Making Sense of the Pandemic with Prof Gagandeep Kang

Written by Aishwarya Rohatgi

Interviewed by Aishwarya Rohatgi, Sreshtha Mondal, Vishwadeep Mane

“In a time of uncertainty, facts provide clarity. In a time of anxiety, facts comfort. In a time of misinformation, facts correct. In a time of division, facts unite. In a time of crisis, facts matter most.” — CNN Communications.

In this long-haul pandemic, with undeniable health and socio-economic ramifications worldwide, evidence-based clinical research and implementation of actionable, preventive public health measures have served as the backbone of our fight against Covid-19.

In addition to providing us a platform to share our experiences and views around the pandemic, the Planet Divoc-91 project has also empowered us with opportunities to seek evidence-based information and keep abreast with the best science. To do this, one of the mediums we chose was to interview experts. These interviews allowed us to question, gather perspectives, and develop understanding around the pandemic and its impact.

Months into the pandemic in 2020, we spoke to Professor Gagandeep Kang who is a prominent virologist, vice-chair of the board of Coalition for Epidemic Preparedness Innovations, and a professor at the Wellcome Trust Research Laboratory at the Christian Medical College—a few of the many hats she wears. Professor Kang is also the first Indian woman to be inducted as a Fellow into the Royal Society. It was an exhilarating and humbling experience for all of us to explore the pandemic with her through the dual lens of science and policy.

The pandemic of misinformation

We had quite a long list of questions spanning multiple themes; we wanted to understand the science to address Covid-19. But first things first, we asked her what the best response could be to fake news and misinformation and how should we respond to it amidst the pandemic.

She stated that the problem with a lot of what is happening now in the world is that we are in echo chambers. Our circles reinforce our messages because we can choose who we interact with. To be able to identify what is the truth and what is fake news is a challenge because one has to break into a group into which one doesn’t actually have an invitation and where people may not necessarily want others with differing points of view. “The best methods for communication and for persuasion are not necessarily bringing people around to one’s point of view, but at least making them open up to listen to what evidence is available. The evidence has to be strong enough to convince everyone. But it is a challenge to make people listen to evidence-based information. And pandemics just multiply this problem,” added Professor Kang.

The world has seen pandemics in the past. However, the Covid-19 pandemic is different—a notorious one. We wondered what helped it achieve this status. Professor Kang quickly presented a list of viral outbreaks the world has encountered. In these outbreaks, we either had earlier knowledge of the virus (H1N1, Ebola), or the new viral infections were restricted to a small number of people (Nipah, SARS, and MERS), or the infections subsided in a span of a few months (Zika). The SARS-CoV-2 virus is an unknown virus—never seen before. The initial reports of the disease were frightening and people were constantly bombarded with information in addition to a great deal of uncertainty. Although Covid-19 causes serious illness in many, the mortality rate is much less in comparison to other viral outbreaks. This has not been communicated enough.

Impact of the pandemic

We wanted to understand the foremost challenges in this pandemic. According to Professor Kang, treating people and expanding the testing coverage in India are all challenges to be addressed but the most difficult phase to traverse is the unmitigated damage that the pandemic has unleashed on our social constructs and mental health. In comparison to the direct health impacts of the pandemics, the polarisation of belief systems, misinformation campaigns, constant messaging of gloom, disaster, and death, and dealing with uncertainty has taken a larger toll on our society and everyday lives.

Thoughts on the public health care system

Professor Kang has been a proponent of widespread testing to curb the pandemic. We wanted to understand why people are averse to getting tested. Professor Kang feels people’s trust in the system has a crucial role to play. Education and health are the pillars on which any society is built and until that is realized we will never be fully equipped to handle disasters and health emergencies well. While most countries have been seeing their health systems in shambles, India too has been facing a crisis where our frontline workers, as well as public health infrastructure, have been overburdened. Though the private health institutions have ramped up service and are accessible, not everyone can afford these services. Professor Kang comments that Governments should invest in building efficient public health systems available to everyone. Looking at the world, countries with strong public health systems have been successful in limiting the infections. It’s a futile assumption if, in the middle of a pandemic, we expect people of all classes to reach out and make use of public health facilities for testing, treatment, and vaccination on their own because trust in public health isn’t built on knee jerk reaction.

Thought on vaccines: Development, Ethics and Equity

The world is buzzing with conversations around vaccines and their development, ethics, and equitable distribution, and we wanted to hear from Professor Kang, a pioneer in vaccinology, about the Covid-19 vaccines. She quickly allayed all our fears around its safety and clarified that despite being approved in a shorter span of time on an emergency line of call, Covid-19 vaccines have been proven to work safely in the clinical trials and are adequately efficacious.

