The deadly new strain of coronavirus, COVID-19, has taken the lives of over thousands of people across the world. India is also currently facing a rapid spread of the infection, leading to the government putting the whole country under 21-day lockdown. This seems to do little to no impact as many people are either unwilling or cannot abide by the lockdown rules. Increasing the number of tests and rapid strengthening of the country’s healthcare system is a need of the hour.
Mindmap Learning Programme (MLP)
What is Coronavirus?
- The coronavirus is a class of RNA based viruses.
- The name is derived from the Latin word, ‘corona’ meaning crown. This is in reference to their crown-like characteristic appearance.
- There are 4 genera of the virus group- Alphacoronavirus, Betacoronavirus, Gammacoronavirus and the Deltacoronavirus.
- There are currently 7 known strains of coronaviruses that affect humans. The latest addition is the Novel Coronavirus – also known as the Wuhan Coronavirus.
- These strains are:
- Human Coronavirus 229E
- Human Coronavirus OC43
- SARS Coronavirus – causes Severe Acute Respiratory Syndrome.
- Human Coronavirus NL63 or the New Haven Coronavirus
- Human Coronavirus HKU1
- MERS Coronavirus – causes the Middle East Respiratory Syndrome
- 2019-Novel Coronavirus or the Wuhan Coronavirus
- On 11th February, the World Health Organisation had officially named the 2019-novel Coronavirus as COVID-19, a shortened version of coronavirus disease 2019.
- The COVID-19 belongs to the Betacoronavirus genus.
- Strains of the virus affect other life forms too. Example: Avian Coronavirus, Bovine Coronavirus etc.
- The viruses were first discovered in the 1960s.
How did COVID-19 outbreak initiate?
- The origin of the virus is still unknown.
- However, it appears to have originated from Wuhan seafood market where wild animals including marmots, birds, rabbits, bats and snakes are traded illegally.
- The new coronavirus is known to jump from animals to humans, so it is thought that the first people infected with the disease – a group primarily made up of stallholders from the seafood market – contracted it from their contact with animals.
- Studies show that it is more likely to have come from bats as a team of virologists at the Wuhan Institute of Virology released a detailed paper showing that the new coronavirus’ genetic makeup is 96% identical to that of a coronavirus found in bats.
- Bats were also the source for the SARS virus.
- From China, the virus has spread across to other countries in other continents. Currently, 183 countries and territories have confirmed COVID-19 infections.
- Timing of this outbreak coincides with the annual Chunyun Migration event – largest human migration event ahead of the Chinese New Year.
What are the symptoms of coronavirus?
- The coronaviruses are noted for affecting the upper respiratory tract and the gastrointestinal tract of the patients.
- According to the World Health Organisation, the symptoms include fever, cough, shortness of breath and breathing difficulties.
- In the more severe cases, it can lead to pneumonia, severe acute respiratory syndrome, kidney failure and even death.
- The most vulnerable to severe infections are those with heart, lung disease or weak immune systems and infants and older adults.
- The incubation period of coronavirus is still unknown. Some say it could be between 10 to 14 days.
What are the stages of COVID-19 epidemic?
There are four stages of COVID-19 infection. They are as follows:
- Stage I: Cases are imported from affected countries. Thus, only those who have travelled abroad test positive. At this stage, there is no spread of the disease locally.
- Stage II: During this stage, there is a local transmission from infected persons. This usually involves relatives or acquaintances of those who travelled abroad and have tested positive. At this stage, only a few people are affected, the source of the virus is known, making it easier to trace contacts and contain the spread via self-quarantining.
- Stage III: This stage involves community transmission. During this stage, those who have not been exposed to an infected person or anyone who has a travel history would still test positive. It would be difficult to identify the source of the infections.
- Stage IV is the worst stage of the infection where it takes on the form of an epidemic. Massive numbers are infected and it is very difficult to control and contain the spread. Countries like China, Italy etc., are facing this situation.
Were there previous outbreaks of coronavirus?
Severe Acute Respiratory Syndrome (SARS)
- It is a viral respiratory disease of zoonotic origin caused by the SARS coronavirus (SARS-CoV).
