Abu Dhabi, UAETuesday 22 September 2020

India has done well so far in contact tracing and thereby reining in the virus

The world’s second-most populous nation has one of the lowest rates of infection so far

A traffic policeman advises commuters to stay home during the first day of a 21-day government-imposed nationwide lockdown as a preventive measure against the Covid-19 coronavirus, in Hyderabad on March 25, 2020. AFP
A traffic policeman advises commuters to stay home during the first day of a 21-day government-imposed nationwide lockdown as a preventive measure against the Covid-19 coronavirus, in Hyderabad on March 25, 2020. AFP
When news of the virus began to emerge from China, most countries were slow to react. As a result, Covid-19 jumped through immigration checks and within weeks, had spread rapidly through Europe, the Americas and Asia.
On Tuesday, Indian Prime Minister Narendra Modi declared an unprecedented nationwide lockdown for 21 days, instructing 1.3 billion people to stay home to avoid a spike in cases. Mr Modi said he would allocate 150 billion rupees (approx Dh7bn) to bolster the country’s healthcare system. An economic aid package is reportedly in the works.
On March 21, India had already began to systematically shut down. Districts, which are the bedrock of India’s administrative set up, were closed to ensure that the Covid-19 virus does not get to stage three.
Of the four stages of an impending virus epidemic, according to the Indian Council for Medical Research, stage three is known as community transmission, when the virus breaks out in population clusters and starts to spread across regions. At this point, it becomes virtually impossible to stop the epidemic and mortality rates grow exponentially. This is the stage that precedes a full epidemic outbreak – the likes of which are now visible in China, Italy, US and Spain.

India has been able to avoid stage three so far because by the middle of February, Indian officials were beginning to screen patients from China. This ensured that anyone infected was identified and quarantined.

As the virus spread, countries like South Korea and Japan were added to the list. By March, a full scale screening programme for all international passengers was implemented across all major airports in India.
While some experts say that India is two weeks behind what Italy and the US are witnessing, fact is that India initiated measures to flatten the virus growth curve long before them

In a constitutional democracy such as India, with a large diaspora spread across the world, addressing a health threat like Covid-19 is not easy. It has a complex form of governance, with healthcare placed within the domain of local state governments. The federal government regulates international boundaries but has to defer to state governments on issues such as health care and law and order. This translates into a power-sharing arrangement that needs a number of disparate elements to come together on a scale that is unparalleled.

While China can shut down cities, in a country as diverse as India, consensus building is the only way forward.

As screenings in India increased, more quarantine centres were opened up, and states began the process of contact tracing. As soon as a suspected infected person is identified, the government starts tracing everyone who may have come in contact with the patient.

This was done successfully for most cases, barring a few in the Southern states of Kerala and Karnataka. The federal and state governments pored through passenger details to find everyone who could have come in contact with infected people as they travelled through airports, train and bus stations.
Indians stand in marked positions to buy essential commodities from a grocery store in Mumbai, India, Wednesday, March 25, 2020. AP
Indians stand in marked positions to buy essential commodities from a grocery store in Mumbai, India, Wednesday, March 25, 2020. AP
Much of the credit for these processes goes to Satish Chandra, who in February 2003, as India’s deputy national advisor, was the first senior Indian official to recognise pandemic threats. The Sars virus was threatening India and Mr Chandra’s colleagues were scrambling for strategies. He was part of the newly constituted National Security Council Secretariat, an adjunct of the Prime Minister’s Office for preparing policies and strategies against national security threats.

“I was worried that a pandemic could have a mortality rate as high as 60 per cent. As we studied our preparedness, we discovered that we had not war-gamed any scenario to tackle it,” he told me this week. His papers had limited scope, but it also led to the creation of the National Disaster Management Authority that eventually raised response battalions trained to tackle any nuclear or biological threats.

Crucially, Mr Chandra and his colleagues, post the Sars epidemic of 2003, recognised the importance of screening passengers, isolating them and contact tracking on a nationwide scale.
As of March 24, India shut down 545 districts across the country on a scale that was not seen even during the war with Pakistan in 1971. It has also imposed a strict protocol for essential services to ensure that basic food and medical supplies and media can function.
The fact that India has reported 511 infections and only 10 deaths so far is proof that its early strategies worked.
While some experts say that India is two weeks behind what Italy and the US are witnessing, it is worth keeping in mind that India initiated measures to flatten the virus growth curve long before them.
The current lockdown will go a long way to delay the spread of the virus, buying much-needed time to create more hospital beds. Private groups like India's Reliance Industries and the Mahindra Group have also stepped forward to create dedicated triage facilities as well as enhance equipment capacity. Surely, these are valuable lessons to be learnt.
A study published by a group of experts drawn across universities in India and the US, who identify themselves as Cov-Ind-19 Study Group, makes dire predictions. It points out that by March 18 only 11,500 people had been tested. This is one of the lowest in the world. According to their prediction model, India can see 2.2 million infections by May 15, in the absence of major government interventions to stop the spread of the virus.

However, with severe interventions infections could come down to 13,800. Till the middle of March, India had only one million test kits and just approved private labs to conduct tests to augment the government's capacity to screen possible carriers.

Testing is the key to any successful intervention, Dr Bharmar Mukherjee, professor of epidemiology at the University of Michigan, told me. She is one of the authors of the Cov-Ind-19 study and has been building predictive models for tracking epidemics. The good news is that their key recommendation of “draconian measures” to contain the epidemic has been implemented across India.

But while tests remain worryingly low to track more infections, India needs to do more. It needs to build strategic mutually-beneficial partnerships with countries like the UAE for developing vaccines to take on such viruses. This kind of collaboration will ensure resources are available for those with decades of experience and expertise. They can develop vaccines and strategies that suit local social, political and economic conditions.

Vaccination, experts agree, is the only magic bullet to combat epidemics.

Countries like India also need to end their dependence on other countries for its Active Pharmaceutical Ingredients and build its own. Without API, countries will not have medicines. Without medicines you do not have a cure. In other words, without API, a nation's capacity to provide medicines to the sick is severely compromised. Whereas a robust API industry and vaccine research capability can significantly boost a region's capacity, extended to the whole South Asia and Middle East, to effectively take on the threat of the next pandemic.
Saikat Datta is a Delhi-based journalist, author of The History of India's Special Forces and founding partner of Centre for Strategic and Defence Research

Updated: March 26, 2020 11:49 AM

Editor's Picks
THE DAILY NEWSLETTER
Sign up to our daily email
Most Popular