Covid-19: Indian leadership on test, nation waits to hear PM’s address to the nation at 8 pm  

While optimists hope the country has still time on its side to take preventive steps to contain its spread, the realists believe that the virus has already penetrated into the community transmission stage. It’s not surfacing because adequate screening has not been done. India should learn fast from the experiences of China, where it originated and the US, which seems to be getting engulfed. The Chinese had first tried to suppress warnings and initial cases in December in Wuhan. Consequently, the great power was trapped into a mini disaster. Even the strongman like XI Jinping, President for life, was not seen or heard for weeks. After a lockdown and 100 days of waging a relentless battle, China lost over 3100 lives and has more than 80,000 infected. Even today, although it claims it’s back to virtually business as usual, a trickle of cases are still being reported. The one big positive is that sustained measures taken by the administration has ensured that the rate and numbers of infected is quite low outside the worst hit Wuhan city and Hubei province.

China also now claims it is able to reach out and help Italy, where the infection and mortality rate is steep and where the textile and leather business in northern Italy is dominated by the Chinese with links to Wuhan. Jack Ma, the multi billionaire founder of Alibaba offered supply of millions of test kits & medical devices to the United States as well. Now, take the case of the US, led by president Donald Trump, the political administration clearly ignored the warnings. According to a New York Times report, Dr Helen Y Chu, an infectious disease expert in Seattle, close to the capital Washington, had reported the first confirmed case in January itself. But, till Feb 25, repeated communications by their research teams did not elicit any response from the Government. Come, March, the greatest superpower on earth, which is waging battles across continents against terrorism and helping other countries build infrastructure has been pushed inwards into a state of health emergency. From Ivanka Trump, the President’s daughter to top Hollywood Stars, many Americans are going into isolation, and big corporates like Microsoft have announced work from home with full pay to all.

India’s response in comparison has been measured or knee-jerk in different states and places. It has been measured in Kerala, where the first positive cases surfaced. Learning from the Nipah virus episode, the Pinarayi Vijayan Govt moved quickly to take on the challenges. While schools were shut down, the state government ensured that mid-day meals reached the children at home. The reaction of the governments in Delhi, Telangana, Maharashtra and Karnataka etc. have however been knee jerk. In all these cases the number of suspected cases is increasing and there are growing complaints that people returning from affected countries are not being screened or isolated adequately. A shining example of such knee-jerk reaction came from the Telangana Chief Minister K Chandrasekhar Rao, who first described it as an issue of no consequence to the state but then did a remarkable U turn and resorted to a lockdown till March 31.

The Union government’s preparedness began with the unleashing of a multi-lingual, recorded phone message encouraging people to wash hands and impose restrictions on travel into the country. It has intensified its screening of incoming Indians from affected nations at airports and seaports. It has also been quick in sending Air India flights with doctors to Iran, Italy etc to bring back stranded Indians. So far, so good. With efforts and luck on our side, the number of people testing positive reached 129 as on March 17. According to the Indian Council of Medical Research (ICMR), which has successfully isolated the strain from an Indian patient and found it to be similar to the one in Wuhan, the likelihood of the virus replicating the China type of spread is high. The 4-stage progression of COVID 19 begins with inflow of cases from abroad, local transmission, community spread and finally turning into an epidemic. India is said to be at stage 2 now and has no option but to halt it from moving forward, warn experts. The Director- General of the ICMR, Dr Balram Bhargava is quoted as saying, “India has a 30 day window to halt the beginning of the community transmission. If we manage this month and community transmission does not happen, we will be on firm footing to contain it”.

Community transmission is when a person who is not exposed to anyone known to be infected and who has not travelled to affected nations, tests positive. Now, what infrastructure do we have to find this out quickly? India has an abysmally low number of 65 testing labs for a population of 1.3 billion. Community participation and ‘Social Distancing’ are the best options to break the chain of transmission for India. “We neither have the infra to effectively screen everybody entering the country nor the test kits at present to study the problem within. One of the reasons for the low numbers at present could be the lack of testing. We do not have facilities to isolate large numbers for the mandatory 14 days too. Priority should be to safeguard geriatric population from exposure”, says leading virologist Sunit Singh from the Banaras Hindu University (BHU).

Surveillance Capability Under Test: In the event of COVID 19 turning into an epidemic the country’s rudimentary public health centres (PHCs) and the disease surveillance system will be severely tested. That the PHCs are in tatters, except for a few and that successive govts have been only promising to strengthen them is no secret. The best health administrators can do now is to turn them into testing centres and utilise the services of trained para medics to extend help in rural areas, before patients are given access to better facilities of isolation and treatment. On the surveillance front, the outbreaks of swine flu, bird flu, SARS and the more recent Nipah virus in Kerala have seen the build-up of an Integrated Disease Surveillance Initiative, with funding from the World Bank being developed under the Union Ministry of Health & Family Welfare during 2004-12. With its portal, central surveillance in Delhi and centres and response units in different states, the Initiative has been alerting on minor outbreaks of human and animal diseases. There is an urgent need to quickly scale up its capabilities with more professionals and funding to face the challenges posed by COVID 19 type outbreaks. Most often, in many states, private and corporate hospitals have proliferated, coinciding with the decline in the public healthcare infrastructure and reduction of funds in the health budget too.

Thus, the familiar story of outbreaks of malaria, diarrhoea, typhoid or the recent dengue fever take a heavy toll on humans and the family economies. With epidemics on the rise both in frequency and intensity, the case for hiking investments in public healthcare might no longer be an option for India.

(The author is a journalist & science writer based in Hyderabad)