The World Health Organization has lauded measures taken by India to contain the spread of the coronavirus. WHO regional emergencies director of South-East Asia, Roderico Ofrin, told ET’s Teena Thacker that the steps taken by India can help slow down transmission of the virus. Edited excerpts:
What are the key concerns for India, keeping in view the lockdown and migrant labour?
India’s response to Covid-19 has been pre-emptive, pro-active and graded with high-level political commitment. India has shown ‘whole of government’ approach and is adopting ‘whole-of society approach.’ The most effective way to control an outbreak is to detect the disease early, isolate and treat cases, trace contacts, and promote social distancing measures. Along with the lockdown, the above key public health interventions are core to stop the epidemic.
WHO has been advising countries, at various stages of response, on the actions they can take to stop transmission and prevent the spread of the Covid-19 virus. Our recommendations are to scale up emergency response mechanisms for which there are step-by-step guidelines and recommended actions around country-level coordination, planning, and monitoring; community engagement; surveillance, rapid response teams and case investigation, points of entry, national laboratories; infection prevention and control; case management; and operational support and logistics.
Where do we stand if you compare us with neighbouring countries in terms of research?
The Indian Council of Medical Research (ICMR) has isolated the virus. India is only the fifth country to do so, and the second in the region after Thailand. We are aware that India is engaging in research on vaccines and better diagnostics which includes serological testing. This will be important to better understand the outbreak.
Also read: Isolation may cut peak numbers by 89%: ICMR
The WHO chief has said that the most effective way to keep the virus at bay is test, test, test. Do you think India’s strategy to test only symptomatic patients is enough?
India has been calibrating its testing strategy as per the need and the transmission scenario of Covid-19. The country has been augmenting its capacity and increasing the scope of testing. Laboratory networks are expanding, private sector is being included. The scope has been expanded and now includes all symptomatic individuals:
-who have undertaken international travel in the last 14 days;
-all symptomatic contacts of laboratory confirmed cases;
-all symptomatic healthcare workers;
-all hospitalised patients with Severe Acute Respiratory Illness (fever and cough and/or shortness of breath);
-asymptomatic direct and high-risk contacts of a confirmed case, who should be tested once between day 5 and day 14 of coming in his/her contact.
Since mid-February, India has included testing for patients (with no travel or contact history) having severe acute respiratory illness (SARI) from the surveillance system.
Just because India is at stage 2, as suggested by ICMR, can we be complacent?
Whatever the stage, the key action points are – engage with people; find, isolate, test and treat cases and trace every contact; ready your hospitals; and protect and train health workers. That’s the only way to combat Covid-19.
Is coronavirus airborne? Do we have any justification to say if it is and otherwise?
Based on the information received so far and on our experience with other coronaviruses, Covid-19 appears to spread mostly through respiratory droplets – for instance, produced when a sick person coughs… Droplets are too large to be airborne for long periods of time and quickly settle out of air. This is why WHO recommends everyone maintain hand and respiratory hygiene.
WHO continues to recommend that healthcare workers take additional precautions when they are working on patients and when they do an aerosol-generating procedure in a medical care facility.
Also read: COVID-19: Advisory for aged people
How effective are HIV drugs to treat coronavirus? China is doing a study. Do we have their results yet?
So far, we have no evidence that any drug is effective. There are no specific treatments for this Covid-19 and treatment is based on clinical presentation. Most cases are mild and self-limiting. 20% patients progress to severe and critical illness and require supportive care interventions such as oxygen and ventilation.
Multiple randomised clinical trials are ongoing for investigating the safety and efficacy of antivirals. WHO recommends enrolling into a randomised controlled trial to test efficacy and safety of interventions. A master global clinical trial protocol for research and prioritisation of therapeutics is ongoing at WHO.
What’s the status of the coronavirus vaccine?
So far, WHO has received applications for review and approval of 40 diagnostic tests, 20 vaccines are in development and many clinical trials of therapeutics are under way. We expect the first results in a few weeks.
We are working very closely with major donors and partners, including the World Bank and CEPI and other agencies at a global level to invest in vaccine development. In the meantime, we can save lives with therapeutics and without disrupting the resources we need to invest in national health capacity.
Vaccines usually take several years. We were able to shorten that in the development to the vaccine for Ebola by harnessing global efforts. We are already working to do the same for Covid-19.
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