The War on Virus

HE COULD NOT see the faces of those who attended on him at Delhi’s Safdarjung Hospital, but he has taken back unforgettable images. On the first day in the hospital room, all by himself, Rohit Datta, the first Covid-19 case detected in the capital, drew up a list of his needs, which included a television, orange juice and mosquito repellent. A 35-year-old doctor bought him the juice and mosquito repellent. A young nurse, on her first day at work, told him he was a famous man and she would like to see him being discharged. A sweeper, whom he thanked, responded by saying he was doing this job by choice and wished him speedy recovery.

The last three weeks have changed him. “You need to introspect… We go for parties and movies. I liked socialising. We all miss out on certain things in life. I would like to be a better person,” says Datta, who received prayers and messages on his phone from people, some whom he had never met, of all faiths. He says when he went through the worst of times, he just prayed.

His room was a well-lit, clean, one-bedroom suite. Datta’s initial anxiety soon turned to hope as doctors, nurses and cleaners in protective clothing from head-to-toe came visiting—and when he started communicating with the rest of the world on phone. The doctors had assured the 45-year-old Covid-19 patient that he would return home safe.

He praises the efforts of the Government and doctors. “The Government did its best. I was in safe hands. The Health Minister [Harsh Vardhan] himself made a video call and asked if I had any problem. He told me even the Prime Minister had enquired about him. I see their faces only on TV. I always wanted to see them, but I never thought I would see them because of coronavirus,” he laughs.

Datta says he will convey to the Government that they should refrain from using the words ‘quarantine’ and ‘isolation’, which frightens people. His message to the world is, “If you have a doubt, get tested. Don’t run away.”

Having returned from Italy via Vienna, Austria, he was not tested at the Delhi airport. A day after a dinner at the Hyatt Regency hotel, one of the two friends who attended it took him for a coronavirus test to the Ram Manohar Lohia hospital since he had a cold and fever. Once his report came positive, he was immediately admitted at Safdarjung. What followed was protocol. Every individual he had contact with was tested, including his friends and their families. “I felt like a culprit. I was worried for my friends. When their reports came negative, I was so relieved that I cried,” he says. Six of his relatives in Agra also tested positive, since two of his brothers-in-law had travelled with him. Most of them have been discharged after hospitalisation.

The Government can shut down theatres, malls, schools and regulate travellers. But beyond these steps containment is the responsibility of citizens

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Datta was discharged after two consecutive reports came negative. He plans to return to work in another week. “Time flies. Tough times fly a bit slower.” For him, the nightmare is over. But as a businessman who exports polyester to Italy, he realises his business will be hit and it will take a long time for the economy to recover. Back home, he and his family continue to face the torment of social stigma and rumour. The garbage man does not come to their doorstep.

Within two days of his testing positive on March 1st, the Government announced that all passengers arriving on international flights would be screened at airports. Then, India had 28 confirmed cases—all of whom had either travelled abroad or had come in contact with those who had. Before that, only passengers from select countries were screened at airports. Screening was also initiated at 12 major ports and 65 other ports.

Faced with an unusual situation triggered by an unfamiliar disease, fear and uncertainty, the Government announced a series of unprecedented measures every day, trying to insulate the country from the epidemic as far as possible. A day after the World Health Organisation (WHO) declared the outbreak a global pandemic on March 11th, India decided to suspend all visas, except a few categories, from March 13th till April 15th and barred visa-free travel for even persons of Indian origin. By then, 73 confirmed cases, including foreigners, were reported. As Covid-19 cases mounted across the world and crossed 100 in India, international borders were further secured, banning the entry of passengers from the European Union, the UK, Turkey, Afghanistan, the Philippines and Malaysia. All travellers, including Indian nationals, from China, Italy, Iran, South Korea, France, Spain, Germany, the UAE, Qatar, Oman and Kuwait will be quarantined for at least 14 days, in facilities provided for the same. While the Government refrained from draconian measures of the kind unleashed in countries like China, there was the realisation that it cannot afford any complacence, either in terms of regulation or rolling out health facilities.

At the same time, it evacuated Indians stranded in Italy and Iran and quarantined in Rajasthan and Delhi, run by paramilitary forces and the army, the only organisations that can rig up such facilities overnight. “I had lost faith in governments but the Indian Government is acting like a parent to its citizens,” says Sujay Kadam, a Mumbai-based gold trader, whose daughter, a student in Milan, was flown back with the help of the Indian Embassy on March 15th. She tested negative, but as per protocol was quarantined at the ITBP hospital in Delhi.

The evacuations began as early as February 1st when 324 students from Wuhan, the epicentre of the outbreak in China, were airlifted. Even a decade ago, this kind of effort was non-existent or, even if possible, would have strained Indian capacities to their limit. The fate of Indians caught in the maelstrom of the First Gulf War offers a vivid comparison. The lesson of building a fleet of large military transport aircraft, vital to such efforts, has been amply proved during the current crisis.

