Can India handle coronavirus outbreak if it turns pandemic?

The coronavirus outbreak has triggered a global health crisis with China battling hard to contain the deadly disease that has already claimed 722 lives so far in the country. It has sent worrisome signals across the globe with the World Health Organisation (WHO) declaring it a global health emergency.

That said, the question that now arises is whether India is prepared to handle the situation if the coronavirus snowballs into a pandemic?

The medical fraternity and healthcare experts in India are divided on the issue. While some say the Indian healthcare system lacks the infrastructure to handle such an outbreak, a few feel the government is doing enough to prevent it. However, doctors believe with the start of summer, the coronavirus may not spread further as it did in China.

Coronavirus is a group of viruses that can cause illnesses such as the common cold, gastrointestinal infections, and diseases including severe acute respiratory syndrome (SARS). Its symptoms range from the common cold to more severe lower respiratory infections such as pneumonia.

On January 30, India woke up to the first case of coronavirus in Kerala and two more cases were reported over the past week. All of them were from the southern state of Kerala which had then declared a health emergency in the state. Subsequently, they lifted the emergency after the cases were brought under control and no fresh cases were reported.

“While the government has instructed all district hospitals and leading private hospitals to reserve ICU beds, we can only handle isolated cases. But if there are more cases, we cannot quarantine people like China did. Besides, we need more virology testing labs so that samples can reach faster,” said Indian Medical Association (IMA)’s national vice-president Dr Prabhakaran GN.

“The government should also take steps to provide preventive gears and suits to medical staff (in government hospitals) so they themselves don’t get infected,” he added.

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Contrary to the assertion that everything is under control in India, The Federal on Saturday reported about suspected cases in Chennai that have not been quarantined due to the lack of isolation wards. It further reported about the unavailability of safety equipment to healthcare workers in a government hospital.

Wuhan City in China built a 1,000-bed makeshift emergency hospital in 10 days and also cut off the region completely in order to contain the spread of the virus to the rest of the country. The country also used artificial intelligence to screen travellers using infrared and face detection technology, and would trigger an alarm if someone’s body temperature is above 37.3℃.

Steps taken by Indian government

Last month, the Indian government banned the export of all kinds of personal protection medical equipment, including N95 masks that are effective in preventing the virus from spreading. It also initiated screening of passengers at 21 airports and cancelled all existing e-visa for any foreign national travelling from China to India. The government also issued an advisory that people travelling to China henceforth will be quarantined on return.

While some of the doctors opine that hot and humid temperature can contain the virus spread, healthcare experts at Indian Council of Medical Research say if the temperature wavers (high during the day and low during nights), the virus could still spread, and that it will take another month and half for peak summer to kick in.

“Though we have about 106 virus research diagnostic labs in the country, only 14 labs, which meet specific criteria to test coronavirus cases, are pressed in. Most of these labs are situated closer to airports,” Dr Raman Gangakhedkar, head of epidemiology and communicable diseases, ICMR, told The Federal.

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With that, Gangakhedkar said India is completely prepared for the eventuality. Besides, All India Institute of Medical Sciences (AIIMS), Delhi, and the National Institute of Biologicals (NIB) can take up about 700 cases if the situation escalates, he said.

Gangakhedkar said he and other health ministry officials conduct video conferences daily with the national institute of virology and labs that are actively testing samples to take stock of the problems.

Meanwhile, Dr Santanu Sen, the immediate past president of IMA, has cautioned media not to spread fake news about the death toll and create a panic situation.

Looking for a possible solution

Gangakhedkar said it is not easy to isolate the virus. “It takes considerable time and effort to do that. But if someone does it, we can do the safety-related test and subsequent studies here and take it forward,” he said.

But, while it may take 7-10 years to develop a new drug, the ICMR has already started to think of a solution. “ICMR is willing to provide an experimental re-purposed drug instead of depending on a new vaccine that could take time to develop,” Gangakhedkar said.

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Though he declined to name the medicines fearing people’s propensity to self-medicate and use it on unconfirmed cases, he said the drug can be administered with the approval of the patient in case of an emergency situation.

Meanwhile, the World Health Organization (WHO) has decided to convene a global research and innovation forum soon to mobilise international efforts to combat the deadly virus.

Contribution of an Indian scientist

A team led by Indian scientist professor SS Vasan of Commonwealth Scientific and Industrial Research Organisation (CISRO) in Australia has grown sufficient stocks of the virus, outside China, to help preclinical studies towards the treatment of the deadly disease.

The breakthrough comes after researchers at Australia’s Doherty Institute isolated the virus from a human sample. In a press release, CISRO confirmed the development and said it will accelerate the development and testing of new vaccines, reducing development time from years to months.

According to 2019 Global Health Security Index, a comprehensive assessment and benchmarking of health security and related capabilities across 195 countries suggests not a single country in the world is fully prepared to handle an epidemic or pandemic.

India was at 57th rank with a score of 46.5 on the health security index while Thailand and South Korea were among the best-performing countries in Asia.

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