COVID-19: IMA’s dangerous advice runs counter to best public health practices

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All countries release data on novel coronavirus cases and deaths on a daily basis. South Korea was releasing the data twice a day. But Indian Medical Association’s demand that India not share numbers daily runs counter to the benefits of being transparent.

China’s initial cover-up of the novel coronavirus (SARS-CoV-2) outbreak for as long as a month allowing the virus to have a free run and its attempt to gag healthcare workers from speaking out about the outbreak of unknown aetiology (cause) invited worldwide condemnation. Similarly, the U.S. endeavour to stifle Dr. Anthony Fauci and other scientists from speaking publicly about the coronavirus outbreak without permission has shocked nations. Dr. Fauci is the director of the National Institute of Allergy and Infectious Diseases since 1984 and has helped combat many novel viruses including SARS, H1N1, MERS and Ebola. Shockingly, the Indian Medical Association, representing over 3,25,000 doctors, wants India to adopt the same opaque manner of functioning like China and the U.S. while dealing with the outbreak.

All countries share data

The World Health Organization holds a daily press briefing and the data on the number of coronavirus disease cases and deaths country-wise is shared every day. A similar practice has been adopted by the Union Health Minister and even the Kerala Health Minister and the data are shared daily, which is indeed commendable. But the IMA now does not want the government to share data with the public on a daily basis. The reason: people are “clueless as to what is expected of them” and the release of data daily has “created panic across the country”.

However, Ironically, the release also mentions “awareness, self precautions, contact tracing and self isolation are the public health measures required”. The Honorary Secretary General Dr. R.V. Asokan wants the government to release the data once in “three or seven days” and to never mention number of people infected but use terms such as low, moderate or high instead to give a sense of the spread. “Why should people know the numbers? This pandemic will escalate and the numbers will increase and people will scrutinise the numbers minutely. So the government should not release actual numbers,” he says.

The need for transparency

While dealing with public health crisis, particularly a pandemic, complete transparency is paramount. It is information that helps build trust in society, it is information that puts people at ease. How does an association representing a few lakh doctors in the country expect people to cooperate, practice self-isolation and take basic precautions when they are not taken into confidence?

“When the government is transparent it gives people the confidence that it is in control and is taking all necessary steps to control the outbreak. The trust factor should not be broken,” says Dr. Anant Bhan a researcher in global health and bioethics.

Lessons others countries can teach

What is indeed shocking is the utter ignorance of the IMA on how other countries have responded quickly to the unfolding coronavirus pandemic. In fact, South Korea shared the data twice a day even when the number of cases and deaths steadily increased; South Korea has the third highest case load in the world outside mainland China.

On March 5, UK made COVID-19 a notifiable disease and added SARS-CoV-2 to the list of notifiable causative agents. By making it a notifiable virus and disease, doctors are now legally bound to report all cases to the nodal body Public Health England.

The government has made some efforts to this end but can surely do much more. It could take a leaf out of Taiwan’s book, for instance. In Taiwan, the public were kept informed every one hour through television and radio broadcast on how the virus spreads, importance of washing hands with soap, and when to wear a mask, to name a few. They learnt that most infected people did not have or had only mild symptoms. They understood how virus spreads and this helped in easily tracing contacts. People also cooperated in cutting the transmission chain — parents checked their children for a fever before sending them to schools.

This is not the first time the Association has made an embarrassing statement. Some time ago, it admonished The Lancet for the journal’s stand in an editorial published on August 17 on the dilution of Article 370 in Jammu and Kashmir. But the dangerous advice this time around makes one wonder if the Association and its office bearers know the best public health practices during a disease outbreak, particularly a pandemic.

In complete contrast to the Association’s views, it is not transparency and data, but opacity and lack of public awareness that cause panic. At a time like this, the right approach would be for the government to constantly educate the public on various aspects of the virus and the disease and the precautions to be taken.

Published in The Hindu on February 13, 2020