- Between November 2002 and July 2003, an outbreak of SARS in southern China caused eventual 8,098 cases and 774 deaths in 17 countries, the majority in China.
- No cases of SARS have been reported globally since 2004.
- The viral outbreak was genetically traced to a colony of cave-dwelling horseshoe bats in China’s Yunnan Province.
Middle East Respiratory Syndrome (MERS):
- Also known as camel flu, MERS is a viral respiratory infection caused by the MERS-coronavirus (MERS-CoV).
- The mortality is about one-third of diagnosed cases.
- MERS-CoV is a betacoronavirus derived from bats. Camels have shown to have antibodies to MERS-CoV but the exact source of infection in camels has not been identified.
How can the COVID-19 infection be prevented from spreading?
- Currently, there is no vaccine to cure COVID-19 infection.
- The World Health Organisation’s standard recommendations to prevent infection spread include:
- Regular hand washing
- Covering mouth and nose while coughing and sneezing
- Thoroughly cooking meat and eggs
- Avoiding contact with anyone who is showing symptoms of respiratory illness like coughing and sneezing.
How dangerous is COVID-19?
- Over 6,67,000 cases have been confirmed in 183 countries and territories since the epidemic first emerged in Wuhan, China in December.
- Of these cases, at least 1,34,000 are now considered recovered.
- Italy, which recorded its first coronavirus death in February, has declared 10,000 fatalities so far.
- Spain has more fatalities than 6,500 and accounts for 78,747 infections.
- China, excluding Hong Kong and Macau, has declared 3,295 deaths and 81,394 cases, with 74,971 recoveries. On 9th February, the death toll in China surpassed that of the 2002-03 SARS epidemic.
- Other worst-hit countries include Iran with 2,640 deaths and 38,309 cases, and France with 2,314 deaths and 37,575 cases.
- The US has the highest number of infected people with more than 1 lakh diagnosed cases, 2,191 deaths and 2,612 recoveries.
- Europe has listed over 3,63,000 cases and more than 22,000 deaths.
- Asia recorded more than 1 lakh cases and 3,761 deaths.
- West Asia has registered nearly 46,000 cases and more than 2,000 deaths.
- This shows it can transmit more readily between humans than SARS, which led to the death of almost 800 people after it originated in China 17 years ago.
- However, the new virus is less virulent than SARS that killed 10% of those who were infected.
- On the other hand, the number of asymptomatic or mildly symptomatic people after the infection was quite low during the SARS epidemic, making it much easier to do isolation and contact tracing.
- However, COVID-19 is much harder to find and track due to the increase in the number of asymptomatic and mildly symptomatic people. This creates panic and uncertainty while dealing with the spreading of infection.
- MERS, another coronavirus that did not spread as widely, was more deadly, killing a third of those it infected.
- COVID-19, in short, is less deadly than SARS and MERS, but more contagious, making it more difficult to control, which in itself is a danger to human lives.
Is the world prepared for a pandemic?
- On March 11, WHO declared coronavirus outbreak as a pandemic. Following this announcement, many countries scaled up their response via stringent actions to stop the spreading of the infection. The last time WHO declared a pandemic was in 2009 during H1N1 “swine flu” outbreak.
- A pandemic is an epidemic disease that has spread across a large region, for instance, multiple continents or worldwide.
- Pandemics in the 21st century are deadlier as they spread faster and are harder to control. This is because, in the current times, the world is interconnected and the economies are interdependent.
- Currently, no country in the world is fully prepared to deal with a pandemic and the governments mostly rely on trial and error.
- A WHO report published last year analysed what would happen if pandemic similar to Spanish flu affects the world again.
- Spanish Flu infected 500 million people around the world and had taken the lives of an estimated 50 million people in the year 1918. The Spanish flu has killed more people than the First World War, which had led to the deaths of about 40 million.
- According to this WHO report, a Spanish Flu-like disease in the current day and age will have the ability to spread across the world in less than 36 hours and more than 50 billion people would die.
- This is mainly because many of the countries lack strong healthcare system.
