Is The COVID 19 Bomb Ticking Fast for India?
You cannot fight, what you cannot see South Korean health officials.
Must Read, a special report on Corona Virus in India is designed to help you navigate through the very scary times ahead. Please feel free to share this and many more these free informative articles. By Vijaylakshmi Nadar, Bureau Chief, TIO.
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Edited By Adam Rizvi TIO: The world is busy tackling the worst health crisis of our times, on a war footing by curbing the ravages caused by the COVID 19 virus, while India is yet to fully wake up to the challenge.
Consider these facts:
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India’s contingency/disaster management fund is only Rs 555 crores and the Prime Minister’s Relief is
another Rs 3800 crores. This is woefully short to tackle the COVID 19 menace, when So far relief efforts
have already crossed 3.5 trillion dollars, in the rest of the world.
Only the Kerala chief minister Pinnarayi Vijayan, with second highest number of COVID cases in his state
has come up with a relief package of Rs 20,000 crores, and a detailed plan to tackle the health crisis. The
chief ministers of Delhi and West Bengal, on more intent on containing the crisis, with better medical
facilities.
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None of the states whether it is Kerala, Bihar, Punjab, Maharashtra or Assam, received any kind of relief
from the center during last year’s severe floods, which claimed hundreds of lives and caused severe loss
and damage to property. Center did not offer a single penny as relief to Delhi riot victims either, though
the riots happened just a few days ago. The states are pretty much left to themselves to tackle the crisis
in their states. No accountability from the center whatsoever for lives lost. It will be no better, when the
COVID 19 unleashes its full impact on the states.
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The country is going through its worst economic crisis, with the GDP figures at 4.5 %, the lowest in 42
years. The center has also swallowed Rs 1.76 lakh crores of Reserve Bank of India reserves. No
government has laid siege on it since independence. No statement has ever been made by the
government as to how the funds, meant for a national crisis, has been or eventually will be used.
India’s total budget for the health sector is a woeful 3.7%, which too is under-utilized allowing the public
sector to collapse over the years. The poor and marginalized have no access to public health care and will
run a huge risk of survival, in case of the community spread of the virus.
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In case of a shutdown, 90% of the unorganized sector, mostly daily wage earners will be severely hit,
with no relief measures including food spelled out for them. No cash support to daily wage workers, no
relief packages like free medicines, free grains through the public distribution system.
Small and medium sector industries which are yet to recover completely from the onslaught of
demonetization in November 2018, risk another round of washout with this virus outbreak. There are still
no official figures of the destruction wrought then. No sops were given to the marginalized even then to
tide over the crisis.
While most countries are offering millions in relief packages, the Indian government is yet to even reveal
steps to curb the menace, if it has any, leave alone offer any relief packages.
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COVID 19 is a respiratory disease and government hospitals in states like Uttar Pradesh and Bihar are
extremely short of ventilators, among other things. Over 80 babies lost their lives in a government
hospital in Uttar Pradesh, in August 2017, for lack of oxygen alone.
At the peak of the epidemic, by the projection of all modeling groups, UK will have an estimated by
500,000 to a million severe cases, upwards of 3-4 million cases in the USA, and 4-8 million severe cases in
India, according to Dr Ramanan Laxminarayan, Director Center for Disease Dynamics, economics and
Policies.
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India has a capacity of an estimated 70,000-100,000 Intensive Care Unit beds, with much fewer
ventilators than that.
In a country of a population of 1.3 billion people, there may be a shortage of seven million hospital beds
with a severe paucity of ventilators, lack of sufficient doctors and other healthcare professionals, besides
a dearth of medicines. Though 98% of the population will self- resolve, 2 % of the population above the
age of 65% risk survival, according to Dr Ramanan.
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234 cases have been detected in the country, with 212 active cases, 14 recovered and four dead, very
suspicious and woefully small for a country this size.
A country like South Korea has tested over 316,664 tests until now. USA 103,945 cases, Vietnam 15,637
cases, Italy 206,886 cases. So far India has tested only 14, 514 cases, when it has the capacity to test
300,000 cases. India has finally placed an order for a million more testing kits from Germany.
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At this rate in a population of 1.3 billion people, only 10 per million are being tested, which is just quarter
of what even Vietnam is testing. Vietnam has so far tested 40 per million, In Thailand 140 per million,
while richer countries like France, Italy and even South Korea have already tested millions.
So far only the Indian council for Medical Research (ICMR) is dealing with the unfolding crisis It has listed
a total of just 52 labs, for the entire country where testing can be done, with 30 more labs to be added.
South Korea has about 500, where they are doing 15,000-20,000 tests a day. India is so far doing about
1000 tests in a week. Only now, efforts are on to involve private hospitals and labs.
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Social distancing over mass testing is the route taken in India.
To tackle the menace “on a war footing” , the prime minister Narendra Modi had nothing at all to offer
in his address to the nation on Friday, except some basic tips to keep the virus away by washing hands,
by imposing a 14 hour curfew just on Sunday and also banging metal plates, to make some noise to
“acknowledge” the medical fraternity. Probably in anticipation of the disaster that lies ahead, where
doctors will be the first line of defense, as seen in other countries. No financial packages or the medical
preparedness was revealed to the anxious citizens.
