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Health Experts Say India Ignored Early Warning, Letting Deadly Coronavirus Spread | India News

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NEW DELHI: A veteran public health expert warned top Indian officials in early March that a new variant of the coronavirus was spreading rapidly in a rural district in the heart of the country and that the outbreak required urgent attention.
Federal health authorities did not respond adequately to that warning, Dr. Subhash Salunke, who has 30 years of public health experience in India, Indonesia and the United States, told Reuters.
The variant, now known as B.1.617, triggered a catastrophic wave of coronavirus cases in India and has since spread to more than 40 other countries. In May, the World Health Organization (WHO) called it a “variant of concern”, citing its high transmissibility.
The first impact of the variant was detected months earlier in the Amravati district of the western state of Maharashtra, where health authorities recorded a rapid rise in coronavirus infections in early February, even as cases fell in other parts of India. .
Salunke, a former WHO official who advises the Maharashtra government, said he alerted some of India’s top health officials in early March, speaking by phone with Prime Minister Narendra Modi’s top coronavirus adviser, VK. Paul, and the director of the National Center for Diseases. Control (NCDC), Sujeet Kumar Singh.
Salunke told Reuters that he warned both Paul and Singh that the virus was showing signs of mutation in Amravati, that its transmissibility was increasing, and requested federal help to sequence more samples to establish how the variant behaved. Reuters could not independently confirm what was said in those talks.
“Even though a public health person like me gave them a strong warning, they ignored it,” Salunke told Reuters.
In response to questions from Reuters, Paul said he spoke to Salunke, but described the conversation as Salunke relaying information rather than issuing a warning.
He rejected Salunke’s accusation that he ignored it, saying he requested that India’s National Institute of Virology (NIV) study the variant more closely and told the Maharashtra state government to step up its current response to the virus.
Reuters could not determine whether the NIV conducted such a study. The NIV directed Reuters questions to the Indian Council for Medical Research, which did not respond.
“The government strengthened sequencing and clinical-epidemiological studies,” Paul told Reuters. “The government intensely, repeatedly, from multiple forums, emphasized the need for containment using all the tools even more vigorously and optimizing testing.”
NCDC’s Singh and the Indian Ministry of Health did not respond to questions from Reuters about Salunke’s warning.
Despite Salunke pointing out the problem and a further warning in early March from a forum of scientific advisers that the new variant was taking hold in the country, the federal government allowed election rallies, religious festivals and other events to take place. mass meetings, and he didn’t. take steps to stop the spread of the virus.
In 80 days, the variant passed from Amravati to dozens of countries around the world, including Britain, the United States and Singapore, a setback for global efforts to contain the disease.
It is impossible to say exactly how many infections in each country have been caused by the new variant, because very few positive test samples have been sequenced. US authorities estimated last week that the variant accounted for 6% of coronavirus infections there.
In India, the dramatic increase in the number of infections starting in April, partly driven by the variance, according to public health studies, overwhelmed the country’s health system, causing hospitals to run out of beds and oxygen and causing them to crematoria and cemeteries will overflow. Indian Health Minister Dr. Harsh Vardhan said last month that the variant was identified in about 20% of samples in the country that had been sequenced.
A SUDDEN RISE
In late January, when India’s daily coronavirus infection count had dropped to around 12,000, Modi nearly declared victory at a World Economic Forum event, saying the country had “saved humanity from a great disaster by contain the coronavirus effectively. ”
That sense of optimism spread across much of India, including Amravati, where cases had dropped to a trickle, according to local health officials. The district, home to 2.9 million people, had reported just dozens of Covid-19 cases daily for much of January, according to government data.
“Everyone was relaxed,” said Shyamsunder Nikam, a civil surgeon from Amravati who oversees public health affairs in the district.
But the number of cases suddenly began to rise in late January, alarming Nikam and other local officials. New infections rose to around 200 a day on February 7 and reached 430 a day a week later, when the virus swept through the rural interior of the district that had emerged largely unscathed during India’s first wave of 2020.
A task force created by the Maharashtra government to guide its response to the pandemic ordered an investigation. Dr Rajesh Karyakarte, who was part of the research, said he tested four positive samples from the region and found that they all contained a mutation called E484Q, a sign that a variant was likely at play.
Karyakarte told Reuters that he presented the findings to the Maharashtra task force in a video conference on February 16. Reuters could not independently confirm whether it did so or how the task force responded. Dr Tatyarao Lahane, a member of the task force, did not respond to questions from Reuters.
RAPID SPREAD
The discovery of the new mutation and the increase in the number of cases in Amravati alarmed Salunke. He said he traveled to Amravati in late February and tested nearly 700 people for coronavirus. About half of them tested positive for Covid-19.
Within days, he told Reuters, state health authorities sent samples of Amravati to the NCDC for subsequent genetic sequencing to establish whether a variant was present. The NCDC did not respond to questions from Reuters about what it did with those samples.
Meanwhile, federal health officials downplayed the potential role of the new variants in increasing infections.
“There is no direct relationship between the recent increase in Covid-19 cases in Maharashtra and some other states with the N440K and E484Q mutant virus strains of Covid-19,” the Indian Ministry of Health said in a press release on 23 of February.
Modi’s coronavirus advisor Paul said the assessment was based on data that authorities had at the time.
“We knew something had been detected, but we did not know its meaning at the time,” Paul told Reuters. “The true meaning of the variants emerges over time. Scientific data has now led us to understand the role of these variants. ”
In late February, federal and local officials met to discuss the increase in Amravati, according to a senior government scientist who attended.
At the meeting, Maharashtra State Watch Officer Dr. Pradip Awate said the spike in cases was due to voters flocking to local elections in January rather than any kind of new variant. the scientist who attended the meeting told Reuters.
Federal officials, including the Indian Council for Medical Research, seemed convinced by that explanation and did not push for further research, the scientist said.
“At the time there was some confusion,” Awate told Reuters, making it difficult to assess exactly why cases were increasing.
‘MAJOR ERROR’
The appearance of the new variant was not treated with the urgency it deserved, Salunke said.
“What happened in Maharashtra is a natural phenomenon. And it should have been approached on the warpath, as an absolute emergency,” he said. “It was ignored and all the focus was on the elections,” he said, referring to a series of state elections that took place during March and April, drawing crowds of thousands to rallies for Modi’s party as well as opposition politicians. .
Missing the emergence of the variant in Amravati in late February was a “big mistake,” said the scientist who attended the Maharashtra meeting.
State health official Awate said Maharashtra could have imposed stricter closures and restricted travel between districts much earlier. Instead, blockades were imposed in Maharashtra and other major cities such as New Delhi only in mid to late April.
Between March and April, the federal government allowed the Hindu Kumbh Mela festival to take place in northern India, drawing millions of people from across the country to a holy bath in the Ganges, many of whom traveled back home with the virus, according to public health. officials.
Even when it spread to India, the variant was carried to other countries where it also caused a number of cases.
In Britain, a related variant, called B.1.617.2 or Delta by the WHO, was found in areas where many people travel to and from India, according to experts.



Times of India

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