COVID-19: India lost good lead time, says expert

By Cheena Kapoor

NEW DELHI, India (AA) - Despite a complete lockdown, coronavirus cases in India continued to rise Friday.

The third day of the lockdown saw a rise to 116 in new cases. At 121, India saw the highest surge in infections Wednesday, the first day of the lockdown confining 1.3 billion people indoors.

According to John Hopkins Coronavirus Resource Center in the U.S., India reported 887 cases, including 20 deaths.

In an exclusive interview with Anadolu Agency, Dr. T. Jacob John, India's leading virologist, who formerly headed the Indian Council for Medical Research's Centre for Advanced Research in Virology, talks about the flaws in the government's handling of COVID-19 -- the reactive approach as opposed to the proactive approach that may affect millions, and steps to take now.

Anadolu Agency (AA): Is the 21-day lockdown a sufficient measure to control this pandemic? If not, what else should be done?

T Jacob John (TJJ): Every action has its objectives. Control of the pandemic is not an objective here. The spread of this virus cannot be controlled since we have no preventive interventions. True prevention from an infected person is wearing protective equipment like doctors. Not all can wear those.

So the purpose of a lockdown is to buy 21 days before widespread community transmission occurs. The 21-day time is only to buy more time or let's say to delay the transmission so that the government can make frantic preparations.

India lost a good lead time when we knew that this was a pandemic in the making. The government had been warned in advance and asked to watch-out, soon after China announced that this was transferred between animals and humans via social contact. A pandemic needed three months to go around the world, and see where we are now. We would have been better off if we [the government] had taken it seriously in early January.

AA: Can this epidemic turn into an endemic disease and so recurrences?

TJJ: Unless SARS-CoV-2 does Hara-Kiri [an ancient way of suicide in Japan] and kill itself and leave the society, it will become 'pan-endemic,' meaning 'endemic globally.' That is what H1N1 flu is today.

There is no way to stop this from spreading at the moment, especially after it became an anthroponotic [person-to-person transmitted infectious disease] virus.

AA: How can we limit the spread in India with the present state of control measures?

TJJ: Control of COVID-19 is not possible as there are no control interventions. People cannot stop breathing, as long as they are breathing, this is going to spread.

With the current measures, we can only reduce its speed for some time, from one week to a month, until we are ready, and that is all is expected of the lockdown.

AA: What are the estimates of human life loss without any medical intervention?

TJJ: Well, we are a 1.3-billion population. And looking at the current statistics, if 50% of the population gets affected, it will be a little 650 million and if 0.5 percent of these die, we are looking at about 3 million deaths.

But these are only predicted cases. We need to focus on the vast majority which will have very mild to no effect. Children will have no problem, it will be mainly adults, who will be at a risk.

AA: How could India do things differently? Are we in the right direction?

TJJ: We are moving in the right direction but at a very slow speed. The path is right, speed is wrong.

Most of the precautionary measures should have had been taken in January itself when the government was warned. We are still mainly in a reactive mode and fighting the enemy from wherever it crops up, instead of being proactive.

India has no war-room thinking, just heroic fighting.

AA: Can India learn any lessons from China?

TJJ: There is nothing much to learn from China. They either do not know much about it or are not revealing the magnitude of the infection of the virus.

If we really have to learn, we should look at countries like South Korea and Germany. Both those countries have taken the right path, including Korea starting early research in January and testing antibodies. They made sure to trace all contacts through their public health system.

As for Germany, it has done wide testing. Public and private partnership in both countries is commendable.

AA: Is there any way to get rid of this virus anytime soon?

TJJ: No, unfortunately, there is no way to avoid this. If the summer heat slows down the spread, we may see less transmission, but it will continue in autumn and winter.

AA: Is there any possibility to get the vaccine of this virus soon?

TJJ: Several candidates are under various levels of testing. Chances are good that we will have some vaccine, but not within the time frame of the first wave -- which is one year.

AA: What can be alternative approaches for testing facilities, if tertiary care hospitals are not available?

TJJ: It is the government's responsibility to make sure that tertiary care facilities are available. It has been 70 years since independence, we should at least have tertiary care in every district. And if it is not available, then we should set-up tents or temporarily convert buildings into centers. But what is worrying is not space, it is the shortage of trained people.

It is good to know that the government has ordered an extra 30,000 ventilators, but there are many other things needed, including PPE [Personal Protection Equipment], extra beds, etc.

AA: Has the genome been decoded by Indian doctors yet? Any plans of making it public?

TJJ: Full genome sequence and gene sequence for PCR primers [short strands of genetic material] were done by the Chinese and are in the public domain from Jan. 7, I think. We do not need to reinvent the wheel as the genome will be the same.

Since this is a single-stranded virus -- RNA [Ribonucleic acid], we may see minor variations, which are known as mutations. The National Institute of Virology has done it and even cultured the virus in their laboratory.