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Is India then poised for its worst health and economic crisis ever? Will India become the next hotspot
for the spread of COVID 19?
The COVID 19 virus has knocked on the doors of the highest echelons of the Indian government. As
many 96 MP’s from Rajasthan and Uttar Pradesh including the president Ram Nath Kovind, may well be
infected with the virus, since MP Dushyant Singh, a possible suspect, was at the breakfast event
organized by the president on March 18. He caused a massive furor in parliament on Saturday, when it was discovered that Dushyant Singh had been to a party on March 16, organized by singer Kanika
Kapoor, who tested positive for the virus on March 20.
Now being viewed as a criminal, Kanika is the perfect example of how when the public is not taken into
confidence by the government on the seriousness of the issue and informed of the precautionary steps
they need to take, before they unwittingly spread the virus around . She landed back in the country on
March 8, from London, at Mumbai airport, where she went through a thermal scan, filled up a
questionnaire and was asked to leave. When she developed symptoms of a cold and a flu, only four days
ago, she was asked to wait to see how bad her flu gets, a common problem in the country and therefore
not taken seriously. After about 22 attempts, she finally got herself tested for the virus, resulting in a
positive, causing quite a panic not only among-st her powerful friends but also the rest of Lucknow,
where she resided as well.
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After she was isolated in a government facility, her sister in law and journalist, Sonal Kapoor, struggled
to get herself tested too, after she exhibited flu symptoms as well.
The conditions prevailing in the quarantine centers in various cities are so bad, and the wait at the
airport so long, that patients are not only fleeing from the quarantine centers but also suppressing
symptoms to escape being harassed and ridiculed.
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Though the first case was detected in India on January 28, there was none detected until March 4.
Despite the reprieve, the government hasn’t come up with a concrete plan to tackle it. A mere thermal
screening at the airport only lulls you into a false sense of security as it happened with Kanika.
Symptoms show up only two weeks after one is infected by the virus.
International media is now raising questions on India’s readiness, methods and intentions. Italy is facing
a crisis despite a population concentration of only 202 citizens per km in Italy, while in India, it is about
464 on an average.
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A red flag was raised by Al Jazeera on March 18, when it reported that cases are not surfacing because
of poor testing which is keeping cases hidden. This despite World Health Organisation (WHO) chief
Tedros Adhanom Ghebreyesus asking to step up testing on March 16, as the coronavirus moves to low
income countries, with high instances of HIV cases and malnourished kids.
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The testing in India is under fire because India is only testing those coming from abroad, or people who
have been in direct touch with those who have tested positive for the virus. Though India has the
capability of doing 8000 tests a day, only 90 are being done. The ICMR director general Dr Balram
Bhargav in a press conference mentioned that WHO guidelines does not apply to India, because the
virus hasn’t spread in India. Several Indians have taken to social media to post that they have voluntarily
gone for testing, after a trip abroad or otherwise, but have been turned away because they do not fulfil
the “criteria”.
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While the government is giving out figures of confirmed cases, many outside remain untested. UK has
confirmed 10,000 cases, in a population of just 60 million. India with a population of 20 times more,
would most likely have 10,000-15,000 infected cases by now, who have not been picked up in testing
yet.
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Unless you test, you cannot stop possibilities of secondary infection from the person. Though isolation
and social distancing is the only preventive cure being taken for now, it is a luxury for those people, who
need to put food on the plate at the end of the day
Therefore, Dr Balram’s insistence that there is no need for increased testing reeks of false comfort.
Claims of a lack of community transmission because they haven’t found something which they haven’t
looked for in the first place, smacks of incompetence.
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By not creating enough awareness of the extent of the problem, the people cannot be expected to
cooperate especially in case of a shutdown.
Several health care professionals in the country are now worried that a lack of testing would have
generated a lot of secondary infections, because they were not quarantined quickly, and now spreading
exponentially.
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The doctors at ICMR have stated that they do not want to run the risk of false negatives, which besides
creating fake reassurances and is a waste of resources. Secondly, they also fear that if there are more
positives, they are afraid they may not have enough isolation beds for them, as an excuse not to test.
During testing, they also run the risk of people being false negative and turning up positive later. But it is
still important to test, to catch hold of the positives, so they can be stopped from going into the public.
Unless people are appraised of the facts, expecting them to subject to a self-quarantine, would be a
huge challenge, which the Modi government has not yet woken to.
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Though tests cannot be deployed widely in an asymptomatic population, everyone with flu like
symptoms, who has respiratory distress, fever and persistent cough, all should be tested.
Though ICMR has insisted that we are only at second stage, where infection goes through direct contact
not third stage where it becomes a community based infection, Dr Ramanan insists that we may have
actually reached stage three, two three weeks ago, based on modeling, determined by the spread of the
virus in other countries.
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The behavior of the virus in India, is no different from virus abroad. We still do not have immunity to the
virus, we are not special in any way. Nor is there any evidence to suggest that the virus cannot survive in
hotter climes., according to Dr Ramanan.
Though the government is not giving verbal assertions of the real case scenario their actions of shutting
down planes coming from abroad starting March 22, speaks volumes of the panic beginning to kick in.
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Images Compiled By Arisha R
