On February 10th, Dr Harsh Vardhan, Union Minister for Health & Family Welfare, issued a suo moto statement in the Lok Sabha on the outbreak of the novel Coronavirus Disease in China and some other countries, and the subsequent actions taken by the Government of India.
Coronaviruses are a large group of viruses that cause illness in humans and animals. Rarely, animal corona viruses can evolve and infect people, and then spread between people as has been seen with Severe Acute Respiratory Syndrome (SARS) in 2003 and Middle East Respiratory Syndrome (MERS) in 2014.
China reported an outbreak of Novel Coronavirus on December 31, 2019. The outbreak was initially noticed in a seafood market in Wuhan city in Hubei Province of China in early December, 2019 and in a short span has spread to all the provinces of China. As on February 9th, a total of 37198 confirmed cases and 811 deaths have been reported in China. A total of 354 confirmed cases have been reported outside China from 27 countries (including HK, Macao and Taiwan). The number of cases and deaths reported from China is showing an upward trend.
The World Health Organization has declared this outbreak as a “Public Health Emergency of International Concern” (PHEIC) on 30th January 2020.
Particulars of the disease
Many of the epidemiological parameters such as incubation period, mode of transmission, subclinical infection, period of virus shedding etc. are still being researched. Once a person is exposed to the infection, it may take about two weeks to develop the illness. The main symptoms of novel Coronavirus disease are fever, cough, and difficulty in breathing. There will be radiological evidence indicative of pneumonia. In 10% to 20% of cases, the disease may become severe enough to require ventilatory support. The case fatality is around 2%.
Human to human transmission has been noticed in cases of Novel Coronavirus and it spreads through droplets/aerosols in persons having close contact. Public health implications of the reports that the virus has been found in fecal samples of infected patients are being worked out. All suspected or probable cases of nCoV must be treated in isolation with barrier nursing and universal precautions to prevent the further spread of disease.
In our country, three positive cases have been reported so far from Kerala. All these cases have travel history from Wuhan, China. They have been isolated and are reported to be clinically stable.
The ever increasing magnitude of this outbreak calls for a concerted effort by not only health but all sectors of Government. The Government of India has initiated a series of action to prevent entry of the disease and to contain it and the Minister himself is daily reviewing the situation.
A Group of Ministers consisting of Minister of External Affairs, Minister of Civil Aviation and Minister of State for Home Affairs, Minister of State for Shipping and Minister of State for Health & Family Welfare chaired by Dr Harsha Vardhan has been constituted to monitor the situation. The Cabinet Secretary has taken daily reviews with all related Ministries of Health, Defence, Ministry of External Affairs, Civil Aviation, Home, Textiles, Pharma, Commerce and other officials including with State Chief Secretaries. The health ministry is constantly reviewing the evolving scenario. Video Conferences are being held with States every other day.
Screening at entry points
The Government of India has also taken several other measures to control the risk of novel Coronavirus infection spreading to India. First Advisory was issued on January 17, 2020 and as the situation is evolving, travel advisories are accordingly getting revised. Presently,
- Existing visas (including eVisa already issued) are no longer valid for any foreign national travelling from China.
- People having compelling reasons to visit India are asked to contact the Indian embassy in Beijing or consulate in Shanghai or Guangzhou.
- People have already been advised to refrain from travel to China through an earlier advisory. People traveling to China henceforth will be quarantined on return.
Screening of passengers was initiated on January 18, 2020. Initially airports at Delhi, Mumbai, Chennai, Kolkata, Bengaluru, Hyderabad and Kochi were covered and screening was subsequently expanded to a total of 21 airports. Universal thermal screening has been made mandatory for all flights from Singapore and Thailand besides Hong Kong and China, and these flights will park at earmarked aero-bridges to facilitate screening.
Signages have been displayed at prominent places in airports and ports, In-flight announcements are being made and self-declaration forms are being filled up by all passengers. As of today, a total of 1818 flights have been screened covering a total of 1,97,192 passengers. Teams of Specialist doctors were sent to all the airports to ensure effective screening and arrangement for isolation in the attached hospitals.
