COVID-19: Not a time to panic but to act decisively

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In addition to testing sick people and their contacts, India should adopt a more aggressive approach by looking for cases in the community to prevent the silent spread of the virus.

With the virus galloping to 116 countries/regions causing more than 118,000 cases and 4,291 deaths as on March 11, the World Health Organization took the last logical step to spotlight the threat posed by the novel coronavirus (SARS-CoV-2) by declaring it a pandemic.

The announcement did not come as a surprise. On March 9, the WHO chief did caution that the “threat of a pandemic has become very real” based on the number of countries reporting new cases. A day after a pandemic was declared, the number of cases increased further to 1,27,863 and deaths to 4,718.

This announcement comes after the WHO, on January 30, declared the outbreak of the coronavirus a ‘Public health emergency of international concern’. Soon, thereafter, the WHO raised the global risk level to its highest — very high. If the spread of the virus to more countries and the number of cases and deaths reported till the third week of February was of concern, it became alarming since then.

Warnings ignored

On February 22, the WHO chief warned that the “window of opportunity for containing the virus is narrowing”. Unfortunately, many countries didn’t take the warning seriously; in the last two weeks, the number of cases reported increased 13-fold and the number of countries reporting the virus tripled.

While Japan, Singapore and Hong Kong were the three countries outside mainland China reporting the most number of cases till the third week of February, cases in South Korea started rising sharply dwarfing the number of cases reported from other countries outside mainland China. By end of February cases in Iran and Italy started rising and since March 8 Italy has the most number of cases outside  mainland China.

Currently, Italy (12,462), Iran (10,075) and South Korea (7,869) have the most cases outside China. Nearly 90% of cases reported from across the world are in just four countries and fresh cases reported daily have seen a sharp drop in both China and South Korea.

How does calling it a pandemic help

The response to WHO’s new classification should not be one of panic but must instead stir countries into “changing the course of the pandemic”. While WHO had always asked all countries to take urgent and aggressive action to contain the spread of the virus, it has now become all the more important to take that warning seriously.

All countries are required to trace, detect, test, isolate and treat cases to prevent a handful of cases from becoming clusters, and for clusters from becoming widespread in the community overwhelming the healthcare system.

What should India do

Even as India has done well in containing the spread by testing, isolating, contact tracing and treating people, it has so far restricted itself to people who have returned from abroad and those who have come in contact with infected people. It may be prudent for India to adopt a more aggressive approach by looking for cases in the community to prevent the silent spread of the virus.

In addition, containment measures such as closing down schools and cancelling mass gatherings in enclosed places should be done wherever necessary. The decision to suspend tourist visas for nearly a month starting March 13 and quarantining Indians if necessary are welcome steps — thermal screening cannot detect infected people who do not show symptoms yet. All imported cases in India showed up with symptoms days after landing.

India should pull out all the stops to cut the transmission chain as its fragile public healthcare system will collapse if cases rise exponentially.

Published in The Hindu on February 13, 2020