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COVID-19

Is India Prepared for Coronavirus?

The 2019 Global Health Security Index report examined the ability of 195 countries to prevent, detect and rapidly respond to public-health emergencies. It found that the national health security of various countries is fundamentally weak and that no country is fully prepared for epidemics or pandemics. The average overall global health security (GHS) score, based on 140 parameters evaluated in all countries, was only 40.2 out of 100. When assessing if India is prepared for Coronavirus disease, India scored 46.5 – placing it at #57 in the ranking.

Yes, we have improved since the last outbreak..

India’s top health research agency is working on a standard treatment protocol for dealing with coronavirus infections, said people with knowledge of the matter. This will comprise a cocktail of antiretrovirals used to treat HIV/AIDS, similar to protocols being followed in China.
The Indian Council of Medical Research (ICMR) has approval from the Drug Controller General of India (DCGI) to allow a combination of lopinavir and ritonavir — approved for AIDS treatment — to be used if coronavirus infections turn into a public health emergency in India. Thus, to some extent India seems to be prepared for Coronavirus.

  • The treatment protocol established in China and followed by physicians in Thailand shows that a combination of lopinavir and ritonavir, along with flu medication oseltamivir, may be working on patients.
  • Since the 2009 swine flu pandemic, India has scaled its laboratory capabilities, risk communication and surveillance systems up to detect and report infectious outbreaks.
  • It has also strengthened its points of entry for effective and efficient surveillance and emergency responses
  • India has fared relatively better on the response and mitigation fronts – i.e. to treat the sick during public-health emergencies, as was evident during the Nipah virus outbreak in Kerala in 2018. This is despite the fact that the country has an abysmal number of doctors, nurses and hospital beds relative to its overall population, tantamount to cracks in the building blocks of its public healthcare system. Strengthening these attributes is the key to be able to detect and manage outbreaks, which in turn improves health security.
  • In addition to thse National Institute of Virology, Pune, 11 virus and research diagnostic laboratories (VRDLs) are performing tests for the coronavirus.19 more laboratories are going to start functioning.
     
  • The Indian health minister said that one testing laboratory with scientists and all necessary equipment is being set-up at coronavirus-hit Iran as well so that the Indian nationals residing there, before being repatriated to India, can be tested in Iran itself.
  • The health minister lauded the government’s ability to trace the patient on time because of the “strong community surveillance system” wherein contact tracing plays a key role.Referring to the first three positive cases from Kerala, Harsh Vardhan said that the authorities did ‘contact-tracing‘ of 81 contacts for the first case, 71 for the second and 162 for the third.For the Telangana patient, they have traced 88 contacts, while, for the Delhi patient, 46 contacts.
  • All regular (sticker) Visa/eVisa [including Visa-on-Arrival for Japan and South Korea] granted to Italy, Iran, South Korea, Japan nationals and issued on or before 03.03.2020 and who have not yet entered India, were suspended with immediate effect

No, India is not prepared for Coronavirus?

  • India is not prepared to tackle health epidemics, particularly given its urban congestion. In fact, given the city structure and the way the settlements have grown, epidemics, once they occur, will spread at a galloping rate. The slum clusters all around the cities, the unhygienic growth, and poor waste disposal system will only aggravate the situation
  • Health infrastructure is the basic support for the delivery of public health activities, but current facilities in the country paint a dismal picture of the delivery system showing that India is not prepared for Coronavirus.There are 23,582 government hospitals with 710,761 beds in the country, according to the National Health Profile 2018.While our laboratory network has improved after the H1N1 scare, much needs to be done to improve the community facing primary health services and risk communication to the public. In general, hospital services can quickly gear up to treat severe cases in urban areas but rural healthcare needs a step up.
  • India is a member of the steering group of Global Health Security Agenda as well as a signatory to the International Health Regulations, 2005 (IHR), the latter an agreement between 196 countries to work together to improve health security. At the same time, India is one of only three countries among the 11 WHO member states in Southeast Asia that haven’t yet published a joint external evaluation (JEE), a voluntary external evaluation regarded as an integral part of strengthening national capacities to implement the IHR.
  • The country lacks a nationwide specimen-transport system and also has insufficient data integration between the human, animal and/or environmental health sectors to detect and report zoonotic diseases faster.
  • The lack of a strategy at the national level to stockpile medical countermeasures such as drugs, consumables, vaccines, devices, etc. to be used in the event of a potential public-health emergency is another prominent area of concern, with the potential to limit the system’s ability to respond effectively. India has a population of over a billion, so it must have a strategic national stockpile: a national repository of life-saving medical countermeasures for use during an emergency
  • On the regulatory front, the National Disaster Management Guidelines for the Management of Biological Disasters (2008) need to be updated. The Public Health (Prevention, Control and Management of Epidemics, Bio-Terrorism and Disasters) Bill of 2017 – intended to replace the old Epidemic Diseases Act of 1897 – is also need of major changes and wider deliberations before it can be tabled in Parliament


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