IO – Globally, as on 12th April, more than 1,783,000 cases of COVID have been confirmed, with 108,907 deaths reported. India, a country of 1.3 billion people, has been able to manage and contain corona cases to around 8300, considerably below the global incidence rate, with negligible community-based infection, the result of a well-executed plan and pre-emptive preventive methodology, under the leadership of PM Shri Narendra Modi.
THE PLANNING AND EXECUTION
With sufficient information available to the world since early January, both in the public domain and from authoritative international sources, India has taken several proactive measures, thus ensuring that that nation stayed ahead of the curve, as this crisis evolved. The Government of India organized a meeting of the Health Crisis Management Group on 8th January 2020; they constituted a Group of Ministers (GOM) to plan, monitor and review the situation regularly, to ensure inter-ministerial coordination.
States/Provinces were provided with guidelines for surveillance and contact tracing, laboratory sample collection, packaging and transport, clinical management protocol, prevention and control in healthcare facilities and discharge guidelines for passengers under quarantine.
The focus areas of the strategy and major actions taken are as follows:
1. Surveillance at the Points of Entry in the Country – The first travel advisory was issued on 17th January (even before the first case was detected in India!), along with initiation of screening of flights from China and Hong Kong at 3 major airports. Screening and graded travel restrictions were tightened up step by step from mid-January up to March 11, when WHO finally declared COVID-19 a pandemic. As of 6 April, 1.5 million passengers have been screened at airports, 44 thousand at sea ports and more than 2 million screened at land borders.
2. Community Surveillance of all Passengers through an Integrated Disease Surveillance Program (IDSP) Network – Passengers are monitored in the community through an IDSP network on a daily basis. At present 621,000 passengers have been brought under surveillance, of whom 33,249 were found to be symptomatic and referred; 5503 have been hospitalized so far. This has ensured that not a single positive case has been able to mix with the general population.
3. Laboratory Testing – A network of labs across the country has been set up to facilitate early and timely sample testing. WHO has stipulated the National Institute of Virology, Pune as the referral laboratory for the entire South East Asia Region. From one laboratory in January 2020 to 223 labs nationwide (157 public labs; 66 private) now, over 190,000 samples have been tested till date. India is also developing indigenous testing kits to meet escalated demand for more liberalized testing.
4. Ramping up production and procurement of medical supplies – Indian private sector is being fully involved in the quest to make affordable local alternatives. For instance, there are now 32 Indian companies that have started work to produce PPE kits. A six-fold increase in supply of oxygen for medical purposes has also been ensured, since February 1, 2020. At present 727,494 beds, 171,317 isolation beds and 74,450 COVID confirm beds have been identified. Up to 40,000 extra isolation beds have been prepared by converting 2500 railway carriages. Production of pharmaceutical supplies like anti-pyretic tablets and Hydroxychloroquine has been expanded to meet domestic needs and for export to other countries.
5. Public Communication – One of the biggest steps in preventing community spread of infection is through communication. Press ads about basic Do’s and Don’ts of COVID-19 management were released and more press ads dealing with other aspects are being developed and released as the situation progresses. Regular press conferences with the Health Minister have been carried out, daily updates by designated officials have been issued and relayed across all media channels. Daily press releases about the number of cases, travel advisories and other COVID-19 related decisions are being issued.
6. Ensuring safety of Indians abroad – Government has taken every step to ensure the safety of its citizens. There have been evacuation operations from Wuhan (China), Iran, Japan (cruise), Italy and Malaysia. The evacuees were escorted to quarantine facilities set-up on a real-time basis, on a war footing.
WORLD’S BIGGEST LOCKDOWN
By mid-March, there was substantial global spread of the disease. On 24 March, the Prime Minister announced a total 21-day lockdown, extending until 15 April. This is truly unprecedented. For example, it has included stoppage of over 13,000 railway passenger services a day, for the first time in India’s history as a Republic, stoppage of all flight services and most public transport. And yet, continuity of essential services— power supply, water, energy, food products, banking, even delivering essential goods to India’s neighbors was ensured.
Humanitarian Approach to Migrant Laborer Crisis: After the lockdown, numbers of migrant laborers from the NCT Delhi started migrating toward their home states. Many people started pouring into inter-state bus terminus and the interstate highways. Many started off on foot and many more were stuck at different inter-state borders. The Government of India swung into action and around 500,000 migrants were safely transported to their home states.
Detailed protocol was evolved to manage the migrants, guidelines were issued to ensure essential supplies, ration and food packets for stranded people ensured. Nearly 28,000 relief camps and shelters have been set up, with relief being provided by State Governments to 1.25 million people. Nationwide, 20,000 food camps are being run, with up to 7.5 million people being fed every day.
Mitigation efforts: During the lockdown, the Government accelerated its efforts for effective management strategies and future planning. The Prime Minister’s Garib Kalyan (Welfare of the Poor) Package sets out US$ 22bn to alleviate the hardships of the poor and vulnerable, including farmers and labors. This includes insurance for 220,000 health care workers.
Food relief measures are being implemented, to provide free food grain and lentils for 3 months to 800 million people. LPG cylinders are being provided to 80 million poor households. Funds are being transferred through the direct cash transfer schemes to poor senior citizens, differently-abled people, and indigent widows.
On 15th March the Prime Minister invited all SAARC countries for a Video Conference to manage the COVID-19 situation and set out a series of measures, including a commitment to provide up to US$ 10 million toward health assistance. India has been able to deliver medical supplies and assistance to Maldives, Sri Lanka, Nepal, Bangladesh and Bhutan, and is in the process of preparing packages of medicine and other needed commodities for Nepal and Afghanistan. Medical commodities have also been provided not only to Myanmar, Seychelles, Mauritius in our extended neighborhood, but also to Italy, Iran and China at the height of the crisis in those countries.
And in keeping with India’s standing as a major and responsible provider of pharmaceutical products to the world, commercial and aid supplies of key pharma products were made to the US, Spain, Brazil, Israel and Indonesia and countries in Africa, Latin America and the Caribbean.
The effort is on and it’s a tough battle ahead…