Professor Sudha Seshayyan, Vice Chancellor, Dr. MGR Tamilnadu Medical University, Chennai, India explains how COVID-19 has impacted his country.
The start and the surge
News about the Coronavirus disease trickled in by early January 2020. As is regular these days, more information was being circulated through social media than the scientific community. Nevertheless, Indians did not bother much as several causative factors including spread from bats and civet cats were being discussed. Though the first case in India was reported on 30th January in Kerala and the number rose to three by 3rd February, the whole of February saw a kind of a restricted precaution, because all the three reported were students who had returned from Wuhan, China. Frequent air travellers spoke more about the novel Coronavirus. By early March, more cases were reported across the country. And India sprung into swift action. By the second week of March, advisories to avoid congregations and to practice physical distancing were well in the air. Social and cultural organisations voluntarily called off events and programmes. With the academic year drawing to a close, schools and colleges juggled with their schedules to keep students at home.
Speaking to the countrymen on a national telecast, the Indian Prime Minister Shri Narendra Modi asked the people to observe a ‘Janatha curfew’ (people’s curfew – curfew self-imposed on the people) on Sunday, 22nd March from 7.00 am to 9.00 pm. Everyone, except those involved in the essential services, was asked to stay home during the 14-hour period. A few criticisms apart, it appeared that the whole populace had suddenly understood the significance of the situation. By this time, several agencies had directed their employees to work from home, many educational institutions had announced holidays, shops were offering restricted transaction hours and physical distancing was getting implemented almost everywhere. The Prime Minister, in another National telecast two days later, announced a nation-wide lockdown for 21 days starting the midnight of 24-25th March 2020.
By and large, India seems to have taken the lockdown in a truly scientific and societal spirit. For a densely populated country that was teeming with huge traffic almost all through the day, the roads are now practically empty. People have well adapted to being at home and even working from home. Universities and larger educational institutions have leveraged digital platforms for teaching & learning and for research too. Access to essential commodities is made available at restricted timings. Rail, Road, and Air services have grounded to a complete halt. However, the crux of the Indian understanding and co-operation is reflected well when even the rural schools and teachers have sought to use computer and smartphone applications like the WhatsApp to impart knowledge. The key word is seen all over – Social and Physical distancing.
Much before all these happened, the medical community had prepared itself to face a difficult situation. Most hospitals were prepared to receive a significant influx of patients by early March. Members of the medical fraternity were trying to keep themselves abreast of all related information. With the lockdown and with some increase of COVID-19 patients, the health care segment is consolidating its efforts in such a way that community transmission of the disease is still kept at bay. Simulation and docking studies with regard to components that can prevent viral entry into cells and viral replication have been taken up at many research stations.
Health care workers, Police force, sanitary workers, special service providers, food suppliers to the migrant and homeless, bankers, researchers, and several others are working …… working from home, working from a safe distance and working well in their fight against COVID-19.
And to seek answers to a few questions that everyone puts through. . .
What is the Burden of COVID- 19 on India?
Despite being the world’s second most populous country, with more than 1.3 billion people, India has reported 164 deaths and around 5500 cases(source: as per Johns Hopkins University’s Corona Virus Resource Center, accessed on 08th April at 8 pm IST).The COVID-19 infection rate in India remains low, apparently.
Are India’s numbers for COVID-19 low due to a low number of tests?
If there are high infections among Indian population, but they were not tested or undetected, then by natural history of the illness, 20% would be severely or critically ill & would have shown up in hospitals. Hence it is unlikely that there are many infections in the population. The lockdown including closure of private clinics would have made sick patients to end up in the hospitals.
How did India’s initial response help?
Among the 200 plus countries that have patients with Covid-19, India so far does not rank in the first 25 places, in terms of the number of confirmed cases.
Even in the early stages, all incoming international passengers who entered India underwent Universal Health Screening. This was followed soon by travel restrictions through suspension of visas and quarantining, travel advisory by the National Government to fellow citizens against all non-essential travel abroad, has helped in the beginning.
Why India has not seen an exponential growth in COVID-19 cases until now ?
The possible reasons:
- Swift Government action to shut borders;
- Implementation of country-wide self-isolation for 21 days imposed at an early stage of the epidemic
- Robust public health field team to quarantine people & trace contacts; Contact tracing and quarantining have ensured that the outbreak is largely limited to family contacts
- Indians have an innate immunity to the virus ?? (many propositions have come up though scientific proof is difficult)
Any Cautionary note for India’s battle against COVID 19?
India is still in a relatively early stage of the epidemic. The benefits so far seen need to be sustained even after the National lockdown is loosened. Officials are hence preparing for a broader outbreak and community transmission. More antibody tests to determine population immunity may be needed. The Indian Council for Medical Research has already announced plans for such surveillance.
“India is a hugely populous country. The future of this pandemic will be determined by what happens to densely-populated countries. It’s important that India takes aggressive action at the public health level, and at the level of society to control, and suppress this disease,” --- Mike Ryan, WHO emergencies programme director, said at the organisation’s headquarters in Geneva (March 23).