- Coronavirus outbreak can be seen as a wakeup call to prepare the world for a possible pandemic in the future.
- According to WHO, an investment of 1-2 USD per person per year could be enough to reach an acceptable level of global preparedness.
- This is much lesser than the money spent by the world on weapons, which is 239 dollars per person per year.
- It is high time that there is an increase in spending on global health.
- The world is close to developing a universal flu vaccine, something that will work against all forms of influenza.
- Now, it is time to consider universal vaccines against all forms of coronaviruses too.
- The world leaders must come together to bring in the world’s best medical minds, necessary resources and funds to help prevent the repetition of this scenario.
What is the WHO’s stand on the COVID-19 outbreak?
- The World Health Organisation had previously decided not to declare the COVID-19 outbreak as PHEIC – Public Health Emergency of International Concern.
- Though was criticised by the global community, this is not the first time the WHO has been reluctant to declare a PHEIC.
- A PHEIC is a technical term for “serious, unusual or unexpected” health crisis that poses a public health risk to other countries through the international spread and potentially requires an immediate coordinated international response.
- Declaring a PHEIC expands WHO’s authority to coordinate that response in various ways, including by issuing recommendations on whether countries should impose trade and travel restrictions.
- In 2019, the WHO repeatedly decided not to declare the Ebola outbreak in the Democratic Republic of Congo a PHEIC before ultimately doing so.
- The reluctance of WHO to declare PHEIC is due to its unwillingness to indulge in politics.
- WHO can declare PHEIC after WHO director-general consults with an Emergency Committee of independent scientific experts, as well as the countries affected by the outbreak. The final decision rests solely on the director general’s shoulders.
- Though the recommendations of the Emergency Committee is the voice of technical expertise, heeding it gives the director-general a cover to take action that might be unpopular with the governments, leading it to become a political move.
- On 30th January 2020, due to the increase in the number of global infections, the WHO declared coronavirus a global emergency.
- The WHO is internationally criticised for its slow response to this pandemic.
India and Coronavirus pandemic:
- Recently, coronavirus cases in India have crossed 1000 and the country has faced 32 causalities because of the pandemic.
- India witnessed a sudden jump in the number of COVID-19 cases since March this year.
What are the measures taken by the government to reduce the spreading of COVID-19 infection?
Declaration of COVID-19 as “notified disaster”:
- Due to the spike in the number of cases and causalities, the Centre had declared COVID-19 as a “notified disaster”.
- This allows the states to spend a larger chunk of funds from the State Disaster Response Fund (SDRF) to fight the pandemic.
- The Centre had said that SDRF fund can be used for providing
- Temporary accommodation,
- food, clothing and medical care for people affected and sheltered in quarantine camps,
- To support checking, screening and contact tracing
- For setting up additional testing laboratories
- States are empowered to decide hospitalisation costs, the number of quarantine camps, their duration and the number of persons in such camps.
- On March 22, India observed “Janata Curfew” (people’s curfew) to stop the spreading of coronavirus infection.
- Everyone except people of “essential services” such as police, medical services, media, home delivery professionals and firefighters were needed to take part in the curfew from 7 AM to 9 PM.
- This nationwide voluntary 14-hour self-quarantine exercise led to a complete lockdown in various states, with some even resorting to Section 144.
- On March 24, Prime Minister had announced 21-day lockdown as social distancing is one of the vital means to contain the infection.
- The orders of lockdown were issued under the Epidemic Disease Act, 1897 and Disaster Management Act, 2005.
- While preventing the spread of the infection, this 21-day lockdown can also spread awareness about the seriousness of the situation.
- Those who have already contracted the infection from foreign source will begin to develop symptoms and will get testing and treatment during the lockdown, preventing the infection from spreading.
- Additionally, it also helps authorities to disinfect all public buildings, vehicles, and other surfaces and allows hospitals to prepare themselves for the next phase of the epidemic.
- This lockdown involves:
- Suspension of transportation
- Executive Magistrate enforces the lockdown
- Some of the vital services like fair price shops, food shops, banks insurance etc., will remain open.
- Vital government services will also be exempted and will be operational.
