The history of the H1N1 (popularly known as Swine Flu) outbreak in India at the beginning of the decade is an apt reminder of the fact that viruses do not respect borders when they go on the rampage. They slip through geographical barriers and within no time and, given the right environment and opportunity, cover a large geographical expanse.
So, it is only a matter of time before the latest Coronavirus — known as the Wuhan virus because of its epicentre — enters India and turns into a serious threat. The virility of the virus, the ease, and pattern of its transmission imply only a miracle would stop it at the Indian borders. So, how concerned should India be?
Three factors turn a virus into a serious health threat. One, it has to be new for humanity — meaning that people should not have immunity, medicines or vaccines against it. Two, it should have the ability to jump from humans to humans at a rate higher than one (each victim should be able to transmit it to more than one person). And three, it should have a significant mortality rate.
On all these three counts, the latest virus scores heavily. It has just recently jumped from animals to humans — possibly from snakes or bats — and, thus, there is no treatment or vaccine against it. Some studies suggest the virus not only has a transmission rate of two to four but can also be passed on even before a person becomes symptomatic, making it difficult to trace the extent of exposure. Finally, it appears to be killing a lot of victims — so far 80 persons have died in China with hundreds more being critical.
Its closest competitor — the SARS virus from 2002-03 — was mild in comparison. Its transmission rate was low as others got infected only when a patient’s symptoms peaked, making it easier to identify threats, limit exposure and track down potential victims. The SARS epidemic raged for almost six months, infecting around 6000 people and killing 800 around the world. In comparison, there are already at least 2800 confirmed cases of victims and 80 deaths because of the Wuhan virus.
Some experts believe the virus may have infected 100,000 people and is now difficult to contain. Conspiracy theories about the virus abound. An Israeli expert argues the new virus escaped from a laboratory near Wuhan, where it was developed by Chinese researchers as a biological weapon, and is designed to wreak havoc. In Beijing, a social media campaign is blaming the US for unleashing a new virus that could cripple the Chinese economy and wipe out hundreds of people.
The situation, as the Chinese government has said, is grim as the virus is acquiring the ability to travel faster among humans and its victims are popping up almost everywhere. In all likelihood, the World Health Organisation will declare it a global health emergency. India’s public healthcare system is among the poorest in the region. In the past, it has reeled regularly under the impact of seasonal diseases like Malaria, Chikungunya and Dengue. A new virus with a high strike rate and no known protection can have a devastating effect on the economy and the population.
Every year around 250,000 Chinese tourists come to India, most of them during the Lunar New Year holiday in their country (late January to February). During the same period, hundreds of Indian students in Chinese varsities return home for a brief vacation. Since China downplayed the threat of the new virus initially, many of these people may have entered or passed through India without being properly screened.
The threat for India is compounded by its proximity to the region where the virus has spread. Every day, hundreds of Indians mix with Chinese travellers in Southeast Asian cities like Bangkok, Kuala Lumpur, Hong Kong, and Singapore. All these places have reported several cases of the new virus and are on the edge as thousands of Chinese travellers have poured into their borders over the past few weeks, turning them into crucibles for a regional rollout.
At the moment India is relying on screening passengers from China, especially those from the affected regions. But, this is, as an expert has said, like looking for a needle in a haystack since many victims of the virus continue to transmit it even when they are asymptomatic. Also, the virus has an incubation period of 14 days—victims may arrive in India, pass through the immigration counters and show symptoms a few days later, in the process putting many others at risk.
India would hope that the SARS-like virus doesn’t enter its borders at all. Even if it does, India would pray, the arrival is delayed till the global community has either found a treatment or developed a vaccine. It would also be relying on the higher temperature in the post-March period to reduce the efficacy of the virus. In all likelihood, a global pandemic whose dynamics are still unknown is evolving. And India’s luck and borders would be tested soon.