How prepared is India to tackle a coronavirus outbreak

In 2017, while red-flagging the concern of biological warfare at an international security conference, philanthropist businessman Bill Gates underlined how a respiratory-spread pathogen could kill 30 million people in less than a year. Coronavirus has not emanated from a terrorist module, but it seems to have the potential to become exactly the global epidemic Gates was warning against. Within three months of its outbreak, coronavirus has already claimed over 3,200 lives and has spread to over 93,000 cases across 70 countries. Outside China which has borne most of the disease brunt, Iran has reported 92 deaths while Italy has reported 79. With WHO declaring it a public health emergency of international concern, the disease has also made its way to the US amid much criticism of the Trump administration’s initial handling of the health threat.

Is India prepared?

For India which shares extensive connectivity and people exchange with China, the coronavirus has emerged as a serious concern. When it comes to infectious diseases, prevention is, without doubt, the best remedy. Fortunately, a robust and effective check and quarantine system has helped India prevents a major outbreak so far. The country is conducting extensive screening of passengers for COVID-19 symptoms across 21 airports, 12 major seaports as well as border crossings across the country and suspects are being quarantined and monitored.

While maintaining a zero-breach screening system must be a priority, it is equally important to ramp preparedness to meet any major outbreak if it occurs. Do we have the wherewithal to contain and fight the epidemic if it occurs on China’s scale? Perhaps not! According to the Global Health Security Index 2019, India ranked 57th among 100 countries on a scale to gauge preparedness for the outbreak of serious infectious diseases. Densely populated cities, low awareness and unhygienic conditions can turn this outbreak into epidemic proportions in a matter of days. Add to it a shortage of hospital beds, healthcare equipment and quarantine facilities, it will wreak havoc on the already overburdened healthcare system.

So, what must a country do to ramp up its preparedness?

Finalise and communicate a standard treatment protocol

With neither a vaccine nor a cure discovered yet, many countries have arrived at different drug combinations to help treat the symptoms and intensity of disease in patients. According to reports, the Indian Council of Medical Research (ICMR) has allowed the use of a cocktail of antiretroviral drugs—Lopinavir and Ritonavir—that is widely used in AIDS treatment in case the disease becomes widespread. This is a similar protocol being followed in China. The government must communicate the standard treatment protocol strongly to all medical institutions, including public and private hospitals. It must also stay alert to any new developments being notified in other countries about possible new treatment lines and be ready to adopt them immediately. Authorities must also stay alert to constantly identify and fill gaps in preparedness and management. Meanwhile, the government must also prioritise investment in research or a vaccine.

Set up containment facilities

Such was the proportion of the epidemic in China that the country had to completely isolate an entire province to prevent the disease from spreading. While India is doing well at screening people at entry points, we must also be ready with large containment facilities in multiple parts of the country to quarantine and treat infected people in case a major outbreak occurs. Such containment facilities—at least one in every state—must be established right away and healthcare workforce should be effectively trained in handling patients to minimise chances of virus spread.

Boost diagnostic preparedness

Speedy diagnosis is a very critical aspect in the collective response to COVID-19. This is where the American response to the disease outbreak has come under severe criticism. A faulty diagnostic kit rolled out by the American Centre for Disease Control & Prevention and slow approvals for other testing kits led to the disease spreading under the nose of the administration. We must take our lessons from such missteps. The need is to prioritise diagnostic tests and strengthen our laboratory response network. Laboratories in all major cities and government hospitals must be prepared to handle the diagnostic burden. Rapid diagnostic kits to identify the virus are currently being tested at different centres. Their testing, readiness and approvals must be prioritised and speeded up to ensure adequate diagnostic preparedness.

Communicate effectively

In moving from containment to mitigation, effective communication is an indispensable tool. Kerala which became the first state in India to encounter the disease tackled the outbreak with a combination of swift measures, travel curbs and effective communication. Timely dissemination of surveillance data, as well as effective communication with the healthcare system, allowed the state to contain the threat and prevent panic at the same time.

This must be the template for the entire country. The government must effectively communicate with all stakeholders, including hospitals, doctors, laboratories as well as people. A daily advisory, informing everyone about the situation, the need for precautions and travel restrictions will help keep a check of the disease at the community level.

The writer is the COO of Paras Healthcare. The opinions expressed in this article are those of the author's and do not purport to reflect the opinions or views of THE WEEK.