She explained the phases of vaccine clinical trials and assured us that we have now come to understand vaccines better than in earlier times when she was working on the Rotavirus vaccines. She reiterated that we must trust scientists in their Covid-19 vaccine endeavour because it’s only the timelines of approval that have been shortened to meet the huge demand worldwide. There has been no compromise in the quality. There has been undeniable collaboration and interdisciplinary engagement in research and development of Covid-19 vaccines globally and Professor Kang seems to take utmost pride in it.

Post the development of vaccines, the important next steps are their distribution and the infrastructural support necessary for it in addition to their acceptance. Interestingly, according to Professor Kang, vaccines are used for two reasons—to prevent people from dying or to prevent spread of infection. The decision of who needs to be vaccinated primarily depends on if a country aims to prevent the spread of infection or curb the severity of the disease. So, if one wants to prevent overburdening of healthcare systems, then high-risk, vulnerable groups should be the focus. And to stop the spread of the infection, the mobile, younger groups should be vaccinated. She firmly asserted that vaccines have started to be considered as the ultimate cure, which is a consequence of misinformed understanding among people at large. It must be communicated effectively that we cannot let our guards down with respect to non-pharmaceutical interventions like handwashing, sanitization, masking, physical distancing, and respiratory hygiene even with the vaccine being around.

Silver lining in the pandemic

There are always silver linings, even in tough times, and the Covid-19 pandemic has been no different. When we asked Professor Kang about the things that gave her hope amidst despair in the pandemic, she was ecstatic to answer this as she believed that this calamity did bring some positive learnings that the world must acknowledge. She commended the science journalists who investigated data and asked the right questions persistently as it ringed in the rise of new age journalism and heightened passion in health literacy. She admired the biomedical and pharmaceutical industry’s unity in these times and willingness to support newer drug development, vaccine research, manufacturing, technological innovations, and distribution; this was a good example of what global cooperation can achieve. Lastly, Professor Kang felt that the coming together of people across all ages and spectrums, volunteering and organizing daily things for the elderly and people in need, was a lesson on hope and togetherness around the world.

Shaping and preparing for the future

To be better prepared for the future, Professor Kang told us that it is important to view such pandemics and health emergencies using a prevention lens. Ramping up our surveillance and strengthening our national health programs will be the way forward.

She highlighted that we shouldn’t expect to build surveillance on a dire demand but focus on groundwork, sustainability, developing an adequate surge capacity that has the bandwidth to deal with all circumstances in the system. Along with surveillance, she emphasised that our human resource should also be well trained and resourceful. We must cancel out noise, which the armchair experts who divert media attention towards false narratives usually generate.

According to Professor Kang, shaping the future from the current pandemic will need communicating issues of science with authenticity, working on preparedness and gathering support in times of need through interdisciplinary collaboration, and building the capacity of health systems worldwide keeping the essence of global solidarity intact.

Youth and the pandemic

As young adults we often wonder if the youth have not been heard and cared for enough in the pandemic and this led us to ask Professor Kang how the young can play a role in guiding the research and policy agenda and feel represented. She answered this by discussing the importance of finding a voice amidst the chaos, a voice that has its own identity—and then building bridges through efficient communication about the issues that affect the youth. She advised us to develop potential solutions to problems that we feel strongly about and offer suggestions in decision making through platforms that we can position ourselves into comfortably and consistently. It’s sad that our society is hierarchical in nature and younger people are not considered partners in the larger scheme of processes and rather viewed as an age group meant to receive directives from peers and elders.

A very significant quality that can help young people in their growth is developing scientific temper and critical thinking; Professor Kang echoed this. She believes that science can only be learnt by doing it every day and eventually it does open a whole new world, a new way of thinking. Professor Kang fuels the need to change and emphatically stated that we, as youth, must not stop communicating and keep persisting on our journeys. We must band together because individual voices can be drowned out, but all voices together in convergence would be harder to suppress.

For Professor Kang, the “one word” that embodied the spirit of fighting the pandemic and traversing the new normal was “Resilience”, which she believed was the foundation of building back better. Her message for young people on how they should deal with this pandemic and the uncertainty around it was about the need to believe that with collective knowledge we will find solutions faster than ever before. However, along with this we must not forget that we have a collective responsibility to do our part and make sure we do not indulge in unnecessarily risky actions and continue supporting those who are affected. In the end, the onus lies on all of us as individuals and as a society.

Finally, Professor Kang thinks that averting emerging diseases and pandemics in the future will require all of us to lead a sustainable life, band together, use our privileges responsibly, and make an impactful case for the things we want to change in the world. If one has a platform as a policymaker, that is a solid ground to use and make a difference. If one is from the field of academia, the power of robust research and its effective communication is enough to reach everyone. On a concluding note, it’s of paramount importance to usher in the realization about the impact that our actions unleash on ecological balance and health of people all over the world and make necessary amends.