Mumbai/New Delhi:
It’s the phone calls at all hours of the night he remembers. As swine flu ravaged northern India in 2015, a radiologist working at a hospital in a Delhi suburb said people would call begging for a bed.
That outbreak ultimately infected more than 31,000 people and killed nearly 2,000, as many died waiting for treatment. With the far more infectious novel coronavirus now sweeping the globe — and threatening to take hold in India — the doctor, who asked not to be identified criticizing the country’s preparedness to tackle the pandemic, thinks this time will be much worse.
Cases of Covid-19 in the world’s second-most populous country have ticked rapidly higher the past week, raising alarm over the ability of India, with its fragile health-care system and battered economy, to handle a virus crisis of the magnitude of China or Italy’s. While India has seen 27 deaths and just over 1,000 cases, experts fear the real tally could be much higher and say the disease is already spreading in the community. Authorities say there’s no evidence for this and have not significantly ramped up testing.
Bloomberg News spoke to more than a dozen front-line physicians across India, and while none reported the sort of spike in patients with respiratory ailments that would suggest Covid-19 is already running rampant, all agreed it’s just a matter of time — and that India isn’t ready.
With its densely packed cities and under-funded medical system, India has little margin for error when it comes to the coronavirus.
It’s a reality not lost on Prime Minister Narendra Modi’s government, which ordered the population of 1.3 billion people not to leave their homes for three weeks on March 24, initiating the world’s largest quarantine even as cases numbered only in the hundreds. But there’s concern it still might not be enough, and such a large-scale lockdown will be difficult to implement, particularly in a place where the poor live in close quarters and the social distancing measures being advocated in the west are almost impossible.
Along with the lockdown, India has also acted to curb inbound travelers from overseas. Should these measures fail to halt the virus’ spread, though, epidemiologists say the numbers could be staggering. A University of Michigan-run study predicts the country could have 915,000 coronavirus infections by mid-May, more than the case load for the whole world right now.
“This is just an interval period,” said Anup Warrier, an infectious diseases specialist in the southern city of Cochin. Warrier was alarmed when 14 patients turned up at the private hospital where he works this week with symptoms similar to acute cases of Covid-19. They all tested negative.
“I do not think this lucky streak is going to last much further,” he said.
India acted relatively early to seal off entry points into the country, with international travelers the main vector for the virus’ global spread. That may have stemmed an influx of cases, but the small infection tally — which puts it below places like Finland and Chile — could be because India is not looking hard enough for new cases, with one of the lowest testing rates in the world.
The country had tested just 35,000 people for coronavirus as of Sunday, according to data from the Indian Council of Medical Research, a minuscule portion given its population size. That’s despite 113 local government laboratories and as many as 47 private labs now authorized to process tests.
The U.S., which has also been criticized for being late to ramp up testing, had undertaken 552,000 tests as of March 26, while South Korea, which has contained its outbreak without a mass quarantine, has tested more than 320,000 people.
In viral hot spots like China’s Hubei province, Italy, Spain and now New York, a rapid surge of infections brought a wave of patients to hospitals that exceeded their capacity for critical care. Doctors have been forced to effectively choose who lived and who died through the deployment of scarce resources like ventilators.