As the coronavirus disease (Covid-19) spreads rapidly across the world, India finds itself dealing with two types of situations. One, the perception in the general public about the magnitude of the pandemic, and two, the mindset that India must now create to fight it. To deal with Covid-19, there must be synergy between the two.
The coronavirus is a different type of virus; it is more virulent and aggressive than those of the past and is spreading quickly. Recognising this is key. The caution that we exercise must be proportionate to its intensity. Although the virus originated in Wuhan, China, and then spread swiftly across the world, India seems to have got it from Italy, Iran and other countries, not China. Of them, Italy has a lethal strain, causing parts of the country to face a severe blow with the death toll exceeding even that of China. If India has got that strain, it must be prepared to face the severity of it.
For India to battle Covid-19 effectively, the approach must be multi-layered.
Identification at the first stage (when travellers who have visited contaminated regions have returned to India) and the second (those infected through direct contact with the traveller) is the best defence. This places the onus on individuals, who must report their travel history to the government, self-isolate for two weeks — the gestation period of the virus — and take various precautions within their own homes. The government can then prepare to successfully contain it at the local level. Simply put, the larger the area, the more difficult it is to contain the virus.
Things get harder as the country reaches stage three — community transmission. Right now, there isn’t clarity on whether the virus is spreading at the community-level or not, but suspicions have arisen due to an incremental number of cases being reported in the last few days. We may well be heading there. As we do, it is important to remember that, while all those with symptoms of Covid-19 — cold, cough and flu among others — may not test positive for the disease, it is imperative that a self-quarantine is put in place to rule out the possibility of a community outbreak. Since the flu season is upon us, it may well be the common flu, swine flu or other illnesses, but people must still exercise self-restraint at the risk of it being Covid-19. And if the flu is accompanied by breathing issues, they must follow the government protocol to ensure that they are tested immediately.
The Centre and state governments must be credited for acting quickly in making efforts. Locking down states, restricting movement, and cancelling events are welcome. But this message must echo among all sections of society. General markets have continued to remain crowded, despite the advisory on limiting the maximum number of people in any space. Awareness on the importance of social distancing as a tool to contain the virus is required.
The Indian Council of Medical Research (ICMR) has begun community surveillance and testing random samples of patients with pneumonia-like or chest-related symptoms. The results of recent tests came up negative, indicating that community transmission may not have occurred. This initiative is welcome, as it gives us a dipstick idea of how rapidly it is spreading.
However, in the wake of Covid-19, India’s health care systems have proved to be inadequate. Cases from isolation centres highlight the dismal quality of facilities, causing people with symptoms to flee isolation wards for fear of contracting illnesses. This must change. With limited resources and a population of 1.37 billion people, the government can’t do this alone. Recognising that the possibility of entering the third phase is looming, reputed and certified private laboratories have shown readiness to conduct tests. The private sector will work alongside the government to combat the disease, if the government so chooses.
As a large country, even a few per cent of infected people will weigh heavy on existing health care systems. It must now proactively build designated Covid-19 hospitals across the country. Maharashtra is a step ahead. It has converted a non-functional facility into a Covid-19 hospital. Hospitals across India, which are no longer operational, along with those that have the flexibility to shift patients, must be converted into specialised units for treatment. This will help isolate patients from the rest of the country, thereby containing the spread.
This approach worked well for China. Although delayed in its response, it built designated Covid-19 hospitals. Six weeks ago, China had an overwhelming majority of the cases of the world, and the rest had just a fraction. Today, the graph is reversing. China’s Hubei province has, for the first time, since the outbreak, on March 19, reported no new cases. Italy, on the other hand, didn’t respond with aggression, causing devastation and death which it is still reeling from.
India must approach the crisis on war-footing. The war against Covid-19 is a national emergency. So far, there is a continuous and strong line of communication between the government and the private sector. But now, India is at an inflection point. The next phase is crucial. While panic isn’t necessary (as it suggests that we have lost our balance), we must, however, show extreme seriousness and exercise maximum caution. The crux lies in prevention and control, rather attempting to tame it after it runs wild.
The country — the media, health care professionals, civil society, corporations — are getting together to spread the right information. As the chairman of Confederation of Indian Industry (CII)’s National Committee on Healthcare, I can confirm that corporations are putting their heads together to continue the conversation of best practices and meaningful collaboration. The CII’s latest video on awareness will soon be available in vernacular languages to spread the message to the remotest parts of India. Across the spectrum, headed by a willing and proactive government, communities must work together. An early warning can definitely flatten the curve. Let it not peak.