The COVID-19 outbreak is not yet an epidemic in India — as of today. From what is happening globally, a huge epidemic, an avalanche, growing bigger week after week, is predictable. Today it is a crisis looming on the horizon, but tomorrow it may turn out to be a disaster of unprecedented proportions.
Culturally we are always optimistic; we do not react fast as most problems, even outbreaks, have a tendency to settle down. So far we have stoically confronted all the new and resurgent communicable diseases that appeared in recent decades. We have shown surge capacity of crisis management during the 2018 Nipah epidemic in Kerala. We handled the Severe Acute Respiratory Syndrome (SARS) scare of 2003 extremely efficiently. The 2009 pandemic influenza H1N1 was also confronted reasonably well. Our weakness in dealing with seasonal influenza is embarrassing: there is no national policy to control seasonal flu. We ignore the high flu death rates reported annually. c
From early February the reality of a very unusual SARS COVID-19 epidemic was known to all Health Ministry officers. In early January only China was known to have the coronavirus, but today more than 100 countries are affected. That speed is about the same as that of the pandemic influenza H1N1 of 2009.
The onerous responsibility of confronting SARS COVID-19 does not rest with the Union Health Secretary who is the administrative head of the Ministry of Health and Family Welfare. It does not rest with the Director of the National Centre for Disease Control (NCDC) unless specifically empowered; The NCDC functions well only when smaller problems erupt in various States. The Director General of Health Services (DGHS) could be the person, but epidemic control is more than health-care service. The DGHS has limited executive powers and there is no competent public health infrastructure under the Directorate. The job of the Department of Health Research and the Indian Council of Medical Research (ICMR) under the unified command of the Secretary Department of Health Research-cum-DG ICMR, is to research all questions identified by the DGHS and the Director of the NCDC. We do need research but priority number one is the control of the epidemic.
The Minister for Health is a key person but this epidemic is more than a medical problem. Many ministries such as those of travel, tourism, industry, education, economics, railways and local governments are all being affected. So this disease avalanche requires responses of unprecedented speed, spread and magnitude.