COVID-19: steps taken by GoI
In continuation of the statement made by me in Rajya Sabha on 7th February and Lok Sabha on 10th February, I would further like to update the Hon’ble members on present situation related to the outbreak of novel Corona Virus Disease and the actions taken by the Government of India.
As mentioned earlier, Coronaviruses are large group of viruses that cause illness in humans and animals. Rarely, animal corona viruses can also evolve and infect people and then spread between people such as has been seen with Severe Acute Respiratory Syndrome(SARS) in 2003 and Middle East Respiratory Syndrome (MERS) in 2014.
Since reporting of an outbreak of Novel Coronavirus on 31st December, 2019 in China, a large number of cases have been reported across all provinces of China and other parts of the world including India. WHO has named the novel coronavirus disease as COVID-19.
As on 4th March, a total of 80,270 confirmed cases and 2981 deaths have been reported in China. Though the daily confirmed cases and deaths have shown a downward trend in China, still new cases are being reported from Hubei province and Wuhan city, the epicenter of the outbreak. A total of 12,857 confirmed cases and 220 deaths have been reported outside China from 78 countries (including Hong Kong, Macao and Taiwan). Among these 30 countries have reported local transmission.
World Health Organization (WHO) has declared this outbreak as a “Public Health Emergency of International Concern” (PHEIC) on 30th January 2020 and raised the level of global risk to “very high” on 28th February, 2020. Though WHO has not declared COVID-19 to be Pandemic, it has asked the countries to remain prepared. It is worth highlighting that India initiated required preparedness and action at field level since 17th January itself, much before the advice from WHO.
Once a person is exposed to the infection, the disease may develop anytime between 1-14 days. The main symptoms of novel corona virus disease are fever, cough, and difficulty in breathing. All suspected or probable cases of COVID-19 must be treated in isolation with barrier nursing and universal precautions to prevent the further spread of disease.
In our country, as on 4th March a total of 29 positive cases have been reported so far. Of these 3 cases were reported in Kerala earlier, who have since recovered and have been discharged already. Since last 3 days, new travel related cases have tested positive. These include one in Delhi (having travel history of Italy) and Telangana (having travel history from Dubai and contact history from person from Singapore). Both are clinically stable. Six more cases have tested positive in Agra, Uttar Pradesh having contact history with case in Delhi. Required action as per Cluster Management plan has been initiated. Further, an Italian Tourist & his wife have tested positive in Rajasthan. 14 other accompanying tourists in this group and their Indian bus driver tested positive on their return to Delhi. All of them are reported to be stable. A recent positive case has also been reported in Delhi yesterday (having travel history from Italy) and is stable.
The ever increasing magnitude of this outbreak globally calls for a concerted effort by not only health but all sectors of Government. Honourable Prime Minister is personally monitoring the preparedness and response on a regular basis .Government of India has initiated a series of action to prevent entry of the disease and to contain it. I am daily reviewing the situation. A Group of Ministers consisting of Minister of External Affairs, Minister of Civil Aviation and Minister of State for Home Affairs, Minister of State for Shipping and Minister of State for Health & Family Welfare chaired by me have been constituted to monitor the situation. The Group of Ministers has met four times since its inception on 3rd February, 2020. Cabinet Secretary is taking regular reviews with all related Ministries of Health, Defence, Ministry of External Affairs, Civil Aviation, Home, Textiles, Pharma, Commerce and other officials including with State Chief Secretaries. My own Ministry is constantly reviewing the evolving scenario. Video Conferences are being held with States every other day.
Government of India has also taken several measures to control the risk of novel Corona virus infection spreading to India. Our First Travel Advisory was issued on 17th January 2020 and as situation is evolving, the travel advisories are accordingly getting revised. Presently it prescribes,
- All regular (sticker) Visas/e-Visa (including Visa on Arrival for Japan and South Korea) granted to nationals of Italy, Iran, South Korea, Japan and issued on or before 03.03.2020 and who have not yet entered India, stand suspended with immediate effect.
- Regular (sticker) visa / e-Visa granted to nationals of Peoples Republic of China, issued on or before 05.02.2020 were suspended earlier. It shall remain in force.
