Health experts say India missed an early alarm, ignoring a deadly variety of coronavirus


NEW DELHI, June 15 (Reuters)-A veteran public health expert warned India’s top officials in March that a new strain of coronavirus had spread quickly in a district of the province. in the heart of the country and that the outbreak needs urgent attention.

Federal health authorities have failed to adequately respond to that warning, Dr Subhash Salunke, who has 30 years of public health experience in India, Indonesia and the United States, told Reuters.

The variety, now known as B.1.617, caused a catastrophic wave of coronavirus cases in India and from it spread to more than 40 other countries. In May, the World Health Organization (WHO) called it a “different concern,” citing its high transmissibility.

The first impact of the variety was seen months earlier in the Amravati district of the western state of Maharashtra, where health authorities recorded a rapid rise in coronavirus infections in early February, although cases fell elsewhere in India.

Salunke, a WHO official advising the Maharashtra government, said he warned some of India’s oldest health officials in the first of March, speaking on the phone to Chief’s coronavirus chief Minister Narendra Modi, VK Paul, and the head of the National Center for Disease Control (NCDC), Sujeet Kumar Singh.

Salunke told Reuters that he warned Paul and Singh that the virus was showing signs of mutating Amravati, increasing transmissibility, and asked for federal help in sequencing more samples to detect how to behave differently. Reuters did not independently confirm what the talks said.

“Even with someone in public health like me giving them a good warning, they didn’t listen,” Salunke told Reuters.

In response to questions from Reuters, Paul said he spoke to Salunke, but described the conversation as Salunke showed information rather than giving a warning.

He dismissed Salunke’s accusation that he had not listened, saying he had asked India’s National Institute of Virology (NIV) to study the diversity, and told the Maharashtra state government to tighten the existing response. in the virus.

Reuters could not determine whether the NIV implemented any such study. The NIV directed Reuters ’questions to the Indian Council of Medical Research, which did not respond.

“The government is strengthening follow-up and clinico-epidemiological studies,” Paul told Reuters. “The government has repeatedly, repeatedly, from many forums, emphasized the need for restraint using all means more vigorously, and optimized testing.”

NCDC Singh and India’s health ministry did not respond to questions from Reuters about Salunke’s warning.

Despite flagging Salunke’s problem, and a additional warning in early March from a forum of science advisors that the new variant made in the country, allowed the federal government to continue election rallies, religious festivals and other mass gatherings, and failed to take steps to prevent the spread of the virus.

Within 80 days, the variation from Amravati to many countries around the world, including Britain, the United States and Singapore, showed a lack of global efforts to prevent the disease.

It is impossible to say exactly how many infections in each country caused the new variety, because only a few samples from positive tests were followed. U.S. authorities estimated last week that the breed had 6% of coronavirus infections there.

In India, the dramatic rise in infection rates since April has continued – partly driven by various, according to public health studies – has overwhelmed the country’s health system, causing hospitals to run out of beds and oxygen. and cause overflow of crematoriums and cemeteries. India’s health minister Dr Harsh Vardhan, said last month that the variant was identified in about 20% of the country’s samples followed.

A Sudden Resurrection

In late January, when the daily number of coronavirus infections in India dropped to nearly 12,000, Modi however was declared the winner of an event at the World Economic Forum, saying the country “saved the people from a major catastrophe through effective coronavirus coverage. “

There is a sense of optimism surrounding many parts of India, including Amravati, where cases have fallen in a trickle, according to local health officials. The district, which has 2.9 million people, only reported multiple COVID-19 cases daily until most of January, according to government data.

“Everyone is relaxed,” said Shyamsunder Nikam, Amravati’s civilian surgeon, who handles public health issues in the district.

But case numbers began to rise sharply at the end of January, alarming Nikam and other local officials. New infections rose to nearly 200 in a single day in Feb. 7 and reached 430 a day a week, as the virus swept through the district’s interior that was largely unaffected by India’s first wave in 2020.

A task force set up by the Maharashtra government to gauge the pandemic response has ordered an investigation. Dr Rajesh Karyakarte, who was part of the investigation, said he examined four positive samples from the region and found that they all had a substance called E484Q, a sign that a different one could be played.

Karyakarte told Reuters that he presented the findings of the Maharashtra task force at a video conference on Feb. 16. Reuters is not independent in confirming whether he did so or how the task force responded. Dr Tatyarao Lahane, a member of the task force, did not respond to questions from Reuters.

EASY APPLICATION

The discovery of the new mutation and Amravati spiking case numbers alarmed Salunke. He said he traveled to Amravati at the end of February and performed coronavirus tests on nearly 700 people. Almost half of them turned positive for COVID-19.

Within days, he told Reuters, state health authorities sent samples from Amravati to the NCDC for further genetic sequencing to establish if there was a variant. The NCDC did not respond to questions from Reuters about what it did with the samples.

Meanwhile, federal health officials downplayed the potential role of new strains in increasing infection.

“There is no direct link between the recent surge of COVID-19 cases in Maharashtra and some other states with mutant virus infected N440K and E484Q in COVID-19,” the minister said in a statement. health in India in a media statement on Feb. 23.

Modi’s coronavirus adviser Paul said the diagnosis was based on data from authorities at the time.

“We knew someone had seen it but we didn’t know how important it was at that point,” Paul told Reuters. “The real importance of varieties comes out with time. Scientific data now leads us to understand the role of these varieties.”

In late February, federal and local officials held a meeting to discuss the rise of Amravati, according to a senior government scientist who attended it.

At the meeting, Maharashtra State Surveillance Officer Dr Pradip Awate said the increase in cases was due to voters rushing to the local elections held in January than any other new breed, the scientist said. who attended the Reuters meeting.

Federal officials, including those from the Indian Council of Medical Research, appeared convinced of that explanation and did not proceed for further investigation, the scientist said.

“At those times there was a certain amount of confusion,” Awate told Reuters, making it difficult to assess exactly why the cases were on the rise.

‘MAJOR MISTAKE’

The emergence of the new variety has not been taken into account with the urgency it deserves, according to Salunke.

“What happened in Maharashtra was a natural occurrence. And it should have been warned of a war footing, as a complete emergency,” he said. “It doesn’t matter and the whole focus is the election,” he said, referring to a series of state elections held until March and April, which brought thousands of rallies to Modi’s party as well. opposition politicians.

The absence of the Amravati variety increase in late February was a “major mistake”, said the scientist who attended the meeting in Maharashtra.

State health official Awate says Maharashtra may have imposed stricter lockdowns and restricted inter-district travel more quickly. However, lockdowns were imposed in Maharashtra and other major cities like New Delhi in mid to late April.

Between March and April, the federal government allowed the Kumbh Mela Hindu festival to continue in northern India, bringing millions of people from across the country for a holy dip in the Ganges, where many of them travel home. carrying the virus, according to public health. officers.

Despite its spread across India, the variety has been brought to other countries where it has also sparked many cases.

In Britain, a very different species – called B.1.617.2 or Delta by the WHO – has been found in areas where many people travel back and forth in India, according to experts.

Reporting by Devjyot Ghoshal and Zeba Siddiqui on NEW DELHI; Further reporting by Alistair Smout of LONDON and Chen Lin of SINGAPORE; Edited by Euan Rocha and Bill Rigby

Our Standards: Principles Trusted by Thomson Reuters.



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