Tackling coronavirus the Indian way
Whether we like it or not, coronavirus is knocking on the door—and we have two weeks to prepare
It is clear coronavirus is not containable, and closing the borders only buys India some time. We must use this time to prepare to manage the virus so that the damage to India’s physical and economic health is minimised. American example provides interesting insights into how fast the virus can spread. As of February 15, there were only 15 diagnosed cases of coronavirus in the United States, almost all with known international travel history. On March 1, this number had increased to 76 and to 1,762 by March 13. If the US experience of community transmission is transported to India, by March 26, we will have over 1,500 COVID-19 cases and then it will increase exponentially. Italy reported 1,577 cases on March 1; as of March 10, it had 10,590 infected people.
Once the infection begins to spread in India, it may move far more rapidly than in the US or Italy. India’s population density is 420 per square kilometre, while American population density is only 26. Even when we compare large cities, Mumbai’s population density is twice that of New York. Close proximity, poor public hygiene and the lack of running water make Indian climate far more hospitable to spreading the virus than the US. There is a saving grace, in that flu and other viruses of the same family tend to slow down in hot temperatures and perhaps India can benefit from that. However, experience of other hot regions, namely Singapore or Australia, do not offer reassurance.
Hence, what we have is two weeks, at the most one month, breathing space to prepare for COVID-19. What should we do? Several mitigation and containment strategies are universal, but we also need to consider a number of India specific requirements. First, we must prepare for mass testing and focus on availability of testing supplies. Several different tests are available but each requires different collection and analysis procedure. One of the laboratories leading in this field — Cosara Diagnostics — is located in Salt Lake City and in Gujarat. The US has been slow in developing a supply of these tests and the test by Cosara (and its sister company Co-dignostics) was just approved for use in the US, long after its use in Europe. We must learn from South Korea and Australia to work on ensuring adequate testing supplies and involve reputable scientists — including home-grown talent— to find ways of setting up diagnostics centres around the country that are easily reachable.
Moreover, India faces several unique challenges. With rampant water shortages, more to come in summer months, washing hands frequently is feasible only for the rich or those living in water abundant areas. The slum dwellers and service providers like vegetable sellers, most at risk of spreading the deadly virus, do not have easy access to running water to wash hands for 30 seconds. Investing in manufacturing hand sanitisers and distributing them almost free via the public distribution systems is an option that should be urgently considered.
Coronavirus spreads when an infected person coughs or sneezes. Most Indians carry a handkerchief to catch the respiratory droplets from cough and sneeze. These handkerchiefs are then tucked into their pockets to spread the contagion. Washing them at riverbanks or hand pumbs may simply lead to more transmission. We must find ways of flooding the market with facial tissue, particularly in dense localities, and then find a way of collecting and disposing of these tissues. Finally, all public transportation systems must be sanitised daily to contain the spread.
There is one ray of sunshine for India. The World Health Organization estimates that the case fatality rate in China was less than 0.5 per cent for people between ages 10 and 40 and increased to 3.6 per cent for individuals aged 60-69 and to 8 per cent for those aged 70
79. According to the 2011 Census, less than 9 per cent of the Indian population is above
60. Policy initiatives that allow older Indians to stay at home from work, gives them priority in testing for the virus and ensures their access to sanitisers may help contain fatalities.
Whether we like it or not, coronavirus is knocking on the door. We only have two weeks, a month if we are lucky, to prepare for its spread. The US wasted this opportunity and is facing spreading virus and economic meltdown. Can India learn from this? As our success with polio vaccination tells us, Indian bureaucracy excels when it must tackle challenges in a campaign mode. It is time for the government to activate this resource and make the best use of the borrowed time.