab and Haryana face no price risk and are incentivised to grow paddy and wheat that are going to waste in FCI godowns. The surplus production at highly subsidised rates leads to increasing government expenditure and wastage of resources. While the government has assured farmers that MSP will continue to be provided, its continued implementation will surely hinder economic growth. 

The APMC Bypass law introduced permits for trade in agricultural produce outside the APMC regulated mandis. Private mandis can be set up across the country where anyone can buy produce from farmers. In addition to this, the bill also includes contract farming laws that facilitate an agreement between farmers and buyers before sowing under which farmers are contracted to sell produce to buyers at a predetermined price. Both the AMPC bypass law and contract farming laws are designed to allow farmers to deal directly with buyers and eliminate middlemen, giving them more choices on whom to sell their produce to. The laws will also allow firms to dictate the crops that the farmers can grow, thereby eliminating the surplus issue and meeting market demands. Crop diversification will allow farmers to contribute more efficiently to the economy and could provide them with greater financial security. In addition to the economic benefits, crop diversification will make farms more environmentally friendly. Planting a variety of crops makes the soil healthier thereby reducing the need to use excessive amounts of fertilizer. It also ensures that crops are more resistant to disease and therefore require fewer pesticides.

If we view these laws through a simple high-school economic lens, they look great as more buyers usually means a better price for the seller. However, that may cease to be the case in a realistic scenario. There is a possibility that these laws may lead to the rise of oligopolies that dictate prices and bulldoze their way with the farmers. This fear of oligopolies controlling the market is a major concern for farmers and a crucial debate made by protestors. The bill in itself doesn’t do much to prevent the rise of oligopolies. It is peremptory that the government regulate these markets to ensure that farmers have a choice in buyers and are not forced to deal in an unfair market.

It is not uncommon for governments to subsidise agriculture.The agricultural industry continues to have the highest subsidies around the world. The government must switch their subsidy allocation. There needs to be a shift from spending money in the MSP system to increasing capital expenditure on infrastructure in machinery and irrigation facilities to help Indian farmers be more competitive in local and global markets. The solution to the economic and environmental challenges facing agriculture in Indian states points towards a shift from the current system to a revised one. The farmer’s bill while representing the first step towards this economic shift requires a second look to ensure that farmers continue to remain protected. 

Karantaj Singh finished his undergraduate in History and International Relations. He is now pursuing a minor in Media Studies and Politics during his time at the Ashoka Scholars Program. He enjoys gaming and comics in his free time.

We publish all articles under a Creative Commons Attribution-Noderivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).

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Issue 7

The White Tiger: Poverty Porn or Gritty Realism?

Balram Halwai, the protagonist of The White Tiger, would have you believe that before any other label engulfs him, he is an Indian entrepreneur. The label of a murderer, a man emerged from ‘the darkness,’ or that of an ex-driver for the son of a wealthy and influential landlord is secondary. 

The White Tiger, released early this year, is an adaptation of Aravind Adiga’s Booker Prize winning novel by the same name. The movie provides an incisive narrative of the glaring class divide in India—and it does this humorously. The truth of the class divide is rather simple, as explained by Balram: the ones who live in ‘the darkness,’ who come from the castes of the narrow bellied and tuberculosis stricken; the ones from drought-struck villages, who make up 90% of India’s population are caught in a chicken coop. They see their fate played out in front of them through others caught in the same coop and they see their kind slaughtered right in front of them, yet they do not try to escape. That is their fate. 

“the trustworthiness of servants is the basis of the entire Indian economy” 

This is how Balram ends his philosophy with a macabre finality. As he says this, the movie displays montages of tired men cycling in rags, carrying furniture worth several lakhs, and being paid less than a hundred rupees for it. The dialogue ends with such a man bowing down to a woman in front of a mansion, displaying his thanks for being paid a meagre amount for his service—the people caught in the chicken coop do not try to escape. This is their fate. 