Screening of passengers has also been initiated in 12 major seaports and all minor ports in the country to identify passengers & crew coming from China and to isolate them in case they are found symptomatic.
In view of a confirmed case in Nepal, Government has initiated screening at all integrated check posts from Nepal in collaboration with states of UP, Uttarakhand, West Bengal, Sikkim and Bihar and Seema Shastra Bal (SSB) and Land Port Authorities. Gram Sabhas have been conducted in villages adjoining the borders with Nepal to create awareness amongst people about the disease and precautions to be taken in collaboration with Panchayati Raj Ministry.
Indian evacuees from China
In view of the continuing lock down of the Hubei Province in China, the Government of India decided to evacuate the Indian students and other professionals working in Wuhan and neighbouring cities in the Hubei Province. In coordinated operation with Ministry of Civil Aviation, Air India, Ministry of Health and Family Welfare, two Special Air India flights were operated between Delhi and Wuhan on 31 January and 1 February 2020 that brought back a total of 654 passengers that included 647 Indian citizens (including two Indian Embassy officials who were on the ground in Wuhan to coordinate the evacuation operation) and 7 Maldivian nationals.
Dr Harsh Vardhan thanked Air India, its crew and the team of doctors and paramedical staff who executed this challenging operation and placed on record his appreciation on behalf of the august house for their contribution.
After evacuation, the people are presently undergoing quarantine at special facilities created by the Indian Army in Manesar and by the Indo Tibetan Border Police (ITBP) in Chawla Camp. 10 of the evacuees who were symptomatic have been shifted to isolation. All of them have tested negative for this disease and are stable. All other evacuees are being medically examined on daily basis and are healthy.
The Indian Embassy and Consulates are also in regular contact with the Indian Community in other parts of China and is keeping a constant track of their well-being. Regular surveillance has been initiated across the country for all cases having travel history from China and for people having contact with such persons and having fever, cough or breathlessness.
Through Integrated Disease Surveillance network all such persons are tracked and presently we are following 9452 passengers across 29 States/UTs in the community.The state surveillance officers, district surveillance officers and rapid response teams of health professionals under the leadership of state Health Secretaries are monitoring all such people on a daily basis.
Sufficient isolation beds have been made available in the tertiary facilities across the country to manage any outbreak. 369 symptomatic travellers have been referred to isolation facility and are being monitored. The Ministry has issued guidelines to support states on Surveillance and contact tracing, Surveillance at Points of Entry, Laboratory samples collection, packaging and transport, Clinical management protocol and Infection prevention and control in healthcare facilities.
To ensure availability of critical items like Personal Protective Equipments (PPE) & N95 masks, exports of the same were also prohibited by the Director General of Foreign Trade. A buffer stock of personal protective equipments & N95 masks is maintained by states as well as the Union Government.
National Institute of Virology, Pune is the nodal Laboratory. As part of ICMR’s preparedness for emerging/ re-emerging infectious disease, NIV, Pune has established capacity for molecular diagnosis of nCoV. Next generation sequencing is also established. Testing of clinical samples has also been initiated in 11 more laboratories. As of now, 1510 samples have been tested and 1507 samples were found negative, 3 samples have tested positive and 27 samples are under process.
Communication and awareness generation
Risk communication material has been prepared and is widely disseminated even in regional languages through states. Required awareness in community is ensured through technical briefings by experts in radio and television. Daily Press briefing is being held by the Ministry of Health and Information is being shared through social media. A 24×7 Control Room is operational (011-23978046).
The Government of India is in regular touch with WHO headquarters, regional office and country office to get updates on evolving scenario. The government has also provided support to other countries in tackling the challenges posed by the nCOV disease. ICMR has offered to do testing of samples for other South East Asian Region countries. Testing of samples from Maldives has already been undertaken. A request from Afghanistan for samples testing has been agreed to. We have agreed to provide technical assistance to Bhutan in managing this infectious disease and screening of passengers also.
The Government of India is constantly monitoring the situation and is taking all the necessary steps to avoid the spread of the novel Coronavirus.[This has been taken from a release issued by the Press Information Bureau and has been republished with minimal edits, except in headline and sub-headings]