Amidst the chaos, sorrow and outrage caused by the global Coronavirus Pandemic, people have started questioning some of the actions taken by the World Health Organisation as well as China’s notorious tendency to play things close to the chest. Looking back at the barrage of news reports through the lens of hindsight, could the WHO have done things differently? Had China been more forthcoming, could the magnitude of the tragedy have been smaller? Complete Coronavirus Coverage
Crux of the Matter
The Ongoing Pandemic It started off as a mysterious pneumonia like affliction in a central province of China called Hubei in December 2019. Three months on, it has engulfed the world in a pandemic of proportions not seen for a century. The novel Coronavirus disease has affected almost a million people worldwide and dealt painful choking death to more than 40 thousand people. As of 1st April, India has seen more than 1700 cases and 50+ deaths because of COVID-19.
China, where the virus first reared its ugly head, has seen close to 80,000 cases with 3,000 fatalities. These numbers have been stable since the past month, whereas the numbers have shot up in USA and Europe. The past week saw the cases in USA climb steeply to almost 200 thousand with 4000+ deaths. Italy and Spain have seen 12000+ and 9000+ deaths respectively. Worldwide, countries have had to resort to strict country-wide lockdowns to try to stem the spread of the contagion. The global economy has come to a grinding halt and the world has entered a recession.
Could WHO Have Done More? December 2019 saw the emergence of this virus in Wuhan in Hubei province of China. Doctors and researchers saw similarities with SARS. As it turned out, it was a new strain of the SARS causing coronavirus. Initially China, allegedly, tried to suppress the spread of information even as the Chinese government tried to come to grips with the entire situation. On 31st December, the Chinese authorities finally informed the WHO about the outbreak of the disease. At this time there were around 30 cases in China.
Early January saw the cases double every week. Wuhan is a central transport hub in China. This coupled with the upcoming Chinese New year related travels, saw the virus spread to other parts of China including Beijing and Shenzhen. On 10th January, WHO put out a general travel advisory for travelers in Wuhan. In hindsight, data shows that there may have been more than 6,000 patients impacted by 20th January.
Around this time, on 14th January, the WHO made a statement that there was “no clear case of human to human transmission” based on preliminary research by Chinese authorities. Notably, Taiwanese authorities had been warning of possible human to human transmission since 1st January.
13th January saw the first case outside China, in Thailand. On 20th January China confirmed human to human transmission had already happened.
On 24th January, WHO recommended entry and exit screenings at airports while advising against blanket travel restrictions. In 3 days it revised its stance and judged the potential global risk to be high and in another 3 days, on 30th January, declared it a a “Public Health Emergency of International Concern” (PHEIC). By then the world had already seen 10,000 cases.
A week earlier, on 23rd January, a WHO committee was divided on whether to declare a PHEIC, with chief Dr Tedros Adhanom Ghebreyesus taking a call to wait and watch – at that time the confirmed cases were around 1000.
On 2nd February, when the cases had doubled to 20,000, WHO chief Dr Adhanomurged countries not to close borders with China.
By 15th February there were already cases in Europe including in Italy, France and Spain – the global count had reached 70,000, mostly in China. On 24th February, when the global case count crossed 80,000 with more than 2500 fatalities, Dr Adhanom warned of a possibility of a global pandemic and WHO raised the global risk assessment to “very high” on 27th February.
The outbreak was declared a global pandemic on 11th March. By then the global cases had crossed 125,000. There were close to 5000 confirmed deaths, 3000 of which were from China. Two days later, and almost 3 months after the outbreak began, Europe was deemed the new epicentre. Within the next 3 weeks the case count would cross 900,000, the death toll would cross 40,000.
WHO Chief’s Chinese Connections? The coronavirus global crisis has brought the WHO chief Dr Tedros Adhanom into the global spotlight – not all of it is flattering. Dr Tedros of Ethiopia, happens to be the first non-medical Director-General of WHO – the Dr signifies his PhD.
He has previously been accused of covering up multiple cholera epidemics as health minister of Ethiopia. Reports suggest, Chinese diplomats had used influence and money to campaign for and beget Dr Tedros the post of Director-General of WHO. He had beaten UK’s Dr David Nabarro to the race. China had reportedly influenced a lot of developing countries’ representatives to vote for Dr Tedros. China has over the years been building a growing industrial presence in Africa and has been flexing its geopolitical muscle at the global scale in UN and its subsidiary bodies.
During the on-going pandemic, Dr Tedros has come out openly in praise of Beijing’s measures, actions and openness to share information even as the western world has accused China of silencing whistleblowers and critics. Other members of the WHO emergency committee have criticised China for obfuscation and delayed reporting of data. He has also seemingly delayed travel restrictions to China and defended China against accusations of opaqueness.
An online petition demanding his resignation has been supported by more than 600,000 people.
WHO Handled SARS-1 In 2003, a SARS outbreak had happened in China. This was caused by a previous version of the coronavirus. Back then, WHO chief Dr Brundtland was quick to put out travel restrictions on China. He had also been a sharp critic of China’s policy of trying to cover up the outbreak through media manipulation, news censoring and arresting whistleblowers. Back then China had delayed a WHO team from traveling to the epicentre in Guangdong province. The outbreak was effectively contained in a 6 month span, with death count of less than 1000.