- Regular (sticker) visas/e-Visas granted to all foreign nationals who have travelled to Peoples Republic of China, Iran, Italy, South Korea and Japan on or after 01.02.2020, and who have not yet entered India stand suspended with immediate effect.
- Diplomats, officials of UN and other International bodies, OCI cardholders and Aircrew from above countries are exempted from such restriction on entry. However, their screening at point of entry is compulsory.
- Passengers of all international flights entering into India from any port are required to furnish duly filled self-declaration form (including personal particulars i.e. phone no. and address in India) and travel history, to Health Officials and Immigration officials at all ports.
- Indian citizens are advised to refrain from travel to China, Iran, Republic of Korea, Italy & Japan and advised to avoid non-essential travel to other COVID-19 affected countries.
Screening of passengers was initiated in the country since 18th January 2020. Initially airports at Delhi, Mumbai, Chennai, Kolkata, Bengaluru, Hyderabad and Kochi were covered and subsequently expanded in a total of 21 airports. As per the evolving situation, initially Universal Screening was taken up for all passengers coming via direct flights from China, South Korea, Japan, Iran, Italy, Hong Kong, Vietnam, Malaysia, Indonesia, Nepal, Thailand and Singapore. Since yesterday directions have also been issued for Universal Screening for all international passengers coming in the country. Signages have been displayed at prominent places in airports and ports, In-flight announcements are being made and self -declaration forms are being filled up by all passengers. As on 4th March, a total of 6241 flights have been screened covering a total of 6,11,167 passengers. Teams of Specialist doctors were sent to all the airports to ensure effective screening and arrangement for isolation in the attached hospitals.
Screening of passengers has also been initiated in 12 major seaports and 65 minor ports in the country to identify passengers & crew coming from China and to isolate them in case they are found symptomatic. As on 4th March, 16,076 persons have been screened at the ports.
Pangolins claimed as outbreak source
Two researchers at the South China Agricultural University in Guangzhou have suggested that pangolins — long-snouted mammals often used in traditional Chinese medicine — are the probable animal source of the coronavirus outbreak.
Shen Yongyi and Xiao Lihua reported at press conference on 7 February that they had identified the pangolin as the potential source of the virus, named nCoV-2019, based on a genetic comparison of coronaviruses taken from the animals and from humans infected in the outbreak.
The identity of the animal source of nCoV-2019 has been one of the key questions that researchers have been trying to answer. Scientists have already suggested that nCoV-2019 originally came from bats, on the basis of the similarity of its genetic sequence to those of other known coronaviruses, but the virus was probably transmitted to humans by another animal.
Researchers say that the suggestion that pangolins spread the coronavirus to people seems plausible — but caution that the researchers’ work is yet to be published.
Government has initiated screening in all integrated check posts with bordering countries in collaboration with states of UP, Uttarakhand, West Bengal, Sikkim and Bihar and Seema Shastra Bal (SSB) and Land Port Authorities. Gram Sabhas have been conducted in villages adjoining the borders to create awareness amongst people about the disease and precautions to be taken in collaboration with Panchayati Raj Ministry. Eight Central Teams visited the bordering villages in States of UP, Uttarakhand, West Bengal, Sikkim and Bihar to review the activities at the border crossing, the conduct of Gram Sabhas and risk communication to the community. A total number of 3823 Gram Sabhas have been conducted and 11, 20,529 people have been screened at the border check post.
In view of the continuing lock down of the Hubei Province in China, the Government of India decided to evacuate the Indian students and other professionals working in Wuhan and neighbouring cities in the Hubei Province. In a coordinated operation with Ministry of Civil Aviation, Air India, Ministry of Health and Family Welfare, two Special Air India flights were operated between Delhi and Wuhan on 31 January and 1 February 2020 that brought back a total of 654 passengers that included 647 Indian citizens (including two Indian Embassy officials who were on the ground in Wuhan to coordinate the evacuation operation) and 7 Maldivian nationals. These evacuees were kept in Army Quarantine Centre at Manesar and ITBP Camp at Chhawla. All these evacuees were tested after 14 days and on being found negative, discharged on 18th February, 2020.
