The Lancet, a leading peer-reviewed medical journal, published an editorial today that was scathing in its criticism of how India is handling the second wave of the Covid pandemic.

"Despite warnings about the risks of superspreader events, the government allowed religious festivals to go ahead, drawing millions of people from around the country, along with huge political rallies —conspicuous for their lack of COVID-19 mitigation measures," the editorial said.

The editorial pointed out how health minister Harsh Vardhan declared in March that India was in "endgame of the novel coronovirus epidemic". It also added that Modi's government "has seemed more intent on removing criticism on Twitter than trying to control the pandemic".

At a federal level, the Lancet continued, India's vaccination plan "soon fell apart". "The government abruptly shifted course without discussing the change in policy with states, expanding vaccination to everyone older than 18 years, draining supplies, and creating mass confusion and a market for vaccine doses in which states and hospital systems competed."

The editorial cited the Institute for Health Metrics and Evaluation's estimate that India will see one million deaths from Covid by August 1.

"If that outcome were to happen, Modi's Government would be responsible for presiding over a self-inflicted national catastrophe," the editorial said.

India must now pursue a two-pronged strategy, the Lancet said. First, "the botched vaccination campaign must be rationalised and implemented with all due speed". India must increase its vaccine supply and work with primary and local healthcare centres "create an equitable distribution system for the vaccine". Second, India must "reduce SARS-CoV-2 transmission as much as possible while the vaccine is rolled out". This includes the government publishing accurate data in a timely manner, "forthrightly" explain to the public "what is happening", and expand genome sequencing.

It said: "Modi's actions in attempting to stifle criticism and open discussion during the crisis are inexcusable."

India also "squandered" its early successes in controlling Covid, the Lancet continued, noting that until April, the central government's Covid taskforce "had not met in months". "The consequences of that decision are clear before us, and India must now restructure its response while the crisis rages. The success of that effort will depend on the government owning up to its mistakes, providing responsible leadership and transparency, and implementing a public health response that has science at its heart."