Hyderabad: Union Health Minister Dr Harsh Vardhan allayed fears on the lack of testing in the country and shortage of PPE kits for the frontline medical workers, in an exclusive interview with ETV Bharat. Harsh Vardhan said that India is producing three lakh PPE kits in a day and around 450 labs are capable of conducting 95,000 tests daily.
Q 1. These are tough times for all of us, everyone wants to know where do we in India stand now. Is your government confident that the situation is under control?
A: In the last months we saw preemptive, proactive and graded response to this outbreak. A GOM headed by Health minister, direct monitoring by PM, screening almost 20 lakh people on our borders and putting almost 10 lakh people on community surveillance. We followed it with innovative methods like Janata curfew and the bold decision of lockdown.
At the end of this proactive strategy, India is well placed when we compare our progress with the rest of the world. We are being watched by the whole world. India has least mortality rate, we have a doubling date of 11-12 days, over 30 % of our patients have recovered and of course, within 4 months we have expanded our capacity to over 450 labs in the country with a daily capacity of 95,000 tests.
Q 2. The COVID 19 cases are increasing leaps & bounds, is the rise in a number of cases more evident with the respective increase in the corresponding test centres?
A: There is no significant increase in COVID-19 cases. The graph looks quite steady. Moreover, we have tested 85,000 people in India in the last 24 hours. When we started testing we started with 2,000 people in a day.
We are trying to search cases of Severe Acute Respiratory Infections (SARI) and Influenza-like illness (ILI) in unaffected districts also. States are also responding so well.
We have around 50,000-60,000 cases in the country in the last 3 months compare this number with cases of small countries. They have cases in lakhs. We have a mortality rate of about 3% while the global average is about 7-7.5%. The so-called surge in the cases is all because of aggressive searches, testing.
Q 3. What is the plan of the government with regards to testing centres? How many testing centres are you planning to have by the end of this month? What is the rationale behind India’s current testing strategy and how is it adequate?
A: We used to send the samples to the US for virology testing. We only had one lab in January when the first case of the virus was reported. Now, in the second week of May, we have expanded and augmented our facilities to 472 labs in the whole country. 275 labs are from the government sector.
So far we have developed test capacity of 95,000. This strategy is based on the advice of a group of experts guided by the ICMR. There are clear advice and guideline on who is to be tested.
Q 4. There is a huge gap in figures being given by few states compared to the central government or the health ministry figures?
A: No discrepancy (in COVID numbers) as the process is dynamic starting from tracing of suspected patients to report being generated in a laboratory. The reports are then transferred to the states, Integrated Disease Surveillance Programme (IDSP) and ICMR.
Ultimately, all data from all sources are collected in the health ministry. Being a dynamic activity, you may see different numbers in different portals. But when we collect everything, there is no discrepancy, no difference and everything is thoroughly transparent.
Q 5. What are the current hotspots that you are focusing on?
A: The whole country is divided into three: Red, Orange and Green. Classifying the country into districts, roughly 130 districts are hotspot districts. There are 284 non-hotspot districts and over 319 remain unaffected. We focus also on unaffected districts.
Within the hotspots, the strategy is different based on small/big cluster, small/big outbreak. There are micro-plans for containment zones including house-to-house surveys.
Local teams, Rapid Response teams, surveillance teams, medical college and central government teams work together in these hotspots, under the guidance of experts.
Government clear on such places, strategy and the implementation of the strategy.
Q 6. How are states responding to the Centre’s call for the implementation of public health measures? What are the challenges?
A: States have been following the guidelines we issue from time-to-time. Regularly we are monitoring, talking to all state health ministers. We are trying to support them in all possible ways, in ways such as supplying PPEs, medicines, N95 masks, ventilators and by giving expert advice to set up labs and ramp up infrastructure.
In hotspots areas, we are sending a team of experts, surveillance teams and making sure good quality support to the health systems in the country.
Challenges are big slums in big cities, a big influx of foreign travellers, huge clusters where norms of social distancing and lockdown cannot be implemented in its spirit.
We had the challenge of handling migrant labourers, Tablighi issue and now the expats coming from abroad.
Q 7. What is the alternative for rapid test kit which has been recently taken back from the hospitals after some issues regarding its quality were raised?
A: As far as testing is concerned, we have RT-PCR testing. When this antibody testing was advocated, we also thought of giving the benefit of this for surveillance and epidemiological purposes.
We tried to procure kits at the fastest possible pace. When we found that they were ineffective, we immediately rejected their use. Now the present situation is such that, we are in the process of developing indigenous test kits.
ICMR has also developed the Elisa test kit, which is going to be the substitute or supplement to antibody test kits.
Q 8. After lockdown 3.0 most of the migrant workers and students will be returning to their home place, even the process has started. In this regard what is the strategy of the Union government vis a vis health administration & preparedness as a mass movement of people could increase the vulnerability of the respective states towards Covid19?
A: The MHA has done its homework. They have devised a comprehensive guidelines on how students, workers and those in need, to be smoothly transferred to their respective home states.
It involves movement of lakhs of human beings. States will experience a strain in the system which is already overburdened with the health scenario. If we act judiciously and with precision, we will be able to take care of the challenge also.
Q 9. Doctors across the country are concerned about the shortage of personal protective equipment. How is the ministry planning to augment PPE supplies?
A: In the initial stages, there was a shortage of PPEs. But COVID-19 episode has turned out to be a blessing for the Make in India movement, with over 100 tested and certified manufacturers making 3 lakh PPE kits in a day. We are distributing all kits to the states. They are finding it difficult to store them! I don't think it is an issue at this particular time.
Q 10. Apart from private laboratories, how is the government planning to involve the private health care sector in managing COVID-19?
A: During the earlier stages, I called private doctors and the association of private hospitals and had appealed them to help the government. They responded positively.
I would like to appeal to private sectors that they too have a professional, social responsibility in this moment of crisis. Private hospitals should introspect their role at the moment.
Q 11. How hopeful are you of being able to contain and mitigate it? Do you have any message for the nation?
A: Viruses will keep coming and affect humanity in some form or the other. There have been only two viruses which have been completely irradicated: smallpox and polio (at least from Southeast Asia region). Rest of them are there in the world. They come and go in epidemic proportions sometimes.
Government's effort is to handle current COVID-19 attack and in future, if we follow social distancing, hand hygiene, respiratory hygiene and using masks, it will help strengthen individual health systems and thereby in handling many more diseases in an efficient manner.
Once the lockdown opens gradually, we have to contribute positively to rebuilding our economy.
