Low screening rate in India may have masked coronavirus cases | India News

Indian authorities have said they will not expand coronavirus testing, as most of the affected countries do, despite criticism that limited testing could leave COVID-19 cases undetected in the country. second most populous country in the world.

The World Health Organization (WHO) has urged countries to test as widely as possible to curb the pandemic, but India has only tested those who have traveled from affected countries or are came into contact with a confirmed case and showed symptoms after two weeks of quarantine.

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On Tuesday, he added healthcare workers with symptoms who are treating patients with serious respiratory illnesses.

India only performs around 90 tests per day, although it can accommodate up to 8,000. So far, 11,500 people have been tested, according to the Associated Press.

WHO orientation "premature"

Officials said the WHO guidelines did not apply in India because the spread of the disease was less severe than elsewhere.

Balaram Bharghava, who heads the Indian Council for Medical Research (ICMR), the country's main medical research organization, said the guidelines were "premature" for India, where community transmission has failed. not yet been detected.

"Therefore, it creates more fear, more paranoia and more hype," he said.

Last week, a British citizen who approached a New Delhi public hospital for a coronavirus test was informed that she was not eligible under the test criteria. India and refused.

The woman, who requested anonymity for fear of business consequences for her employer, said she told hospital officials that she may have been in contact with an infected person in the part of her job in the hospitality industry, but that she was not sure.

After trying and failing a second time, she left India this week for France, where her family lives and where President Emmanuel Macron had announced extreme measures to fight the coronavirus.

Indian authorities have justified their restrictions as a way to prevent a deluge of people from demanding tests that would cost the government the money it needs to fight other diseases such as tuberculosis, malnutrition and HIV / AIDS.

The ICMR has stated that there is no need to extend these tests. However, authorities have said they are preparing for spread to the community by strengthening their laboratory testing infrastructure. India has 52 coronavirus screening centers.

Due to narrow test criteria, sick people potentially exposed to coronavirus are sent home, and some experts fear that India's workload will be much higher than government statistics indicate .

Bharghava, the head of the ICMR, said that viral infections in India can still be traced back to people who have traveled to the country from affected localities and that testing protocols would be revised if community transmission was detected.

Coronavirus cases in India rose to 147 on Wednesday, the day after the death of a third person, a 64-year-old man, in the western state of Maharashtra.

The South Asian nation has closed most schools and entertainment facilities, including cinemas.

Authorities say most of the infections have been "imported" – related to travel abroad or direct contact with a person who caught the disease abroad.

India has suspended all incoming tourists and will ban non-Indian passengers on flights from the European Union, the European Free Trade Association, Turkey and the United Kingdom from Wednesday.

Travelers from or in transit through the United Arab Emirates, Qatar, Oman and Kuwait must be quarantined for 14 days upon arrival in India, the government announced on Monday.

Arrivals from China, Italy, Iran, South Korea, France, Spain and Germany are already subject to similar restrictions, while most posts border with neighboring Bangladesh and Myanmar have been closed.

Spread not detected

But concerns about an undetected community spread are growing.

"Given the pattern of the disease elsewhere and given our low level of screening, I think community transmission occurs," said Dr. Gagandeep Kang, director of the Translational Health Science and Technology Institute.

WHO has stated that, although spontaneous isolation by people with mild symptoms remains the most important community intervention, screening for all suspected cases, symptomatic contacts for probable cases and confirmed, would still be required.

"We must be prepared to respond to changing circumstances with the aim of stopping transmission of COVID-19 as soon as possible in order to minimize the impact. … We must act now" said Dr Poonam Khetrapal Singh, WHO director for the region.

More than 400 million of India's 1.3 billion people live in overcrowded cities, many of which do not have regular access to clean water, conditions that could allow the disease to spread quickly.

"Spread into the community is very likely. But the only way to know for sure is through more extensive testing," said Dr. Anant Bhan, global health researcher in Bhopal, India.

The virus only causes mild or moderate symptoms, such as fever and cough, for most people, but serious illness is more likely in the elderly and people with existing health problems.

India has a lower proportion of older people than other countries, but its health facilities are limited and already struggling to accommodate the large number of patients with other illnesses.

"This, along with our high population density, can be our big challenge," said Oommen Kurian, public health researcher, at the Associated Press.

India has been reluctant to expand testing, not wanting to panic and overwhelm hospitals, but also because of the cost: if the tests are free for patients, they cost the government about 5,000 rupees ($ 67) each.

In an already stretched and underfunded public health system, the money spent on the coronavirus goes less for other public health problems. India spends only 3.7% of its total budget on health.

The coronavirus can also spread to India because health officials have struggled to maintain quarantines, with people fleeing isolation rooms, complaining of dirty conditions.

In Maharashtra, five people, one of whom had a negative result and the others who were awaiting the test results, came out of isolation on Saturday.

Application of containment

India implemented an epidemics law in the 19th century which empowers public officials to apply more stringent containment measures and to impose sanctions and punishments in the event of an escape.

Lav Agarwal, an official with the Ministry of Health, said that the authorities "often do not receive enough support from people".

Similarly, in neighboring Sri Lanka, the government has ordered approximately 170 passengers who have escaped airport control after returning from several affected countries to report to the police or to face financial penalties and prison sentence.

Aditya Bhatnagar, an Indian student who was studying in Spain, described the unsanitary conditions in a seclusion room where he and 50 other passengers on a flight from Barcelona are held since landing in New Delhi Monday.

Bhatnagar said the bedrooms, each containing about eight people, lacked basic hygienic features such as clean sheets and bathrooms. He told the Associated Press that the group, pending the results of their COVID-19 test, had received neither a mask nor a sanitizer.

"I don't think these measures would be enough to contain the pandemic," said Bhatnagar, the head of the ICMR, adding that some passengers had chosen to leave services and in private hotels, paying 4,000 rupees ($ 55) a night. to isolate yourself for at least 14 days.