Further, Indian Air Force, on 26th February 2020 and evacuated a total of 112 people from Wuhan which included 76 Indians and national from Myanmar, Bangladesh, Maldives, China, South Africa, USA and Madagascar. The evacuees reached Delhi on 27th February morning and are kept at ITBP camp for quarantine for a period of 14 days as per protocol. I am happy to inform that they have all tested negative so far and are stable. This flight also had carried Personal Protective Equipments, disposables and medical equipments which was given as a good-will gesture to China from Indian government.
The Indian Embassy and Consulates are also in regular contact with the Indian Community in other parts of China and is keeping a constant track of their well-being.
Another evacuation was successfully carried out by Air India, by bringing back 124 people on 27th February morning including 5 foreign nationals who were on broad the COVID-19 infected Cruise Ship Diamond Princess from Port of Yokohama, Japan. They are kept in Army Facility at Manesar for 14 days quarantine presently. I am happy to highlight that even these evacuees have tested negative and are stable.
Regular surveillance has been initiated across the country for all cases having travel history from all major COVID-19 affected countries and for people having contact with such persons and having fever, cough or breathlessness. Through Integrated Disease Surveillance network all such persons are tracked and as on 4th March, a total of 28529 persons were brought under community surveillance and monitored. The state surveillance officers, district surveillance officers and rapid response teams of health professionals under the leadership of state Health Secretaries are monitoring all such people on a daily basis. Sufficient isolation beds have been made available in the tertiary facilities across the country to manage any outbreak.
Ministry has issued guidelines to support states on Surveillance and contact tracing, Surveillance at Points of Entry, Laboratory samples collection, packaging and transport, Clinical management protocol and Infection prevention and control in healthcare facilities. To ensure availability of critical items like Personal Protective Equipments (PPE) & N95 masks, the exports of the same was also restricted. A buffer stock of personal protective equipments & N95 masks is maintained by states as well as Union Government.
National Institute of Virology, Pune is the nodal Laboratory. As part of ICMR’s preparedness for emerging/ re-emerging infectious disease, NIV, Pune has established capacity for molecular diagnosis of COVID-19. Next generation sequencing is also established. Testing of clinical samples has also been initiated in 15 more laboratories. Another 19 laboratories are being prepared to test samples to ensure adequate geographical spread across the country. The network is being further expanded.
Risk communication material has been prepared and is widely disseminated even in regional languages through states. Required awareness in community is ensured through technical briefings by experts in radio and Television. Daily Press briefing is being held by Ministry of Health and information is being shared through social media. A 24×7 Control Room is operational with call centre number as 011-23978046. So far, more than 9200 calls have been attended including 667 international calls.
Government of India is in regular touch with WHO headquarters, regional office and country office to get updates on evolving scenario.
Our focus is on adherence to core capacities for disease preparedness and response which include surveillance, laboratory diagnosis, hospital preparedness, logistics management, capacity building of health care staff and risk communication to the community. The scale and extent of our interventions have increased in alignment with the evolving situation of COVID-19 across the world and India in particular.
With the increasing global spread of the diseases, we are confronted with new challenges. The contact tracing of positive cases requires tracing of hundreds of contacts in multiple locations and monitoring their health. Similarly, the cases in Agra being transmitted to family members by the confirmed case has necessitated putting up a containment plan to contain the cluster of cases in Agra.
Another major area of concern is Indian pilgrims and students stranded in Tehran and Quam, Iran, epicentres of the Iran Covid-19 outbreak. Government of India is following up with Iran authorities for their well-being and to tie up evacuation as per need.
In addition to manage travel related cases, additional challenge is to contain clusters due to local transmission that requires highly resource intensive containment operations. We have provided the Containment Action Plan to all the States. A national level training workshop has been planned for all the states and hospitals from other Ministries on COVID-19 management on 6th March 2020 which will then be taken up to district level. Senior Officers of the Ministry have been deputed to States and UTs to review their preparedness and provide required guidance in the containment efforts.
We have designated District Collector as the nodal officer at field level for containment operations. States have been guided in terms of identifying containment zone, buffer zone and preparation of micro plan to ensure effective active and passive surveillance and contact tracing through inter-disciplinary teams in the areas where cases are located.
I want to inform this house that the Government is taking all necessary measures to prevent spread of the COVID-19 in India.
(The text is based on the statement of Union Health Minister Dr. Harsh Vardhan in Rajya Sabha)