The film takes this simple philosophy, as thought of by Balram, and expands it into a carefully embroidered, gritty and rusted story that climaxes with a murder. Not once does the film slack in its depiction of the class divide—cities, when they belong to the caste of the big-bellied are grand, boasting of malls, clubs, people who converse seamlessly in English and wear short clothes. The same cities, when they belong to their populous, but largely overlooked counterparts are crowded, immobile, and reek with the stench of hate, crime, resentment, and, of course, open defecation. Throughout the movie, we see shots of crowded cities choked with poor people, and in the very next shot, open tennis courts, big residences occupied by not more than two people. We are very clearly shown how the rich (take, for example, the landowner) are unafraid of claiming the poor and treat the land and lives of the poor as if they already belong to them—like when Balram offers money to a crippled beggar, but receives scalding scorn from his ‘masters’; they treat his money as if it is theirs.  

Although this grisly, gritty depiction of urban and rural spaces contributes to how we view the limited accessibility of both public and private spaces, I thought this resolute ugliness veered towards the lauded portrayal of Indian poverty by Hollywood—think slumdog millionaire. This ugliness often felt like an attempt to translate Indian poverty, class and caste to a public who is far too separated from this problem to view it as anything more than entertainment. My saying that the portrayal of poverty often exists as a translation is also a privileged stance—after all, I am also writing this as a big-bellied person who has never had to step inside The White Tiger’s portrayal of ‘darkness.’ But the film often also presents poverty as a thesis; something to be dissected, explained and proved. We see this in the caricatural depictions of the wealthy high-class landlords, the bitter, soulless and money-hungry joint family back in the village and the typical rich, kind of nice, “caste-doesn’t-exist-anymore-papa” Americanized son. 

The characters, to prove a point of poverty, lack complexity and emotional depth. They are cruel just because they are. Their actions as a function of their class, caste and religion are one dimensional, and, frankly, a little boring. I mean, what’s new about a wealthy politically-inclined family that’s Islamophobic, casteist and misogynistic? In attempting to present and translate the ‘truth’ about Indian class, the movie misses out on a lot of character depth, choosing, instead, to employ stereotypes. The only redemption to this is a depth of contempt that runs through every character, despite their differences: nobody is happy, everyone wants to be somewhere they are not. The othering is mutual—the poor do not see the rich as one of their own, and of course, neither do the rich. 

The only character to break out of the stereotype, though, is the protagonist Balram Halwai, played phenomenally by Adarsh Gourav. If nothing else, I would recommend this film for its exceptional fresh-faced talent. Balram Halwai is probably the only intricately crafted character in the movie. He displays deep concern for his brother, which is laced with equal amounts of contempt. He cares for his ‘master’ (the landlord’s son) like one would care for a brother or a best friend, is hurt by his lack of consideration for him, but still does not hesitate for a second in believing that he has been greatly wronged by this supposedly nice man. 

The character of Balram Halwai is also charming and humorous. This humour seeps into the movie, and takes a dense and gritty topic accessible and interesting. We find ourselves agreeing with Balram, even when he is clearly in the moral wrong—we also see how our moral compass is deeply stricken by privilege. While watching the movie, I shamefully recognized some of my behaviours in the behaviour of the privileged. This is exactly where the film gets it right—although the characters portrayed as caricatural, their actions are mundane. They do what we all have done at some point in our lives. To be shown the wrongness of our beliefs and our actions is inherently shocking, and The White Tiger does a phenomenal job of that—shocking us by making our ‘mundane’ classism so lucid, so perceptible. 

Shivani Deshmukh is a second year undergraduate at Ashoka University. She studies Sociology and Anthropology.

Picture Credits: Netflix India

We publish all articles under a Creative Commons Attribution-Noderivatives license. This means any news organisation, blog, website, newspaper or newsletter can republish our pieces for free, provided they attribute the original source (OpenAxis).