India has a short window to win the war against Covid-19 | Opinion – analysis
The coronavirus pandemic (Covid-19) has already affected the health care of people worldwide. Forty years ago, the world witnessed the Pandemic of Acquired Immune Deficiency Syndrome (AIDS) that killed 40 million people and left another 30 million HIV +. While Africa endured the brunt of the pandemic, Covid-19’s epicenter appears to be the wealthy nations of Western Europe and the United States (USA).
Initially, India’s response to Covid-19 was rapid. The government identified the risk of allowing people from China to enter the country and adopted quarantine procedures for those who were evacuated from Wuhan and other cities in China, and later from Iran and Italy. India could minimize the initial impact due to these timely steps.
However, what followed later was a large influx of people (approximately two to two and a half million), including students, tourists, pilgrims, and residents of India, who returned to the country between January and March 2020 to the borders . they were closed to international traffic on March 21. They returned from various international destinations and headed to Delhi, Mumbai, Bangalore, Hyderabad, and airports in North Kerala, among other places.
The government introduced thermal detection procedures for those coming from abroad, while others who were not detected by thermal scanners were allowed to enter with a notice to stay home and observe quarantine procedures. But many did not strictly follow him.
In the interim period, they traveled the country, met people, participated in social functions, and infected large numbers of people. The increasing infections in the last weeks are mainly reported from this section of the population and its contacts.
The government has done a good job of sharing the details of incoming passengers with state governments and district administrations. But it is unclear how effectively they were followed up and advised to stay home. Some state governments have now begun monitoring these cases, but that was only after they tested positive. Critical time was lost to enforce quarantine instructions until the “janata curfew” (people’s curfew) and subsequent closure in high-prevalence districts began to take effect.
The Prime Minister has announced a prolonged blockade for 21 days, which is very timely. It will provide time and a window of opportunity for the central and state governments to mount an intensified response within a short period of identifying and testing the returnees from abroad and their families. This test load will surely be large and the current test arrangements will be extended to full capacity. The testing procedures so far are based on viral load tests when taking throat swabs. The time required for the test results is between three and five days. The tests are expensive and can only be carried out in specialized institutions.
The key to scaling tests in a large population is to introduce tests that can give results the same day to allow treatment at an early stage of infection. These tests are based on the detection of antibodies in the infected person. Antibody tests are generally more affordable for both patients and government agencies. In the case of HIV / AIDS, the entire testing program focused on making rapid tests available to verify HIV status. Within a short period of time, large numbers of HIV-positive individuals were identified to provide antiretroviral therapy (ART), and AIDS-related mortality was substantially reduced.
This is an opportune time for the government to look for rapid tests for Covid-19 antibodies for symptomatic and asymptomatic travelers and their close contacts. South Korea and Singapore effectively used rapid tests to identify positive cases that were quarantined and followed up. The United States Food and Drug Administration recently approved a rapid test for Covid-19.
India has the technological capacity to quickly produce a high quality rapid test. In the short term, the government may import quick test kits and use them in test programs. This will help expand testing facilities in health care institutions to the district level and remove pressure from specialized institutions and laboratories.
The battle for control of Covid-19 can be won if the new infection rates can be substantially reduced in the next two to three weeks. And providing testing and treatment facilities to those at risk is the key to success. We must not make the mistakes that some European countries made by not responding quickly enough. It will be unavailable in the Indian context.
Prasada Rao is Former Secretary of Health, Government of India
The opinions expressed are personal.