On 12 March, India reported its first death arising from the novel coronavirus, or COVID-19—a 76-year-old man from Karnataka. The previous day, the World Health Organisation had declared COVID-19 a pandemic, confirming what was already clear by then—that the virus will likely spread to all countries around the globe. That same day, the union health ministry announced drastic travel restrictions, preventing foreigners from entering the country and suspending all visas, barring a few categories, till 15 April. But these travel restrictions may not be effective, given that the virus has reached most corners of the world. “This will stop new cases coming in, but now it is about tracking down local transmission,” Giridhara Babu, a professor of epidemiology at the Indian Institute of Public Health, said.
Even as the state government of Karnataka started tracing and isolating those in contact with the deceased man, union health ministry officials maintained that the government had no evidence of local transmission in India. Addressing a media briefing on 12 March, Lav Agarwal, a joint secretary in the health ministry, noted, “There is no need to panic as we have limited local transmission.” But public-health experts have highlighted two primary concerns with the Indian government’s response to the ongoing crisis. First, the health ministry has restricted testing for COVID-19 to the few government-accredited laboratories in the country. Second, the government is limiting the tests only to those with a travel history, and those who came in contact with international travellers.
Since it was first identified, in China’s Wuhan city last December, COVID-19 has swept across 114 countries and killed more than four thousand people. As of 6 pm on 12 March, according to the health ministry, India had reported 74 positive cases of COVID-19. With the travel restrictions, India joined a growing list of countries that have taken similar decisions, including Israel and the United States. “Since the virus is already in India, it is important to trace the contacts of all infected people to ensure that we are not missing any human to human transmission,” Babu said. “It is better to be over cautious now than repent later. The logical way to ensure there is no local transmission is to monitor contacts of all travellers, and positive cases, through the incubation period of 14 days.”
In the press conference, Agarwal stated that twelve states across the country had reported positive cases of COVID-19. Given the extent to which it had spread already, public-health experts had hoped that the testing parameters would be expanded to include people without a travel history, which would reveal the full scale of crisis. But Agarwal made it clear that the Indian government had “no plans to revise testing parameters, as testing everyone would create panic.”
Experts also hoped that the health ministry would allow private laboratories to test for COVID-19, so as to not overwhelm the government sector. “There is a real concern that the government is not expanding testing parameters to include everyone because they want to keep the numbers low,” an epidemiologist working with a global-health organisation said, on the condition of anonymity. “If you are not looking for cases, you are not going to find any cases. How can the government know that there is no community transmission, when they are not testing enough people?”
Vidya Krishnan is a health journalist based in Goa. Her first book, on the rise of antibiotic resistance and the threat to global health security, is slated to be published in 2020.