- Hospitals and all related medical establishments, including their manufacturing and distribution units, such as dispensaries, chemist and medical equipment shops, laboratories, clinics, nursing homes etc., will remain operational.
- Transportation for frontline workers is also permitted.
Economic Relief Measures:
- The Finance Minister had announced a slew of financial relief measures to help deal with the pandemic-induced economic crisis in the country.
- The government had extended deadlines for income tax returns for FY2018-19, GST filing for March, April and May and also the last date for linking PAN card with Aadhaar.
- The Bank account holders also need not worry about maintaining a minimum monthly balance as the non-maintenance charge will be waived off for three months.
- ATM withdrawals from any bank ATMs will also be free for debit cardholders for the next three months.
- The Government had also announced numerous other economic measures to help people survive this pandemic.
- To provide relief to the farmers affected due to the 21-day lockdown, the government will transfer in the first week of April, the first instalment of Rs.2,000 to each of 8.69 crore beneficiaries of the PM-Kisan Samman Nidhi.
- The Centre will also provide 5 kg of rice or wheat and 1 kg of pulses free under PM Garib Kalyan Package.
- Additionally, the Ujjwala Yojana beneficiaries will get free LPG cylinders for the next three months.
- The government also announced that 20 crore women Jan Dhan account holders will get an ex-gratia amount of Rs.500 per month for the next 3 months.
- It also doubled the collateral-free loans to Rs.20 lakhs for women SHGs, helping 7 crore women.
- Apart from these measures by the Centre, the state government are also involved in giving economic relief packages and easing financial burdens faced by their people.
- To address the liquidity issues faced by the borrowers in paying their equated monthly instalment (EMI) amid the nationwide lockdown, the RBI had permitted banks and other financial institutions to provide moratorium of three months to all term loan borrowers.
- The moratorium means that the borrowers need not pay their EMIs for the specified period and no penal interest will be charged.
- To implement this moratorium, the banks would calculate simple interest rates for the three months in which loan repayment was due but not paid under the moratorium.
- This would be added into the EMIs at the end of the three-month forbearance, raising the monthly bills.
- Also, the apex bank instructed credit information companies to ensure that the credit score of the borrowers does not get impacted due to moratorium.
- Apart from these measures, the RBI brought the repo rate down to 4.4% from the earlier 5.15%.
- The reverse repo rate has also been reduced by 90 basis points (4%) to maintain financial stability and revive growth.
Involvement of the private sector:
- The Government has sought help from private players in treating patients as a part of its efforts to increase resources to combat COVID-19.
- The private hospitals have been asked to earmark beds and isolation rooms.
- About 50 private laboratories have been involved in COVID-19 tests.
- The National Health Authority, the nodal agency for Ayushman Bharat, health insurance scheme for poor was told to strengthen health package for the economically vulnerable section of the population
- Apart from this, the MSME ministry had asked manufacturers and suppliers of medical equipment like ventilators, alcohol-based hand-rub, face shield, N95 masks etc., to register on the Centre’s e-marketplace, GeM platform so that these items can be used for combating COVID-19.
Addressing Mental Illness:
- The World Health Organisation had earlier warned that the coronavirus crisis and the restrictive measures that many countries use to contain the outbreak could harm people’s mental health and well-being.
- With the majority of people facing 21-day lockdown within the country, this issue is at its peak.
- To combat this issue, the National Institute of Mental Health and Neuro-Science (NIMHANS) had launched a toll-free number for people who may face mental illness due to this situation.
What are the issues faced by the government while implementing the lockdown?
The mass exodus of migrant workers:
- The announcement of 21-day lockdown with little to no time for preparation forced migrant workers, who travel to the cities for work to commute to their home states.
- This lockdown coincides with the harvest season, the time when the migrant workers seek harvesting jobs in large states.
- To return to their homes, these migrant workers walked a long distance.
- However, they were stopped by authorities, which led to them being stranded in large masses.
- In response to this crisis, shelters and food were provided for these migrant labourers by the state governments.
- Yet, their accommodations do not provide for social distancing.
