The Corona Viral

12 March 2020

Irony could have blushed with how we use the term ‘Viral’ these days and completely lost it when confronted with an actual virus! Remember how much of January and February of 2020 was European and American grand standing, trying to put down China as she struggled with the Covid-19 contagion from Wuhan? Internet is such a wonderful thing, that no one can quite fob off the past, mansplain it or spin it, because it is out there, in clear and broad daylight of the web archive.

China did some astonishing things, which people assumed was because she was an autocracy authoritarian regime with a people renowned for compliance! She walled off entire provinces, she forced people to stay shuttered, set out permits for them to come out and transact physically, she made what is now trending in the West as ‘Social Distancing’ where an arbitrary 3 feet of separation was enforced for people as minimum distance for public engagement with one and another. She used technology innovation, from robots to apps that collected grocery lists and arranged for drops and pick ups, to school classes, she managed to switch effectively to online virtual society, which was already one highly controlled by her censors, filtering and guiding her people even more as she struggled to control panic and rumour amongst her populace.

This is not an epidemiology or community medicine paper. I can assure you that reams of research will get published, sifted and sorted, for decades about this Chinese Model. In all likelihood, Mr Xi as President For Life, has somehow cemented his position in China with this containment of the contagion. In less than three weeks the transmission of the infection came down to approximately 0.3%, through these non medical community methods. The most important tool used by Chinese authorities was clinical symptoms of a ‘cold’ or ‘flu’ and thermoguns ( Infrared sensors that pick up body temperature at a distance, instead of conventional thermometers both mercury and digital versions which need contact with skin of the individual to measure their temperature) as medical devices to filter out those with fever which was a definite ‘No-Go’! The key to current fresh infection rates that are in their low tens in China and which demonstrate that the tide has turned for the better there is this transmission rate nosediving to the extent it did, due to social or community measures of quarantine, distancing, public practises and preventive measures. Remember there were videos of Chinese looking citizens being forcibly taken to quarantine centers, of rumours of many dozens being machine gunned and incinerated to prevent the spread of dreaded disease? I am sure that Chinese public health officials and administrators did what they had to, yet it would have fallen far short of culling humans to curb the contagion. There were interestingly no news items of poultry being culled from China whereas such news is being now reported from various parts of India.
Being the world’s factory had its advantages, no doubt. China could construct overnight literally Isolation and treatment wards adding thousands of beds once the crises was defined and an action plan was approved. It could overnight marshal additional equipment of medical nature, from thermoguns to masks and oxygen concentrators. Yet, there are no reports, unlike India, where Chinese medical authorities experimented with ‘traditional medicine’ or with retrovirals used for HIV, against Covid-19. The few reports we have seen in medical circles of social media have been the use of plasma as an experimental therapy harvested from Covid-19 patients who recovered from the infection and were fully healthy.
China’s health care industry can take a bow, that instead of being overwhelmed, instead of panic or chaos, it handled the crises with intensity, sticking to basics of infectious disease protocol as practised by WHO standards and undertaken in Ebola outbreak in Africa. The Chinese health system had so internalised their lessons form the SARS outbreak in the first decade of this millennium that they were more than ready to roll out and conduct themselves in a most prescribed and rehearsed manner! The videos we see of Chinese folk paying tributes to their health workers as doctors, nurses and paramedicals is a typical Chinese cultural response of gratitude, and you can be rest assured, in the coming years, that instead of medieval Chinese warlords and their struggles for supremacy, the Chinese studios are going to churn out stories of Doctors and Nurses, indefatigable and wise, who fought off this grave contagion!
Unlike Indian social media which took political shades over the Covid-19, by insinuating that Shaheen Bagh protestors had an infected person amidst them, or how Shaheen Bagh and all Anti CAA gatherings was now a threat to public safety as a health hazard, no Chinese chatter was picked up about the unrest in Hong Kong. Definitely the island region has taken its internal dissension and dissent to a backseat, as it enforced screening and public health safety measures, but there was no evidence of opportunistic use of this contagion, which indicates a rare level of maturity in a polity that is yet to be democratic. Here in India, in hallowed Parliament we saw an MP accuse Mr Rahul Gandhi of bringing the infection from his ‘Italian’ connections and visit. We see WhatsApp joke about Mr Scindia quitting the INC because of threat of spread of Covid-19 from Italy. Imagine how shortchanged our ruling dispensation and whataboutery fans would be, if Ms Sonia Gandhi was a Jatni from Hastinapur and not a Maino from Italy!

