How serious is the COVID-19 situation in India and how prepared are we?
Considering a country of our size, we have so far handled the situation to the best of our ability. As of today, there are 44 total cases with 3 positive cases from Kerala which have already been discharged and 41 active cases. Regular ‘contact surveillance’ has been initiated across the country for all cases having travel history from COVID-19-affected countries and for people having contact with such persons and/or having symptoms. No death has been reported due to COVID-19 in the country. As far as our preparedness goes, we have already advised states and the central government-run hospitals to assess isolation and critical care facilities and adhere to infection prevention and control guidelines. Sufficient isolation beds and supplies have been made available in the tertiary facilities across the country to manage any outbreak. As on date, around 17,500 beds are available at various government facilities at the central and state government level. Further, around 14,000 quarantine beds have also been made available. Additional facilities will be made available as and when required. I have also held meetings with leading private hospitals of the country and they have all assured all support to tackle the situation.
The facility for collection and testing of clinical samples has been established in 51 laboratories across the country. Additionally, 56 Laboratories have been identified as sample collection centres. The network is being further expanded. Focusing on capacity-building in areas such as epidemiology, surveillance, laboratory support, clinical management, non-pharmaceutical interventions, infection prevention control and risk communication, we have done massive capacity-building in the last 45 days. The cutting-edge officers, Airport Health Officers and Immigration officials, have been trained. State & District Surveillance Officers have been oriented through video conferences. Quarantine Medical Teams have been oriented on patient management and infection prevention and control. NDMA has convened meetings of 20 civil society organisations and 300 NGOs.
We are also spreading awareness among the general public so that they are prepared to deal with the disease. We have sent 117.2 crore SMSs to mobile phones. Dos and don’ts for tackling the disease are being played on every mobile call by all telecom operators. Advertisements have been issued in 156 newspapers on March 5 and 6, 2020. MyGov weekly mailers have been sent to 70 lakh users and push notifications have been sent to another 20 lakh users. We have also asked government departments concerned to ensure display of dos and don’ts at post offices, railway stations, airports, gram panchayat meetings, MGNREGS rozgar sewaks, drug stores, corporate offices, CSCs, schools, hospitals, banks, private clinics, metro stations, NYKs and tourist places.
If large gatherings are to be avoided, how safe are crowded public transports?
I understand that we have already issued advisory to the states to avoid mass gatherings based on advice received from experts across the world on ways to tackle spread of COVID-19 in the country. I agree that public transport is an area of concern. But threat perception also lies from any infected individual visiting public places despite advice to the contrary. So, the best way to avoid spread of the risk is to follow simple public health measures at all times that have been communicated time and again through various advisories by my ministry. These include observing good personal hygiene, monitoring your health, practising frequent hand-washing with soap and water or use of an alcohol-based hand sanitizer, following respiratory etiquettes — covering your mouth with tissue or handkerchief while coughing, avoiding touching your eyes, nose and mouth, avoiding close contact with people who are unwell or showing symptoms of illness, such as cough, difficulty in breathing etc. and most important of all, wearing a mask if you have symptoms such as cough, fever or difficulty in breathing so that you do not become a carrier of infection. We are also requesting railways to ensure that there is timely cleaning of railway tracks, trains as well as stations including metro stations.
Is it safe for children to go to school?
We want our children to be safe and healthy. As a precautionary measure to ward off infection, we have asked state governments to take all measures to create awareness about preventive interventions among students to check spread of the disease.
ICMR has taken approval for use of second-line HIV drugs on COVID-19 patients. Have we used them so far? Do we have enough masks, personal protection equipment etc?
Yes, ICMR has taken approval for use of second-line HIV drugs on COVID patients but this Lopinavir/Ritonavir combination therapy has been approved for emergency use among COVID-19 patients with moderate degree of severity with laid down protocols. Till now, this combination therapy has been given to two Italian patients hospitalised at Jaipur. We have asked leading manufacturers of masks, personal equipment etc. to share details of their production capacities, stocks in hand etc. Details of all manufacturers of the above items have been shared with Principal Secretaries of all states/ UTs to enable them to contact suppliers and undertake procurement. Sufficient supplies are available to handle any situation that might arise.
How safe is it for people to travel abroad if the destination is not among those for which a travel advisory has been issued?
As of now, our focus is on COVID-19-affected countries which are more than 100 today. We have advised Indian citizens to refrain from travel to China, Iran, Republic of Korea, Italy and Japan and to avoid non-essential travel to other COVID-19-affected countries. As of now, we are not saying anything about other countries. But we have clearly mentioned in our travel advisory that even during travel to foreign countries, they should follow simple public health measures at all times which I have outlined above.
We started screening flyers from Thailand very early in the first week of February. How then did the third Delhi case get past airport screening? How did the Kerala patients escape it?
I know of only the Delhi case who had travelled back to India on February 23 from Thailand but developed symptoms on February 25. Thus, at the time of screening at the airport he was asymptomatic. Further, as far as three Kerala patients are concerned, even though they landed on February 29 and despite onboard announcements, signages and help desk, they did not report their travel history voluntarily. At the time of screening, they were asymptomatic and hence not detected. You should appreciate that as per the epidemiology of the disease, there are many reasons as to why the airport screening might miss such cases, which include: (i) The individual might be in incubation period and therefore not showing signs and symptoms at the time of screening, or, (ii) The individual might have taken anti-fever medicine to suppress fever during travel.
Therefore, we have been requesting people to come forward and divulge their true travel history at the time of landing at the airport so that preventive action can be taken on time. Similarly, appearance of symptoms should also be reported promptly.
Some Chief Ministers have alleged that the COVID-19 scare has been created to divert attention from Delhi riots. What do you have to say?
I would not like to talk about petty politics at this point when my entire focus is on taking all measures that are possible to check the spread of the disease. Being the Health Minister, I know that the best check for this disease is prevention and personal hygiene. Rather than giving significance to petty politics, I would request media to work with us to spread awareness about ways and means to check this disease. There is no need to create panic about COVID-19 among the masses.
The Ministry of AYUSH brought out an advisory on alternative medicine remedies to “prevent” coronavirus infection, we have prescriptions of yoga and gaumutra for preventing Corona. Your take as a medical man.
I have full faith in the power of Ayurveda and Yoga as a system of medicine which improves the well-being of an individual and builds immunity. However, the Ministry of AYUSH has already issued a clarification on February 4 on the two advisories issued on January 29 as they were concerned that efforts were being made in certain quarters to malign the image of AYUSH systems of healthcare as well as to create distrust among the public towards these medical systems. They have clarified that the advisories are only indicating general precautionary measures to be followed in the context of such viral diseases. These are based on the principles of approach in respective medical systems to those viral diseases where respiratory involvement is evident.
How long do you think before the outbreak is controlled?
My gut feeling is that it should subside in the coming weeks. It further depends on various factors such as how other countries are handling the situation, awareness among the masses and their attitude towards this epidemic.
How will import restrictions from China affect availability of medicines? How much stock do we have?
The Department of Pharmaceuticals is closely monitoring the effect of import restrictions from China. We have stocks of medicines varying from five months to nine months depending on the medicine. We understand that import disturbances from China are not likely to affect availability of drugs, since China has restarted their plants and commenced supply of medicines from the second week of February from all their provinces, except Hubei.
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