The vulnerability of rural India:
- Majority of the Indian population live in rural areas.
- Rural India especially has limited access to the healthcare system, making it difficult for these people to be tested and treated.
- This, as a result, makes it highly difficult to monitor the spreading of infection in these areas.
The ambiguity of the term “essential items”:
- The Centre has exempted “essential items” manufacturing in its 21-day lockdown notification.
- However, there is no clear definition of the term “essential items”, leading to states having different views on what is essential.
- Even when they agree, unanticipated gaps appear.
- For example, while soap can be listed under essential items list, the supporting items are not listed, like that of the packaging of soaps.
- The people who would face the worst impact of the lockdown would be those relying on the unorganised sector, which amounts to about three-fourths of India’s working population.
- Due to the lockdown, states governments will also not be able to effectively deliver the welfare schemes to support these people.
- These individuals are vulnerable because they do not have financial security due to the lack of jobs during the time of lockdown.
Disregard to lockdown orders:
- The lack of public adherence to health and safety request is also one of the major issues faced by the authorities.
- Use of force or requests seems to do little to make people stay indoors.
- This may be due to people’s lack of awareness about the seriousness of the situation, their inability to stay cooped up inside or panic buying
- It is also highly difficult for law enforcement authorities to impose nationwide lockdown on all 1.3 billion Indians without the cooperation from the people themselves.
What are the challenges faced by India while combating COVID-19?
- During the early stages of the outbreak, the Indian Council for Medical Research (ICMR) only allowed testing of those who have travel history and those who have come in contact with them and then have gone on to develop symptoms to be tested for COVID-19.
- This led to India having one of the lowest testing rates in the world as of March 13.
- Also, the initial tests didn’t specifically test for COVID-19 but just any strain of coronavirus, including SARS and MERS.
- This led to many unnecessary positives and unnecessary people being quarantined.
- Currently, India has effective test kits with sensitivity and specificity.
- Furthermore, the ICMR had revised its strategy to fight the infection by allowing the testing of all hospitalised patients with severe acute respiratory illness, shortness of breath and having fever and cough.
- It also allows testing of asymptomatic direct and high-risk contacts of a confirmed case.
- As of March 24, India has just tested 18 individuals per million people
Lack of communication and internet connectivity in Jammu and Kashmir:
- Since August, the Centre put the Union Territory of Jammu and Kashmir under military lockdown to quash any dissent within the area due to security concerns and the possibility of unrest and terror attacks.
- Apart from being close to China and Pakistan, which are seeing a spike in infection, the newly formed union territory also lack reliable access to the internet, which has alternated between being dramatically slowed down or shut off completely by Indian authorities.
- This makes it especially difficult for locals to get vital information about the disease from trusted sources, work from home or continue their education online, leading to uncertainty and panic among the public.
- Lack of internet is also posing as a challenge for healthcare workers who are involved in treating COVID-19 patients as they couldn’t gather the vital information.
- In India, states control their own public healthcare system.
- The biggest states are the most vulnerable as their healthcare may be overwhelmed due to their dense population.
- Though the majority of healthcare is provided by private hospitals, which are generally better-run and better equipped, is costly and inaccessible for many.
- India’s government hospitals are ill-equipped to handle this situation and the private hospital is not accountable to anyone.
- This means that India’s healthcare is not equipped to deal with Stage 3 of the COVID-19 infection.
A limited number of beds:
- According to a study, India has over 700,000 government hospital beds. This means that there are 0.55 beds for every 1000 individuals. This ratio is one of the lowest in Asia.
- This figure is much lesser than China’s as it has 4.3 beds per 1000 individuals.
- If India’s number of beds is low, it means that the number of critical care units, which is vital to combat COVID-19, is even lower.
Dependence on ventilator imports:
- India imports about 70% of the ventilators, making it vulnerable as other countries are also facing an increase in demand.
- To address this issue, the government had asked the public sector companies to make at least 40,000 ventilators to meet the requirements.
India’s elderly at risk:
- Around 100 million people in India are over the age of 60 (the age group that is most susceptible to the infection).
- This figure is higher than Italy’s population, the country that is worst hit due to the pandemic.