WHO – The World Health Organization is a specialized agency of the United Nations responsible for international public health. It is part of the U.N. Sustainable Development Group. The WHO Constitution, which establishes the agency’s governing structure and principles, states its main objective as ensuring “the attainment by all peoples of the highest possible level of health.” It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide. More Info
SARS Outbreak – The 2002–2004 SARS outbreak was an epidemic involving severe acute respiratory syndrome (SARS) caused by SARS-CoV. Prior to the 2019-20 coronavirus pandemic, the outbreak was first identified in Foshan, Guangdong, China in November 2002. Over 8,000 people from 29 different countries and territories were infected, and at least 774 died worldwide. The World Health Organization declared severe acute respiratory syndrome contained on 5 July 2003, however several SARS cases were reported until May 2004. More Info
Tedros Adhanom Ghebreyesus is an Ethiopian politician and academic who has been Director-General of the World Health Organization since 2017. He previously served in the Government of Ethiopia as Minister of Health from 2005 to 2012 and as Minister of Foreign Affairs from 2012 to 2016. More Info
On 24th March 2020, Prime Minister Narendra Modi announced an unprecedented complete lockdown of India for 21 days to mitigate the spread of the worldwide pandemic, coronavirus. The world has seen more than 4 lakh cases in the first quarter of 2020, while India has seen over 600 cases.
Crux of the Matter
India saw its first Coronavirus case on 30th Jan 2020. The case count touched 100 after 44 days, after which the cases have doubled roughly every 4-5 days. As of 25th March the case count has crossed 600 with 11 deaths, 55 days after the first case.
This exponential rise in cases has caused a sense of panic among the people. So far the world has seen over 4 lakh cases and around 20,000 deaths. The virus which originated in China in November 2019, has travelled across the Silk Route, wreaking havoc in Italy, Spain, UK and the rest of Europe along with Iran. It has now spread in the USA and India, and has also affected China’s neighbours such as South Korea and Japan. In a massively globalised world, a virulently contagious disease is spreading like wild fire. Countries across the world including China, Italy and Spain, the 3 worst hit countries in terms of death toll, have resorted to locking down affected areas to contain the spread of the virus.
PM’s Appeal Although India hasn’t seen nearly as many cases as Europe, China or USA, given the country’s size and population density, Coronavirus poses a very potent threat to this country.
To stop the spread in its tracks, the Prime Minister has decided to implement a nation wide lock down of 3 weeks starting from 25th March. PM Modi made a special televised address on 24th March, and conveyed the seriousness of the situation in simple terms. He requested the citizens to stand together with discipline against this potential calamity.
Earlier on 22nd March Modi had announced a Junta Curfew, a self imposed curfew by the citizenry, which was observed by most of the country. Since then, different states had started announcing various lockdown measures till the end of March. Since the Junta Curfew day, streets across India have become empty with people staying locked up in their homes.
How will we lock down? In the upcoming weeks, all non-essential places of business will be closed. Police forces have been mandated to ensure that people stay at home. The government has promised the citizens that it will try to reduce the inconveniences of the general population while taking specific steps to combat the spread of coronavirus. PM Modi has already announced a Rs 15,000 crore package for strengthening the medical infrastructure of the country while the FM has announced a slew of relief measures to ease the fiscal burden on the working class.
To make the lockdown manageable, essential services such as groceries, medical stores, hospitals, police stations, fire stations, etc will stay open. Government will function with reduced capacity of work force. The government will not be cutting wages of its employees and has appealed to private business owners to follow suit. By and large, the prime minister’s appeal has been met with support by the populace as well as the industry.
Exponential Explosion At present, no vaccine or medicine has been confirmed as an antidote for the virus, although certain malaria and HIV medications have worked in treating some patients. Currently, the overall fatality rate across the world lies at 4% on the optimistic side. In cases that have been closed (i.e. the cases whose outcome has been determined), the worldwide fatality rate is currently 15%. Italy, the worst hit country so far, has a closed case fatality rate of 45% and overall fatality rate of 10%. (Here overall fatality rate is the total percentage of active and closed cases that resulted in deaths.)
The virus is transmittable across humans and is as contagious as flu. Every new patient increases the chance of spread. Also the symptoms stay dormant for 1-2 weeks, which means that an affected person may spread it without knowing about it. All of this increases the probability of transmission. The contagiousness of the disease makes it spread exponentially – assume 1 person transmits to 2 people, those 2 can transmit to 4, 4 to 8, 8 to 16 and so on and so forth. Given the asymptomatic first week, every carrier can transmit to many more people which would just increase the rate of spread.
This can be seen in the case data as well. It took 87 days to spread to the first 50,000 people. It doubled to 100,000 in another 23 days, then 200,000 in another 12 days and 400,000 in another 6 days. After the first 50,000 cases (which were mostly in China) once it spread out, the cases have doubled in half the time for every doubling event. This kind of exponential explosion can be curbed by pre-emptively restricting the interaction of humans – and hence, governments across the world are resorting to nation-wide lockdowns.
