What if India gets coronavirus?

The new coronavirus (COVID-19) outbreak, now threatening to snowball into a full-fledged pandemic, has already begun to wreak a sort of global havoc, causing alarm and even panic in several countries, spasms in financial markets and, most painfully, loss of life. There has been very little time so far for reflection, and few of us have stopped to wonder what this crisis might tell us about ourselves — about our political systems, our infrastructure readiness and our social systems.

When this epidemic is spreading across the globe, some countries hit more than others, India has not seen high exposure so far. But then, in case the spread increases in India, are we ready to tackle the same? I think, to answer this question, we need to look at the two aspects. One, are we ready to stop this virus to enter in India? And second, if that happens, are we ready to stop or limit the spread and treat the infected with the required sophistication.

Well, to start with the first point, the Indian government has imposed visa restrictions for a few countries and closely watching the incoming traffic from other countries. There is still the danger of infected persons slipping through in the asymptomatic but infectious phase of the illness. These high-level technologies, currently used, are available mostly at the airports and maybe at some seaports. With our interconnectedness across land borders, migration or illegal migration through these borders is very common. How can we make sure that we prevent virus spread through these sources? Do we have required technology, manpower and infrastructure to detect and put preventive measures so that we can fight the spread of current thread of coronavirus?

Moving to the second point, what if the virus gets it feet in the country apart from all the efforts put in by the government and other agencies? Currently, isolation of clinically-suspected cases is essential even where a specific diagnosis is not immediately available. Considering there is no vaccine or trial-proven drug therapy yet, aff¬ected patients are being treated symptomatically based on clinical severity. "Serious cases who have viral pneumonia will need supportive intensive care, including mechanical ventilation when required. Hospitals in large cities can provide this if the numbers are not overwhelming. Small towns and rural areas in most states will be ill-equipped if the virus spreads further," says Dr K. Srinath Reddy, president, Public Health Foundation of India (PHFI).

There are two very serious cues in the statement made by Dr Srinath. “If the numbers are not overwhelming” and “Rural areas in most states will be ill-equipped”.

What if the numbers start getting overwhelming? This pause a grim concern whether our urban government hospitals can take this challenge given their current conditions. Will private hospitals be willing to provide treatments to those who cannot afford them? I personally think that the government needs to step up their efforts right from now without waiting until the last moment to make sure that we will have enough facilities to handle the worst-case scenario. Also, the government should allocate sufficient funds for readiness.

Now talking about our rural areas, I believe that more than required facilities, the bigger threat is our social system, lack of awareness and improper guidance. India has a high rate of internal migration between rural and urban areas. That could make it harder to contain an outbreak. Also with the level of education and very low health check-up priorities in rural areas makes it hard to detect the infection at a low scale and hold it to a small population.

There are more questions than answers at this stage. Despite India being in the top 30 countries at risk from the virus, there has been no statement from the minister of health and no central guidelines for detecting and controlling the infection. A concerted multi-agency response, led by a competent public health system, is the need of the hour, but it is currently hampered by the limited expertise in the country. Precautionary guidelines for the public in India are yet to be widely disseminated, in English or in local languages.

Apart from health risks, a large-scale outbreak stands to put a heavy strain on India’s economy, which is much smaller than China’s and where growth this year is on track to be the weakest in more than a decade. The impact on the economy, healthcare and public morale could be catastrophic. With one of the world's highest population densities maintaining a three-foot distance between individuals will be impossible, nor will the lockdown of an entire city be feasible.

I sincerely hope that our government will press the gas paddle to start the precautionary efforts instead of waiting until the last moment. Till that time, we all will keep doing what we, Indians, are best at; praying to God and believe that some angelic power will save us all.