- India’s population density is about 450 inhabitants per square kilometre. China, which has the world’s highest population, has a density of 150 inhabitants per square kilometre.
- About 120,000 people share 1 Km2 in Mumbai, which is 12 times more than New York City’s population density.
- Also, one-sixth of the population lives in the slums, making them even more vulnerable to the infection.
How can India counter the spreading of the COVID-19 infection?
- One of the efficient ways to prevent the spreading of infection is by implementing the lockdown effectively.
- The lack of detailed planning on the lockdown led to another bout of crowding, with people rushing to buy supplies and medicines and the mass exodus of migrant workers.
- It would also have been easier if the Centre had discussed this with States.
- If the prolonged lockdown is to be executed without too much trauma for the public, the government must take several measures.
- Chief among the measures include ensuring reliable access to food, medicine, water and emergency assistance.
- Here, some states have taken steps like providing cash relief and free rations.
- These can be effectively delivered by ensuring door-delivery to the elderly and setting up time frames and shops for specific areas so that there is no crowding within that area.
- Door delivery of medicines must also be ensured to prevent the movement of people.
- The government must take stringent steps to ensure that healthcare workers are provided with necessary facilities and that they are not discriminated by society.
- The countrywide lockdown will have economic ramifications, especially for the millions of daily wage earners, the self-employees, small businesses and the rural landless poor, as they would face a lack of income and hunger crisis.
- It is hard to even for people employed in vital sectors of manufacturing or the utilities due to the lack of transportation.
- The Centre’s slew of economic measures and state governments’ financial packages and other welfare schemes can only do little to tackle the unprecedented economic crisis.
- Any package to address it, therefore, demands a set of mitigation and subsequent stimulus measures that would need to be of an exceptional scale and require efficient implementation. These are as follows:
- Centre must abandon its fiscal deficit goals at this moment to counter the COVID-19 infection, for at least a short duration of time.
- Centre, like some states as well as most developed economies, must immediately release sizable cash grants to all persons with Jan Dhan accounts and BPL ration cards.
- The plan must encompass comprehensive spending measures like a substantial investment in public health infrastructure, specifically for COVID-19 treatment
- Loan repayment holidays and a wage bill subsidy to all MSME businesses that retain the workforce at pre-crisis levels
- After the lockdown is lifted, a huge public infrastructure creation can boost jobs and restart the economy.
- A modest doubling of the budgeted fiscal deficit figure for 2020-21 could see about Rs.16 lakh crore being freed up for the Centre to both spend directly and provide capital support in the form of grants and subsidies to state governments and banks.
- It should also be noted that a single lockdown does not address this crisis.
- Through this lockdown, the number of infected people can be reduced. However, there may be few who may have an infection and may infect others after the lockdown is lifted.
- Thus, to address this issue, it is necessary to ensure repeated lockdowns, not nationwide, but based on hotspots that show severe infections.
- Also, travel restrictions must not be lifted without quick and efficient testing methods.
- In this context, India should ensure an increase in research to manufacture testers like that of the South Korean-made simple tester that is said to detect COVID-19 infection in just 10 minutes. This tester checks nasal discharge for the presence of the virus within 10 minutes with an accuracy rate of 85%
- This is because increasing the number of testing while accurately identifying the hotspots to lock them down can efficiently bring down the curve.
- A new test kit called Patho Lab was developed by a private diagnostic company, MyLab. It has been permitted by National Institute of Virology (NIV) in Pune.
- Imported coronavirus testing kits in India takes a minimum of 7-8 hours to work and are comparatively more expensive.
- The newly developed Indian test kit takes just 2.5 hours to deliver results and is much cheaper.
- Increasing research on this aspect can ensure a reduction in testing time and can even further reduce the cost.
Increasing the pace and resource mobilisation for researching to create new drugs to curb the spreading of the COVID-19 is a need of the hour. This can be more efficiently done with coordinated efforts of the international community.
Practice Question for Mains?
The rapid spread of COVID-19 infection shows the risk of globalisation. What are the measures that can be taken to prevent the repetition of the same? (250 words)