This is the first coronavirus to reach pandemic levels. For at least 18 months, no vaccine can be market-ready.
On March 11, as COVID-19 spread rapidly outside China with a 13-fold increase in infections detected and the World Health Organisation declared it a pandemic, Secretary General Tedros Adhanom Ghebreyesus offered hope: “If countries detect, test, treat, isolate, trace, and mobilise their people in the response, those with a handful of cases can prevent those cases becoming clusters, and those clusters becoming community transmission.” India, with 70-odd cases, has the advantage, and commendably, the central and state governments have reacted rapidly to the developing pandemic. Equally importantly, they have set aside the acrimony over the CAA-NRC question and pulled together, without the need for external urging, because everyone realises that COVID-19 is everyone’s problem. No visas are being issued, screening is in progress, health education messaging is visible, public gatherings are sharply reduced and there is no sign of the wearying political blame game which generally besets such challenges.
The secretary general has also cautioned that while many nations can avoid the pandemic, the operative verb is not “can” but “will”. The Indian response has displayed political will, but there is no room for complacency. This is the first coronavirus to reach pandemic levels. For at least 18 months, no vaccine can be market-ready. At least until the summer, there will be insufficient information about the behaviour of the organism in the wild. Wisely, Homo sapiens fears the unknown. Until we learn more about the nature of the beast, abundant caution is the only credible prescription. At present, the focus of the response is isolation (including self-isolation) and the maintenance of sanitation barriers. Schools have been closing down, some workplaces are screening staff, and people are discouraged from leaving home without a compelling reason. However, outside the controlled conditions in homes and hospitals, maintaining the patency of the sanitation barrier requires extraordinary vigilance and self-control.
In the case of breaches — a few oversights or accidents are inevitable — the readiness of healthcare facilities would become a serious factor in controlling mortality. The quality of the states’ level of preparedness and the quality of health services varies. While Kerala efficiently controlled the Nipa virus, Uttar Pradesh, the most populous state, has failed to contain annual outbreaks of Acute Encephalitis Syndrome for over a decade. And the capital’s initial failure in the face of seasonal waves of lethal mosquito-borne diseases cannot be forgotten. How much less protected would a rural cluster be, serviced by a poorly equipped primary health centre? If community transmission becomes commonplace, it would become a difficult battle. Hence, the sanitation barrier remains the most reliable epidemiological response. If the government has to resurrect primordial provisions from the era of bubonic plagues to keep it patent, so be it.