ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles By T Jacob John

COVID-19 Mortality Trends and Reporting

During the early phase of the coronavirus pandemic, Italy had a high infection burden and death rate while India appeared much less affected. By 22 May, Italy and India had 3,770 and 86 infections/million population with mortality rates of 14.24% and 3.03%, respectively. There was speculation about hidden advantages to India leading to a false sense of security. These differences are readily explained by the time and frequency of virus importations and the differences of the age profile of Italy and India.

Underestimation of the COVID-19 Burden

The number infected with SARS-CoV-2 in early May in India is estimated by a method utilising the unequivocal number available, namely deaths due to COVID-19. The estimated numbers are far in excess of reported numbers and indicate the systemic flaws in reporting deaths in India, augmenting the extent of underestimation. Additionally, there is the overestimation of the doubling time of infection. A realistic picture of the epidemic at the community level is presented, which informs us about the level of preparedness required to deal effectively with the epidemic.

How Prepared Is India to Control the COVID-19 Pandemic?

The SARS-CoV-2 infection, COVID-19, has reached many places in India, from Kerala to Kashmir. With local spread occurring from infection seeded by importations, a nationwide epidemic of unprecedented seriousness is imminent. The Prime Minister should assume leadership immediately and a full-time war-room, run by a task force with the best national experts, must be set up, and immediate, medium- and long-term strategies designed and implemented. We have lost one month already.

 

Ebola and India

While the chances of the Ebola virus entering India are low, Ebola and pandemic flu teach us to expect the unexpected and be prepared. New diseases are appearing in the world again and again. We live today in a "global village". Ebola-infected bats are probably present in Asia. Nipah virus-infected bats are widely prevalent in east Asia; there is no guarantee their territorial flight paths will not extend to peninsular India. Is India prepared? Who exactly is in charge?

Can the Polio Elimination Success Story Breed More Successes in India?

Overcoming formidable biological and sociocultural barriers, India eliminated wild polioviruses from its territory in January 2011. Looking back, it is obvious that the best policy would have been to introduce the inactivated poliovirus vaccine to prevent polio in every vaccinated child, and to use oral poliovirus vaccine by pulse campaigns to eliminate WPVs rapidly. This would have eliminated polio decades ago. Now that WPVs have been eliminated, IPV must be introduced as a prelude to withdrawing OPV. The road ahead is bumpy, but with the important lessons learnt so far, India can no longer pretend that it is too difficult to design a permanent public health infrastructure to control other communicable and non-communicable diseases.