Coronavirus is here: Is India ready?

While the COVID-19, the self-mutating new Novel Coronavirus, was tying up the Chinese dragon in knots in China, the social media in India was populated by imagery and videos from China and tended to take a lighter or comical view. The government made feeble attempts to reassure people.

But, as soon as COVID-19, broke out of Wuhan, Hubei, etc and started to fly out with travellers, the mood started changing. Over 325 Indians were airlifted by Air India from Hubei on February 1 and a similar number, mostly students, from Wuhan the next day. Preventive quarantine was the first line of defence. The two confirmed cases in Kerala and many suspected were
managed well.

However, come March and the virus has spread across continents, geographies and more than 70 nations are grappling with it. It has started to cripple aviation, travel and many other businesses. With the proverbial ‘Ides of March are coming’, India, which was considered comparatively safe, is facing ominous signs of an epidemic with six confirmed cases already. This summer of discontent may not be just about the usual heat but from the chills that the virus seems to be sending down our spines.

From March 1, at least six cases have been confirmed. Out of three are: One Indian national who came from Dubai to Hyderabad, Telangana, another who returned from Vienna to Delhi and the third who had come from Italy (which is facing a big problem) and belongs to Jaipur. Scores are being screened for suspicious symptoms. In short, it means COVID-19 is spreading across the country slowly but surely.

The panic button has been pressed with two schools in Noida forced to unofficially shut for a week following a scare in the Delhi and NCR region. Fumigation operations are on. About 40 students have been sent to 28-day isolation.

While the risk of its spread across the country is exponentially rising, reactions from many sectors are coming thick and fast. Travel companies are notifying restrictions, there are question marks on big events, especially in vulnerable areas. Like the case of Xiomi postponing its launch and Tata Motors scaling down operations.

As we discuss the issue, COVID-19 has already infected around 90,000 people across 73 countries and public health officials are operating in ‘Unchartered territory’, as they combat it, acoording to the chief of the World Health Organisation (WHO), Dr Tedros Adhanom Ghebreyesus, as per media reports. The death toll too has mounted to 3115 worldwide.

HOW PREPARED IS INDIA?

If this is the global scenario, the big question now is how prepared we are to handle the challenge. If an epidemic breaks out, is the public health system and government machinery prepared to combat the crisis?

According to noted virologist Prof Sunit Singh of Banaras Hindu University (BHU), with no drug or vaccine available, the best bet, as of now, are preventive measures and increasing the efficiency of the healthcare management system.

Singh says to understand pathogens transmitted through the aerosols route, a biosafety level 3 facility is necessary. At present, India has 10 such centres. The National Institute of Virology (NIV), Pune, is the main confirmatory lab for the tests done using PCR (Polymerase Chain Reaction) kits. Some of the bigger government and corporate hospitals are equipped with isolation wards, screening and preventive treatments.

The Indian Council of Medical Research (ICMR) provides Laboratory support with NIV, Pune, as the nodal laboratory and 14 other network laboratories. This can be expanded to include 50 laboratories, if the situation so demands. A 24x7 Control room cum call centre is operational, the Union government claims.

But given the struggle that the government-run and corporate hospitals go through in handling outbreaks of even dengue and viral fevers one understands that we are up against heavy odds in the event of COVID-19 turning into an pan-Indian epidemic, several healthcare experts concur. The single biggest hurdle would be to break the chain or rate of transmission that can skyrocket consequent to an epidemic or results of rumour and misinformation. At present, the virus manifests initially with common cold and cough.

There is a need for an awareness blitz by the government and concerned medical fraternity on the best ways of prevention and precautions, failing which the sudden rush or burden on the healthcare system will become unmanageable. The public health system and hospital infrastructure in India is woefully inadequate and not ready to face a sudden pandemic, experts argue.

If the transmission of the virus is so quick in European countries like Italy, Austria where populations are sparse and spread out, one can imagine the consequences in India where population density is extremely high.

False claims of cures through cow urine and rise of pseudo experts with unproven remedies will worsen the situation. The comments by Uttar Pradesh Chief Minister Yogi Adityanath on Swine Flu that it wasn’t a disease but just a flu will not help the cause either.

Take the case of Sunita Krishnan, founder of Prajwala, an NGO that has been fighting human trafficking for decades and a Padma Shri awardee. On her return from Bangkok on March 2, she reported to the Gandhi Hospital in Secunderabad as she had some symptoms like cough and cold. In a tweet, she alleged that there was considerable delay in conducting the necessary tests. Luckily, she tested negative.

Inadequate supply of test kits, specialised masks (N75), surgical equipment may also add to complications. On paper, capacities may exist, but whether they will rise to the task is anybody’s guess. During the Ebola virus outbreak in 2014, good capacity was demonstrated when all those who arrived at 21 international airports and six seaports were screened by trained manpower. That experience may come handy this time. But the task would be of Herculean proportions as the number of entry points have grown in leaps and bounds.

Union Health and Family Welfare Minister, Dr Harsh Vardhan, has stated, “We have good and effective co-ordination among ministries, robust surveillance system, network of laboratories to support diagnosis, upgraded medical facilities, trained health work force and media presence that can reach even remote areas. We have put all these resources at our disposal to prevent/contain outbreak of coronavirus in India.” Vardhan stated that all ministries and states have done commendable work, in particular Kerala, which has put up a sturdy system of surveillance. Incidentally, Kerala which was hit by the Nipah virus did well to control its spread. But Vardhan’s words will be tested if COVID-19 becomes an
epidemic.

(The author is a science writer)