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Coronavirus: Is India prepared for an outbreak?


India says it had been among the first countries within the world to prepare for an outbreak of the respiratory disease, which has already killed over 3,000 people and spread to 60 countries. Health Minister Harsh Vardhan says India began screening people at airports from 17 January onwards, six days after Chinese state media reported the primary known death from an illness caused by the virus and a two good weeks of time before the World Health Organization (WHO) declared it a worldwide health emergency.
As of 6 March, India has reported 31 cases, the bulk of them within the past few days. They include 16 Italian tourists. There's growing anxiety. Schools have begin sending out advisories, some offices have shut temporarily after employees tested positive for Covid-19.

By Tuesday, over 600,000 people had been tested for the virus at the country's 21 airports and 77 seaports, in step with Mr Vardhan. over 27,000 people living in five states near the border with neighbouring Nepal are drug surveillance and 1,000,000 people tested within the area, he said. And India is putting in a screening lab in Iran to check returnees.

The minister claims medical experts are being trained for a possible outbreak, and isolation wards are being founded in state-run hospitals. By the top of the week, 34 labs across India are testing for the virus, up from 15 to date. India has also stopped exports of N95 masks to create sure there are enough supplies reception.

"India is thoroughly prepared to handle any situation that would emerge. We are alert, meticulous and conscious," says Mr Vardhan.

All this sounds impressive, but should still be not enough to forestall an endemic.

For one, the $64000 extent of the spread of the infection might not be clear, despite the screening at air and sea ports. The period - between infection and showing any symptoms - lasts up to 14 days. Some researchers say it should even be up to 24 days.

That means many of us who test negative at air and seaports could also be carrying the infection into India's teeming cities and villages. "Airport entry screening is sweet and may be continued, but that's not visiting be sufficient now. we've got to place in situ other surveillance mechanisms through systems India already has," Soumya Swaminathan, chief scientist at the WHO, says.

Despite a creaky and uneven public healthcare system, India features a formidable record during a defeating polio and facing up to a flu pandemic in 2009 and handling a more moderen outbreak of the deadly Nipah virus. The National Polio Surveillance Project (NPSP), a collaboration between the govt and therefore the WHO, is well-known for community surveillance and call testing, both of which are needed for effectively containing the spread of coronavirus. (Authorities say medical experts contacted nearly 450 folks that had been in grips with five Indians who tested positive in three states.)

India also has an influenza surveillance programme - four sorts of flu viruses, including H1N1, are prevalent here - involving a clutch of medical colleges that screen people for the flu, which usually thrives in winter, but also attacks during India's summers and monsoons.

This influenza programme, say virologists, will be used now to check negative samples for coronavirus to seek out out whether it's circulating within the community. "We have done this before and that we can bang again. we are able to do quick diagnostics. It's doable, and most of the Covid-19 infections are mild," says Lalit Kant, a Delhi-based communicable diseases expert.

Other challenges
In the event of a serious outbreak, India will face other challenges. the standard of its public health system is vastly uneven. Existing hospitals will be easily overwhelmed by a sudden spike in admissions. it's not clear whether there are ample supplies of masks, gloves, gowns, drugs and ventilators. Virologist Jacob John says India will struggle to handle an endemic.

"We haven't yet established a 21st century health management system within the country, so we've got the face the results of that gap," he told Scroll.in.

Also it'd be near impossible for India to force its citizens into mass quarantine and hospitalise people in numbers like China. Virologists instead discuss a 'Indian solution' wherein prompt detection and effective triage make sure that milder infections are taken care of reception, and hospital admissions are reserved strictly for critical patients. Also recommended are emergency operations centres at the federal and state levels with special specialise in states with weaker health systems.

There are concerns about the country's scanty healthcare data: India features a shoddy record in even recording deaths and disease - only 77% of deaths are registered, and doctors are more likely to urge the reason behind death wrong than right, in step with a study the Toronto-based Centre for Global Research. There's patchy data for flu-related deaths.

Myths and misconceptions
Rumours, myths and misconceptions spread through social media could also hurt a good response to the infection.

One viral rumour on WhatsApp, the messaging app owned by Facebook, suggests garlic, ginger, ascorbic acid and lemon can protect people against the virus, says Sumaiya Sheikh, editor of fact checking site Alt News Science. "This is that the most viral WhatsApp forward because it is not complex and [because it advocates] easily available at-home treatment methods. Such rumours also reinforce the 'big pharma hoax' - that pharmaceuticals don't encourage the people to treat themselves with easily available and natural remedies," says Dr Sheikh. to create matters worse, a section actually released advisories recommending a homeopathy drug, and native indigenous "medicine" for prevention and management of the infection.

Messages recommending yoga, inhaling cannabis and consuming cow urine and dung for prevention have also been circulating wildly. Mr Vardhan says people mustn't listen to such reports, and folks should follow simply simple precautions - wash hands, maintain hygiene, and report for tests if symptoms are contact.

In the end, India has to strategise nimbly and communicate openly and transparently to forestall the spread of infection - 24-hour hotlines, for instance, where people can get more information about matters.

"What is required is an agile and evidence based graded response, adapting to the changing epidemiology of the disease. Being an enormous country, actions and decisions will have to be decentralised, but well coordinated," says Dr Swaminathan.

There's no reason to panic yet, because the health minister says. But India has to be very vigilant and open about the spread and containment of the infection.

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