GP Insights

GP Insights # 294, 18 March 2020

India: With 147 cases, it is contained so far; the challenge now is to prevent the community spread
Rashmi Ramesh

The numbers
India reported its first case in February when three students studying in Wuhan returned to Kerala. As of 18 March 2020, the total number of active COVID-19 cases in the country is 147, including 25 foreign nationals. So far, three patients have succumbed to the virus, while 14 patients have been cured. 

Maharashtra, Kerala, Uttar Pradesh, Karnataka, Delhi and the Union Territory of Ladakh account for with the highest number of cases.

Government initiatives
Reports by various organizations pointed out that India is one of the countries at risk of importing coronavirus. The gravity of the situation pushed the government to take specific measures as a precaution. At present, India is taking several steps both at the central as well as the state level to contain the further spread of the epidemic.

Ministry of Health and Family Welfare along with the Prime Minister's Office is at the helm of affairs, trying to generate awareness through visual, print and social media. To ensure preparedness, the provisions under the Epidemic Diseases Act of 1897 has been invoked. India has issued advisory for travel within borders and has imposed strict restrictions on international travel. Travel of passengers from China, Afghanistan, Philippines, Malaysia, European Union, European Free Trade Association, Turkey and the United Kingdom have been prohibited. The government has also undertaken Universal Health Screening at all points of entry into the country. 

The government has arranged for quarantine facilities at public hospitals and few quarantine shelters run by the Indian Army. However, due to the weak health care system in place, the country might be at a higher risk in the near future. The crumbling public health infrastructure has forced few patients to flee the quarantine facilities at Delhi and Maharashtra, while many more patients have demanded treatment from private hospitals. An epidemic such as this reflects on the necessity for spending on strengthening the health care system in the country.

At the provincial level, states like Karnataka, Kerala, Maharashtra, Madhya Pradesh, Delhi, Uttar Pradesh and West Bengal have imposed restrictions on gatherings, travel, encouraged social distancing and have ordered for a temporary closure of educational institutions and public places. Kerala is being praised for its swift action in combating the virus. It has successfully implemented both hospital-based and community-based quarantine for a period of 28 days in total. Community surveillance systems are ensuring that the community spread does not begin in the state. Maharashtra faces a severe challenge, as new cases have been reported in rural areas like Yavatmal and Ahmednagar. The state government has extended restrictions to rural areas as well. Another big challenge for the state is the mass transit network in Mumbai, which, when completely halted, can adversely affect the economy of the commercial capital of India.

Public responses
While governments at the federal and state levels are responding with all might, it is essential to know the public response to this epidemic. In the age of all-pervasive media, the spread of fake news in India regarding COVID-19 is much faster than the spread of the epidemic itself. Though the authorities have time and again busted the myths of coronavirus, social media has been bustling with false information, aimed at generating chaos among the public.

The society, on the other hand, has responded by taking some precautionary measures, though the apathy still prevails. Private schools declared holidays in early March. While the governments – especially the state government announced the closure of public places – malls and theatres, people took it seriously. 

The media – especially the print media in the vernacular languages have provided more space on the virus – both informing and explaining. 
Also, in certain regions, fearing social stigma, many people with symptoms of the virus have refused to get themselves tested. Maharashtra's step to stamp the hands of home-quarantined people will further encourage stigmatization. 

So far, India has been able to contain the epidemic to a large extent. The challenge would be to ensure that community spread does not take place. A pandemic such as this, demands a joint action from the authorities, health professionals, sensitive population and responsible media.

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