The Indian government’s proactive measures to stem the coronavirus seem working. With nationwide lockdown and containment measures there are 5,194 confirmed cases as of now. The alternate scenario as per projection would have been 1.2 lakh cases by 15 April with containment measures but no lockdown.
Had the government not introduced any lockdown or containment measure, the confirmed cases by 15 April would spike to 8.2 lakh (similar to Italy’s progression), according to the Indian government. Prime Minister Narendra Modi introduces ‘Janata curfew’ on 22 March and nation-wide lockdown on 25 March. “If we compare the case trajectory of India with other countries, since the 100th case (21 days till 7 April), India’s doubling rate is 4.4 days, cases per million is only 3.3,” said a report.
This is in sharp contrast to US where doubling rate is 2.4 but cases per million is 1125.4. In Italy, the doubling rate is 2.8 and the cases per million population is 2193.4. Unfortunately due to the Tabligh Jamaat incident at Nizamuddin Markaz, the total cases have risen to 4067 with the doubling rate of 3.6 days. Without the Tabligh Jamaat incident, the cases would have been 2622 with doubling rate of 5.4 days.
“India’s public health response is proactive, pre-emptive and graded – includes screening and travel restrictions, social distancing and lockdown.” In India, active screening and isolation of travelers started on 18 January - this is 12 days before the first case was reported on 30 January. Globally, passenger screening started at stage II and III of the infection-Italy and Spain doing it 25 and 39 days after the first reported case.
Similarly, partial lockdown was introduced by India 52 days after 451 cases and complete lockdown on 55th day of the outbreak. Compare this with Italy and the US that introduced partial lockdown after 6000 and 4663 cases respectively. India implemented visa restrictions very early starting from 17 January by issuing the advisory of not to travel to China followed by suspension of visa facility for China from 5 February.
Travel advisory was issued on 5 February requesting people to refrain from non-essential travel to the five affected countries. By 2 March, visa was suspended for South Korea, Iran, Italy and Japan. Restrictions on travel by sea were started from 10 March when entry of cruise ships was prohibited and visa suspended for France, Germany and Spain.
By 11 March all existing visas were suspended for France, Spain and Germany and incoming flights prohibited from 19 March. With regard to hospital preparedness guidelines were issued on surveillance and contact tracing, sample collection, packaging and transportation, infection prevention control and clinical management protocol.
Some 508 dedicated COVID-19 hospitals are ready with 82,795 isolation beds, 8,182 ICU beds and 4,935 ventilators. Besides these, 5,110 additional health facilities are ready with 113,315 isolation beds, 27,641 ICU beds and 12,867 ventilators. Union Government has also provided funds to health centres under National Health Mission (NHM).
Government has also taken steps to ensure availability of medical equipment in the form of PPEs, N95 masks and ventilators. Export of PPEs was banned from 31 January and now there are 20 domestic manufacturers with orders placed for 1.7 crore more PPEs. 2.75 lakh PPEs were available initially and states were given 2.94 lakh PPEs.
Export of N95 masks were banned on 31 January and orders placed for 2.13 crores. 9 lakh masks were available initially and states were supplied with 20.4 lakh N95 masks. Domestic manufacturers for ventilators were developed and order placed for 49,000 more. Initially 8,400 were available but now 16,500 are available.
An institutional response framework has been put in place with the Prime Minister monitoring the situation everyday and continuously engaging with Chief Ministers and State Health Ministers. The National Task Force of eminent medical and public health experts are guiding strategy and senior officials deputed to states to act as a continuous link. Best practices shared by districts and continuous focus on surveillance, contact tracing and patient management were some of the measures taken so far.
