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Healthcare workers check temperatures of residents in a slum in Mumbai, India's worst-hit city.(Reuters: Francis Mascarenhas
With hundreds of train carriages being converted into makeshift wards and Mumbai's hospitals overwhelmed, there are fears India could become the next global hotspot for the deadly coronavirus.
Key points:
- The world's second-most-populous country has recorded more than 12,500 COVID-19 deaths
- India went into early lockdown in March, but cases are now on the rise
- An expert urges "smart lockdowns" with stricter quarantines for "super-spreaders"
It marks a rapid rise. At the start of June, there were fewer than 200,000 cases. A month before that, it was fewer than 38,000. Last Friday's tally of more than 13,500 was the biggest spike in cases in a single day.
But despite the high caseload, the Indian Government maintains there is no community transmission.
"India is such a large country and prevalence is very low. India is not in community transmission," Balram Bhargava, director general of the Indian Council of Medical Research (ICMR), said last week.
Community transmission is where COVID-19 has spread to a person who hasn't recently been overseas and who isn't a recent contact with a confirmed case, meaning the source of infection is unknown.
"India has not declared community transmission simply because there isn't any," said economics professor Raghbendra Jha, head of the Australia South Asia Research Centre at ANU's Crawford School of Public Policy.
India's answer to Norman Swan for her number-crunching tweets to explain the pandemic, said that "detection of community spread can only happen through contact tracing data," which she doesn't have access to.
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Anthropologist and India expert Assa Doron, also of ANU, pointed out the Indian Government has always maintained there is local transmission — that is, the virus is spreading within India — and there have been concerted efforts to find the direct sources of infection.
Coronavirus update: Follow all the latest news in our daily wrap.
How has India handled the outbreak so far?
Dr Poonam Khetrapal Singh, the regional director for the World Health Organization's South-East Asia Region, said "the number of cases in India today should be seen against the country's population of 1.3 billion".
As Professor Ravi points out, some Indian states are the size of whole European countries.
Dr Singh added the spread of COVID-19 was not homogenous within any country.
In India, "there are areas yet to see any positive case, some have sporadic cases, some small clusters, while the mega cities are witnessing large clusters and numbers from their densely-populated areas," Dr Singh said.
India has yet to hit its peak. Last month, All India Institute of Medical Sciences director Randeep Guleria predicted cases would peak in June or July, based on the data at that time.
Data sources: Johns Hopkins Coronavirus Resource Center, Our World in Data, ABC
But modelling released this week forecasts the peak could occur in mid-August, with the caveat that easing lockdown restrictions in June could bring the peak closer.
In an effort to trace and treat the country's rising infections, the Government said it would ramp up rates of rapid-testing.
Effective testing also requires collaboration between the central government and the states — a relationship that has been under strain, Professor Doron said, by the mass movements of migrant labourers back to their home states in the wake of a sudden lockdown in March.
An exodus of migrant workers tried to return to their home villages after the world's largest coronavirus lockdown was imposed in March.(AP)
That nationwide lockdown, where people were given just four hours' notice, has proved controversial — some praise it for putting a rapid halt to the spread of the virus, but others criticised it for effectively stranding hand-to-mouth workers.
India could become the next COVID-19 epicentre, Professor Doron pointed out India could take advantage of the lessons learned from observing how the pandemic has unfolded in other parts of the world.
an analysis piece for the Hindustan Times, she pointed to the example of Kasaragod and Mumbai.
In early April, they had a similar number of COVID-19 cases — 127 in Kasaragod and 185 in Mumbai.
Two weeks later, Kasaragod had zero cases, but Mumbai was in the throes of a devastating outbreak. Soon its hospitals would be overwhelmed.
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She said Kasaragod authorities performed "aggressive contract tracing", identifying potential "super-spreaders" and putting them under stricter quarantines.
she wrote.
India's Ministry of Health and ICMR director general Balram Bhargava did not respond to the ABC's requests for comment.
The WHO's Dr Singh said India took "bold, decisive and early measures" to screen people, trace contacts, train health workers and scale up testing capacities.
But, as in other countries, "scaling up capacities and response remains a constant need and challenge," she said.
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https://www.abc.net.au/news/2020-06...ghest-covid19-community-transmission/12365738