Exponential growth is a specific way that a quantity may increase over time. It occurs when the instantaneous rate of change of a quantity with respect to time is proportional to the quantity itself. In the long run, exponential growth of any kind will overtake linear growth of any kind. A virus (for example SARS, or smallpox) typically will spread exponentially at first, if no artificial immunization is available. Each infected person can infect multiple new people. More Info
On 13 March 2020, Indian PM Narendra Modi asked the leaders of the SAARC nations to assemble to figure out a joint strategy to deal with the Coronavirus pandemic. The group of leaders convened on March 15 and discussed measures including joint research, combined ministerial task forces and an emergency contribution fund. India has offered to seed the plan with $10 million.
Crux of the Matter
“Prepare, but Don’t Panic” The emergency SAARC video meeting called by PM Modi was attended by Presidents of Sri Lanka, Maldives and Afghanistan, Prime Ministers of Nepal, Bhutan and Bangladesh, and Health Minister of Pakistan.
Modi stressed the importance of SAARC nations to be prepared to fight the contagious virus given that the region houses one fifth of humanity. At the time of the meeting, the region had seen less than 200 cases whereas the rest of the world (led by China, Middle East and Europe) had seen more than 150,000 cases. Other SAARC leaders concurred with India’s approach and pledged to pool resources and task-forces to put up a united fight in terms of research, information sharing and diplomatic co-ordination. India also started a fund with a seed of $10 million to be used as a common resource by all SAARC countries to fight off the contagion.
Indian airport authorities have been conducting screening tests on passengers from January itself while slowly ramping up travel restrictions. Currently, India has banned pretty much all entries into the country from abroad. Earlier India had canceled in-bound visas from China and other affected areas.
The Indian government has also readily deployed it’s air force to evacuate its citizens from Coronavirus hit places. In February, India had evacuated not just Indian but Pakistani students as well who were stranded in Wuhan – the epicentre of the outbreak. Last week India evacuated its citizens from Iran, where the contagion has wreaked havoc since early 2020.
India’s humongous population always poses a logistical challenge to any scaling problem. India has been pre-emptively preparing its medical facilities to prepare for an outbreak since February. Major cities in India including Delhi, Mumbai, Hyderabad and Bengaluru have set up isolation wards in multiple hospitals and prepared labs for testing. Further basic precautionary guidelines are being communicated by the government on all channels including a caller tone before every telephone call.
British Media’s Petty Colonial Hangover Even as the entire globe was gripped in panic over the pandemic, certain British news agencies went out of the way to criticize India’s “under-preparedness” for dealing with the pandemic while simultaneously praising measures taken by China. To put this hypocrisy into perspective, UK which has 5% of India’s population has seen over 1,500 cases and 55 deaths, whereas India has so far seen around 129 cases and 3 deaths (as of 17 March 2020). China in comparison has seen over 80,000 cases and more than 3,000 deaths due to coronavirus.
The British government has recently been universally panned for delaying precautionary bans on gatherings in a bid to try and develop “herd immunity” by allowing “controlled spread of the disease”.
Impact Update As of 17th March, India has recorded 129 confirmed cases with 3 deaths. All the deceased were elderly, aged 76, 68 and 64 respectively. This is in line with data that suggests a high fatality rate (over 10%) for people above 60 and the fact that the median age of deceased patients in Italy is 81.
In a bid to arrest the further spread of the disease, government authorities have put restrictions on gathering of people. Universities and schools have declared holidays. Many offices have followed suit, with a lot of companies opting to promote work-from-home among their employees. Indian researchers have also made headway in treating patients and researching the pathogen to develop vaccines.
SAARC – The South Asian Association for Regional Cooperation (SAARC) is the regional intergovernmental organization and geopolitical union of states in South Asia. Its member states are Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka. SAARC was founded in Dhaka on 8 December 1985. Its secretariat is based in Kathmandu, Nepal. More Info
Quarantine is a restriction on the movement of people and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been exposed to a communicable disease, but do not have a confirmed medical diagnosis. The term is often used synonymously with medical isolation, in which those confirmed to be infected with a communicable disease are isolated from the healthy population. More Info
Pandemic is a disease epidemic that has spread across a large region, for instance multiple continents, or worldwide. A widespread endemic disease with a stable number of infected people is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu. Throughout history, there have been a number of pandemics of diseases such as smallpox and tuberculosis. One of the most devastating pandemics was the Black Death, which killed an estimated 75–200 million people in the 14th century. The current pandemics are HIV/AIDS and coronavirus disease 2019. Other notable pandemics include the 1918 influenza pandemic (Spanish flu) and the 2009 flu pandemic (H1N1). More Info
This week saw the Coronovirus epidemic spread rampantly across Europe and Middle East even as it reared its head in India. This led to the US benchmark bonds bottoming out as global finances took a hit because of fears of a pandemic. US and Taliban decided to put an end to their sometimes covert, often overt war of the past 2 decades – but all signs point towards this becoming a flashback of Vietnam. Back home, GST collections kept showing positive growth while the behind-the-scenes machinations of the 2020 Delhi riots unravelled over the week leading to controversies and conspiracies.