Beyond India’s Italian connect or disconnect, ( remember that RSS is ideologically indebted to Italy, for its concept of nation state, its relation to citizenry and social structure, which are all deeply anchored in Italian fascist ideology), Italy is herself a centrestage with a harrowing fortnight where infections went from their tens to ten thousands. While Italy remains walled off, quarantining and cordoning off millions of citizens, its nightmare is how its health system has been overwhelmed as it operates at 200% capacity. Little is officially available in Italy, rumours swilling thick and fast about mortality rates that are several times the Chinese experience, with isolated social media posts of Italian intensivists who describe the inability of the health system in Italy to carry out long hours of vigil and supportive care for patients suffering from Covid-19 pneumonia.
The clue that Italy is wilting comes from French and British health commentators and stark words from President Macron. The use of Game of Thrones analogy of the impending attack on Winterfell may be extreme for two reasons, there is no indication that on ground EU is as prepared like John Snow and the Northerners for the onslaught, nor for good measure do they have a Targaryean with Dragons! There is no magic bullet for the virus, the anticipated vaccine for it is more than a year away at the earliest. Then comes GPS headlining the threat, Fareed Zakaria for once showing either age is catching up with him or he seriously miscalculated western preparedness for such a mass public health calamity! (https://view.newsletters.cnn.com/messages/1583968549381d97f9734aae5/raw?utm_term=1583968549381d97f9734aae5&utm_source=Fareed%27s+Global+Briefing%2C+March+11%2C+2020&utm_medium=email&utm_campaign=187598_1583968549386&bt_ee=bLj2Hi6gtIZMqDIftVcbvlXy7e7vNFDV%2By6wwhyPAXlKvjiUC4bmOi1UxU9Y02hS&bt_ts=1583968549386)
Germany seems to settle for the worst, assuming an infection rate of upto 70% of her population as inevitable, and a mortality rate of upwards of 3%. We expect that would mean more than a double of the Chinese experience so far. A tired Ms Merkel is expected to now take this challenge hands on, and the entire EU hopes that the lady will show the way to deal with it.

There is an acute shortage of nursing staff for the kind of round the clock supportive care one needs for Covid-19. There would also be a shortage of isolation space, where Bhutan has shown innovation by converting hotels into shelters for isolation. Most importantly the world needs to halt all movement and congregation of humans, coming to an actual ‘stand still’ for the most restless species on the Planet- Us!

In India, Kerala has shown with Nipah outbreak how she can handle this. I am confident about the Southern states, (peninsular) which traditionally have better health and public health indices compared to the ‘Hindi Heartland’ or the Gangetic plains. Where India has issues is shortage of masks and thermoguns, of intensive care equipment from Oxygen sources like concentrators to ventilators and monitors since she has negligible local productive capacity and has been heavily dependent on China for quite some time. Even Active Pharmaceutical Ingredients may run out since bulk of these are of Chinese origin. It is here that India may be lucky in how the contagion is arriving now when it is ebbing in China and China may be able to ramp up production and restore supplies by mid April. As an analyst I can see that a delayed monsoon is on the cards, which means that from April till July, much of India will be open for Covid-19 transmission, with a tide ebb due to increasing humidity and rainfall around late June and early July. From April to August, India will meet its worst nightmare with the mettle at its disposal- A Public Health Care system depleted by resource scrounging and diversion for the last six years, a Private Health Care that is struggling to stay afloat with high costs for tertiary care and diminishing rates of returns on investments therein! An economy that is generally diminished in its capacity to spend, a population of children and aged that suffers from documented malnutrition and poor immunity! One hopes that Providence will bail India out and we are left none the wiser with our wisecracks and insipid jokes!