Don’t pin hopes on summer, social distancing still best Covid ‘vaccine’, says Harsh Vardhan

In an exclusive interview to ThePrint, Union Health Minister Harsh Vardhan also said the government is aiming to test one lakh people per day by 31 May.

File photo of Union Health Minister Dr Harsh Vardhan | Twitter

New Delhi: There isn’t strong enough evidence that indicates that the high temperatures in summer could help limit the spread of coronavirus, said Union Health Minister Harsh Vardhan Friday, adding that countries with hot weather have reported Covid-19 cases too.

“Some people hope that outbreaks of the new coronavirus will wane as temperature rises, but pandemics often don’t behave in the same way as seasonal outbreaks. Many of the largest outbreaks have been in regions where the weather is cooler, leading to speculation that the disease might begin to tail off with the arrival of summer,” he said.

He added that many experts, however, have already cautioned against banking too much on the virus dying down over the summer.

In an exclusive interview to ThePrint, the Union minister spoke about a range of issues related to the current Covid-19 crisis in India and how the government was tackling it.

For instance, he said the government was working on manufacturing more protective gear to plug the shortage of masks and gloves, and was also planning on ramping up testing to a lakh per day in about a month.

He also reiterated that India was not seeing mass community transmission of the virus, technically called stage three of transmission, and explained that the government had initially decided on a 21-day lockdown to account for the 14-day incubation period of the virus plus a week for the infection to die out. This way, the lockdown would ensure person-to-person transmission was limited while the virus passed from “infection to cure”.

On testing

Refuting talk that the government was not testing enough people to tackle Covid-19, Harsh Vardhan said they were looking at ramping up testing to carry out at least one lakh tests per day by May-end.

The current capacity of testing is 55,000 per day and 5,75,067 tests have been done as of 24 April, Harsh Vardhan said.

“With the scaling up of the testing, it is envisioned that we shall reach optimal levels of case detection. We intend to do at least one lakh tests per day by 31 May 2020,” he said.

The minister added that the current testing strategy is customised to India based on the “transmission typology” (the type of virus transmission seen in the country), and prioritises testing individuals who are primarily at risk.

“We are making sure that quality of the testing kits and the biosafety of the testing labs are maintained so as to avoid any issues related to unreliable results or iatrogenic transmission (illness caused by medical examination) among healthcare or laboratory staff. Given the population of India, we have been scaling up in a manner which can be sustained while we build up capacity for testing and management of positive cases,” he added.

Social distancing and lockdown remain the most potent social vaccine right now, he said.

BCG vaccine for Covid treatment

The health minister said he is aware of the study that states the BCG vaccine could be a tool to fight Covid-19, but added that one can’t draw a conclusion based on this.

“I am aware of the study, but we need to study the evidence critically before leaping to any conclusion. It is a correlation study which does not prove causation. The country-level data has been used for analysis and conclusion. What may hold true at the aggregate or population level may not hold true when the individual level heterogeneity is considered,” he said.

The BCG vaccine is primarily used against tuberculosis in many countries, including India.

“The idea that BCG which protects against a bacterial lung disease will also confer protection against a viral lung disease needs further pathophysiological clarification. Till definite evidence is generated, these assertions will remain hypothesis-generating rather than policy-altering,” he added.

‘Govt has faith in ayurveda, homeopathy’

When asked if it is advisable to use ayurveda and homeopathy to treat coronavirus, he said the government has a “very open mind” on the subject.

The Indian Council of Medical Research (ICMR) and the Ministry of AYUSH are already in the process of developing research protocols for establishing and validating the claims of various ayurveda and homeopathic practitioners for Covid-19 solutions. “Worthy proposals sent to us are being shortlisted,” he added.

The ministry has already issued guidelines on how to improve body resistance and strengthen immune capacity, the minister said.

“The Hon’ble Prime Minister has, time and again, appealed to people to follow the guidelines. We have full faith in the overall strength of ayurveda and homeopathy as definite systems of medicine,” he said.

India not at stage 3 transmission

Denying that India has reached stage 3 of community transmission, Harsh Vardhan said there is no clear, well defined, globally accepted definition of community transmission.

“There is no doubt about it that the novel coronavirus outbreak in India has not reached the community transmission stage or stage 3. Right now, India has mostly cases related to international travel, or their contacts.

“Some sporadic cases have also been seen in some clusters because some travellers concealed the information, to avoid quarantine, and moved freely till they developed symptoms, but by then, they had already done the damage. Containment strategies are being used to take care of such cluster cases,” the minister said.

He went on to explain that the government had first called for 21-day lockdown because according to the current evidence, people can catch Covid-19 from others who have the virus.

“Most estimates of the incubation period for Covid-19 range from 1-14 days, most commonly around five days and given another week for the residual infection to die out, the lockdown of 21 days will allow the virus to pass from incubation to cure and will thus reduce the spread of the disease by breaking the chain of transmission,” he said.

Indian companies to produce PPE

Harsh Vardhan said the health ministry had issued guidelines on rational use of personal protective equipment (PPE), stating who should wear which PPE, depending on the nature of job and placement. “This will allow rational use of PPE and will prevent wastage. Exports for these items have also been banned since 31 January,” he said.

Pointing out that the availability of PPE has been a problem worldwide, he went on to say that it got aggravated in India as “the cloth used for manufacturing was imported from China and PPE could not be manufactured locally”.

“With the help of the Ministry of Textile, now we have identified 104 domestic manufacturers for PPE and 10 domestic manufacturers for N 95 masks for local production in India.”

He also denied that there was a shortage of hospital beds, and cited WHO data that says 80 per cent of Covid-19 infections are mild or asymptomatic, 15 per cent are severe, requiring oxygen, and only 5 per cent are critical requiring ventilation.

“It is quite evident that it is only 20 per cent of patients who may require indoor treatment. So far, as isolation beds are concerned, 1,35,370 beds are available in Covid-19 dedicated hospitals and 1,00,876 in dedicated Covid-19 health centers, making it a total of 2,36,246 isolation beds. Similarly, 19,738 ICU beds are available at Covid-19 dedicated hospitals and 9,981 in dedicated Covid-19 health centers, making a total of 29,719 ICU beds exclusively for Covid-19 patients,” he said.

Moving the conversation from hospital facilities to healthcare workers, Harsh Vardhan said the incidents of attacks on paramedical staff were “unfortunate and distressing” and warned that such people will face action under the National Security Act and be charged for the damages caused.

Tablighi controversy

While the lockdown has proven to be effective in India’s efforts to limit the spread of the virus, the Tablighi Jamaat congregation had serious implications across the country.

“Even after the nation was placed under a three-week lockdown, large number of attendees defied social distancing norms and continued to stay at the Tablighi Markaz. Many of these participants travelled to various states and became a key source of transmission and spread of Covid-19 across the country,” Harsh Vardhan said.

The minister said Tablighi links have been found in cases across 24 states, including Andaman and Nicobar, Andhra Pradesh, Bihar, Chhattisgarh, Gujarat, Delhi, Haryana, Jammu and Kashmir, Kerala, Jharkhand, Karnataka, Maharashtra, Madhya Pradesh, Punjab, Rajasthan, Tamil Nadu, Telangana, Uttar Pradesh among others.

The Centre has been coordinating with all state teams and regular meetings are being held with the health ministers to ensure the overall situation is under control, Harsh Vardhan said, but added that “some states unfortunately are politicising the issue and not providing adequate information about the actual state of affairs”.