Coronavirus: India’s health system, preparedness under test

Coronavirus 4-Optimized

Since the novel coronavirus was declared public health emergency, the virus has been galloping and infecting hundreds and killing tens of people each day in China and in other countries, including India.

Meeting for the second time in just a week, the Emergency Committee convened by the World Health Organization on January 30 declared the outbreak of novel coronavirus in China as ‘Public health emergency of international concern’.

The virus has been galloping and infecting hundreds and killing tens of people each day in China and in other countries since it last met on January 22-23. From 584 cases globally and 17 deaths, and just six countries reporting exported cases when the committee last met, the virus spread has escalated into an unprecedented outbreak since then.

On February 3, the total number of cases in mainland China stood at 17,202 and deaths at 361; there were at least 169 cases have been reported from 25 countries. Cases have been reported from all 31 provinces in China. There has also been the first confirmed fatality outside China, with a death in the Philippines, and an exported case reported in South Korea from Japan.

As on February 3, with 20, Japan has the most number of cases outside China closely followed by Thailand with 19 cases, Singapore 18, South Korea and Hong Kong 15 each, Australia 12, the U.S. 11, Taiwan and Germany 10 each, Malaysia and Macao 8 each, Vietnam 7, France 6, UAE 5, Canada 4, India 3, Philippines, Italy and Russia, and UK 2 each, Cambodia, Spain, Sweden, Finland, Sri Lanka, and Nepal 1 case each,

Human-to-human spread outside China

But the critical factor that promoted the emergency committee to declare the outbreak as public health emergency is the human-to-human spread of the virus in other countries. At least nine such cases have been reported from five countries — Vietnam, Germany, Japan, the U.S. and South Korea.

In fact, WHO reconvened the committee to assess the situation mainly because of local transmission in other countries, a potential scenario for further global spread. “We don’t know what sort of damage this novel coronavirus could do if it were to spread in a country with a weaker health system,” Director-General of WHO Tedros Adhanom Ghebreyesus tweeted after public health emergency was declared.

Why thermal screening is not foolproof

A student in Kerala who had travelled from China’s Wuhan city, the epicentre of the current outbreak, has been found to be infected with the novel virus; Kerala health authorities reported two more cases on February 2 and February 3. The first student who landed in India on January 23 developed symptoms four days later, clearly indicating that she had arrived during the incubation period; the second student too had travelled during the incubation period.

Besides isolating people who exhibit overt symptoms and conducting contact tracing, there is an urgent need to raise public awareness among people. This is essential so that they report to a hospital when symptoms show up days after arriving in India or coming in contact with a person, even if appearing healthy, who has recently travelled to China.

It must be borne in mind that there is evidence that people who appear to be healthy despite being infected with the novel virus can spread the virus even during the incubation period. Also, cases have been reported wherein people have not exhibited symptoms in spite of being infected.

Time-tested preventive measures

In both instances, thermal screening at airports, which is largely helpful, would fail to detect infected people much like in the case of the student from Kerala. Hence, time-tested measures including hand-washing, wearing protective gear while attending to sick people and properly covering one’s mouth and nose when coughing or sneezing will go a long way in reducing infection risk.

Most importantly, it must be remembered that there is no clinical evidence whatsoever that any specific drug — modern or of traditional system of medicine — can prevent or treat people infected with the novel coronavirus.

And it is the novel virus transmitted through physical contact or air droplets that cause the infection and not any food items as social media claims.

Published in The Hindu on February 3, 2020