Can India combat Covid-19?

The latest strain of coronavirus, Covid-19, that originated in the Hubei province in China, is a healthcare threat warranting introspection and deliberations across countries. Over the last two months, China has recorded over 2500 deaths and nearly 76288 new cases. It wouldn’t be surprising if the numbers are indeed much higher, given that data transparency has been a persistent issue.

Coronavirus cases have been detected in at least 26 countries. Although the worldwide numbers are small as compared to China, we must ask ourselves: If the situation snowballs into a global epidemic, are we equipped to deal with it? More specifically, can India combat coronavirus?

Addressing the issue

Right from small pox (fortunately eradicated), rabies, marburg virus, ebola virus to HIV, hantavirus, rotavirus, influenza and dengue, viral outbreaks are not a new phenomenon. Coronavirus belongs to a family of deadly viruses that have made an appearance from time to time in human history. Incidentally, the name is derived from the crown-like appearance around the virus when seen through a transmission electron microscope (TEM).

Did you know that the first coronavirus discovered in 1960 could cause common cold? We have seen the later strains, such as severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 and the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, become deadlier. Studies show that the latest strain, COVID-19, actually has a mortality rate of two-three percent, much lower than earlier strains, such as the ebola zaire strain with 90 percent mortality.

Lessons from China

There are important lessons to be learnt from China’s handling of the latest outbreak. Dr Li Wenliang, the Chinese doctor, who was the first to detect these cases and alert the media in December 2019, was called to the local police station and reprimanded for spreading rumours online. In fact, he was forced to sign a statement acknowledging his “misdemeanor” before he was allowed to leave the police station.

Weeks later, China’s Supreme Court vindicated him and other “rumour mongers” by saying, “It might have been a fortunate thing... if the public had listened to this ‘rumour’ at the time.” It’s truly unfortunate that the doctor had to suffer for speaking the truth, before ultimately succumbing to the disease. In the age of ever-growing medical misinformation, especially on social media, COVID-19 has been an eye-opener in terms of the havoc that it can cause, endangering precious lives.

It’s also important to acknowledge China’s prompt efforts in building two hospitals with 2300 beds each and converting auditoriums, gymnasiums, and stadiums into supplementary healthcare centres to deal with the epidemic. While researchers across the globe have been working ceaselessly to develop a timely vaccine to help prevent such a viral outbreak in the future, it’s equally important to look for effective antiviral treatment modalities. Dr Benjamin Cowling, a professor of epidemiology at the University of Hong Kong, for instance, is working on a promising project that looks at utilising plasma to make antibodies to fight the coronavirus.

Challenges galore

For populated countries like India, the fear of transmission of infections is substantially higher. Overcrowded places, like trains, buses, markets, places of worship, etc, pose massive challenges when it comes to curbing the spread of a viral outbreak.

The sad reality is that even hospitals that cater to immuno-suppressed patients, like those battling cancer, are not adequately equipped to prevent the spread of such infections. Lack of funding, non-availability of masks, protective suits and goggles are major concerns.

For proper diagnosis of Covid-19, the swab has to be refrigerated immediately and then sent to the laboratory. This can be truly challenging, given India’s healthcare infrastructure. In fact, there have been delays in testing even in the US because the samples have to go to the central laboratory.

As per currently available data, the main driver of transmission for the coronavirus is through symptomatic cases. However, if the virus starts to spread from patients who are asymptomatic, then we are in true danger.

Given that the virus cannot be cultivated in the laboratory, it’s hard to gauge its impact on the national economy and public health. However, experts are unanimous in their opinion that if the supply of raw materials from China to the global pharmaceutical industry is not restored soon, the world will face a huge crisis. The cost of generic drugs will rise steeply, particularly affecting patients from developing countries like India.

As Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO), rightly said, the viral outbreak could have “more powerful consequences than any terrorist action”. Are we ready to face it?

(The writer is clinical director and senior consultant oncoplastic breast surgery, Cytecare Cancer Hospitals, Bengaluru)