Now, the Centre has put in place a mechanism that ranges from a group of scientists at the Indian Council of Medical Research (ICMR) keeping in touch with the situation across the world on SARS-CoV-2, which causes Covid-19, to district magistrates, who have been roped in to help authorities in states. On March 15th, the ICMR started testing samples of some people with flu-like symptoms even if they had no travel history. So far, those who had tested positive had either travelled abroad or could be linked to those who had come from Covid-19-afflicted countries. The ICMR, declaring India was in Stage II (local transmission) of the coronavirus outbreak, has appealed to private laboratories for testing for coronavirus free of cost. It is adding another 49 of its own laboratories to the existing 72 by the month’s end. Widening the testing strategy, it has also asked all asymptomatic people who have taken international flights in the last 14 days to get tested in case of symptoms, besides symptomatic health workers. Experts have been insisting on widespread testing, as a vital step in containing the spread of the virus. The third stage is community transmission, which ICMR Director General Balram Bhargava hoped India had not yet entered. “It would depend on how strongly we close our international borders, on which the Government has taken very proactive steps. But we can’t say community transmission won’t happen,” says Bhargava. By this time, the number of positive cases had touched 140, the highest in Maharashtra, followed by Kerala and Uttar Pradesh. Deaths of three Covid-19 patients had been reported at the time of going to press.

Sooner or later, as the viral infection proceeds through different stages, it is inevitable a national effort involving all sections of society, including private medical institutions and healthcare providers, will be needed. More than that, it would have to be an effort crossing political and geographical boundaries.

On March 13th, Prime Minister Narendra Modi tweeted: ‘I would like to propose that the leadership of SAARC nations chalk out a strong strategy to fight Coronavirus. We could discuss, via video conferencing, ways to keep our citizens healthy.’ He added: ‘Together, we can set an example to the world, and contribute to a healthier planet.’

The response from all the SAARC countries, with the exception of Pakistan, was positive. Two days later, on March 15th, heads of government/state of seven of the eight SAARC countries deliberated measures to tackle the pandemic in South Asia. Pakistan delegated a junior minister, in charge of health, to discuss the pressing issue. As a result of the meeting, India decided to make an initial contribution of $10 million to an emergency fund to tackle the coronavirus. In addition, the Prime Minister committed a team of medical experts that will be available to SAARC members. India also offered an Integrated Disease Surveillance Portal of the kind being used in India to keep track of infected individuals.

Any slip can be a prescription for disaster. The challenge for the Government is to alter its guidelines depending on the changing numbers

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All heads of government welcomed the Prime Minister’s proposal. Just around that time, India also dispatched a 14-member medical team to the Maldives to help establish medical centres and quarantine facilities in the island nation. The team and medical aid were requested by the Maldivian authorities.

In India, the efforts percolate down to district magistrates. “They play a very crucial role,” says Dr Anurag Bhargav, Chief Medical Officer of Gautam Budh Nagar in Uttar Pradesh. A box of hand sanitisers is moved into his office. His phone does not stop ringing. At 5 PM, he is yet to have lunch. He got a list of 200-300 of those who had come from abroad as long ago as December 2019, during the Auto Expo in Greater Noida. So far, 180 samples have been tested in the district. Among those who tested positive was a tourist guide, who went with an Italian group, and a man who had returned from Italy, France and Switzerland and went to work in an office in Noida. All 707 people in the office have been quarantined in their homes. A quarantine ward is being built nearby.

“There is a graph for every disease. Gradually, it will die. Old people are at risk,” he says. He gets a call about a missing person who was to be quarantined. He says it’s been 28 days, well beyond the 14 days, since the person went missing. Almost his entire team of doctors is involved in the battle against coronavirus, along the lines of the guidelines sent by the Centre to the state. Bhargav walks up to the cabin of the epidemiologist to find out if there have been any fresh cases. None of the samples tested positive that day. But, the war is yet to end.

Noted diabetologist Dr Anjali Bhatt, who works with Pune’s Chellaram Diabetes Institute, tells Open that governments are doing their best at the Centre and in states to contain Covid-19. Stating that diabetics are often at a greater risk of contracting Covid-19 than healthy people, she notes, “In the case of a pandemic, governments cannot overly focus on high-risk groups such as diabetics and cancer patients. The government treats all patients as a high-risk group, and so it is the responsibility of people with such ailments to maintain social distancing on their own. They cannot expect the government to do what they ought to do,” she states, emphasising, “Dangers to diabetics and other such people are two-fold: they tend to get infections faster and take longer to heal”. Therefore, people need to complement the state’s efforts with self-discipline and self-isolation, Bhatt says.

Although many states have decided to ensure social distancing through partial lockdown, that Uttar Pradesh has decided to go ahead with Ayodhya Ram Navami Mela, from March 25th to April 2nd, despite the pandemic is a cause for major concern.

For the Government, it poses a challenge it cannot afford to be half-hearted about. Any slip can be a prescription for disaster. The bigger challenge for the Government will be to not only sustain its vigilance, testing and regulations, but also alter its guidelines depending on how the numbers stack up. All this, while it staves off panic. The Government can shut down theatres, malls, schools and colleges, ban gatherings and regulate the inflow of travellers from abroad, but beyond these steps containment of the virus is the responsibility of citizens. As part of its blitzkrieg to create awareness, the Government has roped in superstar Amitabh Bachchan. People will have to keep in mind the precautions prescribed by experts—personal hygiene, avoiding non-essential travel, social distancing and testing in case of doubt. The question is, for how long? As yet, nobody can predict that.

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Amita Shah