On Wednesday, the public fear of the novel coronavirus spreading in India rose significantly as the central government announced that 28 people in the country were now infected, including 14 Italians who were visiting India.
Officially called COVID-19, the disease has already killed more than 3,100 people and infected over 90,000 since its outbreak in the Chinese city of Wuhan at the end of 2019. In China alone, the death toll has been more than 2,900 people, and the Chinese government has imposed a complete lockdown on Wuhan and other parts of the Hubei province.
With coronavirus spreading rapidly across the globe, the Indian government is screening passengers coming from infected countries at airports, quarantining people displaying symptoms of the disease and issuing health advisories.
But if the epidemic spreads even further through the country – as experts are now predicting – will India be able to contain it? Is the Indian healthcare system equipped enough to detect, prevent and treat a rapidly expanding communicable disease?
No, according to Dr Jacob John, one of India’s leading virologists based in Vellore, Tamil Nadu.
India’s track record with handling common infectious diseases is poor, he said in an interview with Scroll.in. It is difficult to be optimistic about how India will continue to manage coronavirus if it spreads beyond a few scattered cases, he added.
Here are excerpts from the interview.
Is India handling the coronavirus well so far, with respect to prevention and containment of the disease?
So far, yes, the Ministry of Health is handling the disease the right way, through airport screenings based on people’s travel histories, testing and quarantining. As preventative measures, I don’t think we can do anything more, but we should be prepared that in spite of these measures, the virus can spread within India anytime soon – which could mean tomorrow, three days from now or next week. That is the global consensus.
Is the Indian healthcare system equipped to deal with coronavirus if the disease spreads further in the country?
A country manages the health of its people through two major avenues: universal healthcare and public health. If I live a hundred km from a big city and I fall seriously ill, I should have a place where I can rightfully go and get diagnosed by a reasonably good doctor, who can recommend me to other specialist doctors if needed. If I don’t have this, then India does not have universal healthcare. Today, if I am from a remote place and I get coronavirus, doctors I would have access to would not even be equipped to diagnose basic influenza. So both the spread of universal healthcare and competence of doctors is a problem in India.
A public health system is supposed to be exclusively in charge of monitoring and containing the spread of all communicable diseases through surveillance, preventative measures and assessment of environmental and social risk factors. In India, we don’t have public health because we have separate vertical programmes to monitor different diseases like tuberculosis, malaria or cholera. They are all tackled separately instead of being placed under one umbrella and tackled together. We don’t control diseases, we collect them. Our track record with preventing all major widespread infectious diseases – malaria, typhoid, cholera, flu – is not great.
Today the global mortality rate for the H1N1 flu is 0.1%, which is one in a thousand people. But in India, the H1N1 mortality rate is around 5%, which is 50 in a thousand people. This gives you a clue that we have not been able to handle pandemic flus. Our infrastructure is not geared to face them, so how will we handle a newcomer disease like coronavirus? We will end up adding one more disease to our collection.
So I don’t think we can be optimistic about how India will handle COVID-19 if it becomes widespread. We have not yet established a 21st century health management system in the country, so we have the face the consequences of that gap.
As a doctor, do you see panic among patients and the general public?
I have not seen panic among people, but most people are asking sensible questions about prevention measures for the well-being of their families. However, social media seems to be spreading some scary rumours – which is inevitable in this era of smartphones – and I don’t think the health ministry is using social media effectively enough to counter them and spread the right information about preventative measures.