Billions Under Lockdown: The Inside Story of India's Fight against COVID-19

By Abantika Ghosh

When WHO first declared COVID-19 a global pandemic in March 2020, there was a great deal of apprehension about how India - the country with the highest TB cases and diabetes, inadequate health infrastructure and a population of 1.3 billion - would fare.

Between the Janata Curfew and the first vaccinations, a massive machinery has been working as seamlessly as possible to make sure that, despite some missteps and missed infections, India conquers what has been the greatest challenge the world has encountered in decades.

Covering the pandemic from the start, first for The Indian Express and then for ThePrint, Abantika Ghosh has had a ringside view of India's battle against the pandemic. A thrilling tale of unnamed thousands battling against a little-understood virus from the frontlines, Billions Under Lockdown brings that gripping theatre and its dramatis personae to life.

• Language: English
• Publisher: Bloomsbury Publishing
• Release date: Mar 18, 2021
• ISBN: 9789390252176

Book preview

1

2020 dawned with no sense of foreboding. Politics in India played out as usual. Analysts on television were discussing threadbare the government’s decision to allow a group of Delhi-based diplomats to travel to locked-down Kashmir. Actor Deepika Padukone had stirred up a hornet’s nest by deciding to spend some time with agitating students at Jawaharlal Nehru University (the students were protesting an ‘attack’ inside the campus allegedly by a ‘right-wing’ mob) and the image of the heroine in black played in a loop. The all women sit-in at South-East Delhi’s Shaheen Bagh against the controversial Citizenship Amendment Act (CAA) had just completed 17 days (it would go on for 101 days). A new virus in ‘faraway’ China was a blip on everyone’s radar, of interest to nobody except us news junkies.

In other words, it was business as usual.

That is why, when the Government of India held its first meeting on the Novel Coronavirus on 8 January 2020, it was hardly surprising that it did not get any media coverage. Not even the bland bulletins of the Press Information Bureau (the communication arm of the government of India) arrived that day. The meeting was only spoken of many days later, at the peak of the crisis, when the government needed to remind Indian citizens that it had been an early starter. As a result, references to this meeting – ‘It was 7 January 2020 when China had confirmed to the World Health Organization (WHO) that a new strain of coronavirus had affected people there. On 8 January 2020, the Health Ministry had its first meeting of the group of technical experts in India’ – became a constant fixture of every statement that the Health Minister Dr Harsh Vardhan made on the Novel Coronavirus Disease (COVID-19).

Dr Vardhan, a trained ENT surgeon, had done all his politics from the national capital Delhi and considers, as the crowning glory of his long career in politics, his stint as the health minister of Delhi. That is when the pulse polio programme was launched in the city. It was eventually expanded to the whole country and played a major role in the elimination of polio from the country. He had once been the putative chief minister candidate in Delhi but now makes do with managing a ministry that is not usually considered high-profile.

Just about eight days before that first meeting on COVID-19, on 31 December 2019, the Wuhan Municipal Health Commission, China reported a cluster of pneumonia cases in Wuhan, Hubei Province, China. A novel coronavirus was eventually identified. It is a member of the same virus family as the one that caused the Severe Acute Respiratory Syndrome (SARS) that terrorised the world in and around 2003, and also the Middle East Respiratory Syndrome (MERS) virus. MERS was first reported in Saudi Arabia in 2012. However, as the name suggests, the nature of this new ‘Chinese’ virus that entered the medical lexicon in 2020, beyond its essential structure, was largely unknown.

In its disease outbreak news of 5 January 2020, the WHO said, ‘On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown aetiology (unknown cause) detected in Wuhan City, Hubei Province of China. As of 3 January 2020, a total of 44 patients with pneumonia of unknown aetiology have been reported to WHO by the national authorities in China. Of the 44 cases reported, 11 are severely ill, while the remaining 33 patients are in stable condition. According to media reports, the concerned market in Wuhan was closed on 1 January 2020 for environmental sanitation and disinfection. The causal agent has not yet been identified or confirmed. On 1 January 2020, WHO requested further information from national authorities to assess the risk. National authorities report that all patients are isolated and receiving treatment in Wuhan medical institutions. The clinical signs and symptoms are mainly fever, with a few patients having difficulty in breathing, and chest radiographs showing invasive lesions of both lungs. According to the authorities, some patients were operating dealers or vendors in the Huanan Seafood Market. Based on the preliminary information from the Chinese investigation team, no evidence of significant human-to-human transmission and no health care worker infections have been reported.’

There is a 3,488 km long boundary between India and China. And yet, for reasons both diplomatic and cultural, there was an iron curtain firmly in place at one time, both on the west with Pakistan and on the east with China. In China’s case, even though the wounds of the 1962 war are strangely fresh and the distrust remains mutual, there is no dearth of respect. India respects China’s military might and its ability to bring India’s much-vaunted generic drug industry completely to its knees, should it choose to discontinue supplying over 70 per cent of the active ingredients for the medicines manufactured in India. China respects India’s potential as a 1.3 billion strong market.

That is why, in recent years, small businessmen from India have increasingly started travelling to China to source cheap products, ranging from textiles to plastic toys, while Indian students have been making the trip to study medicine – the eternal favourite of middle-class Indian parents. So, China, in some ways, has grown closer to India than it has to Pakistan. However, what was striking about the promptness of the Health Ministry’s response, even if it just meant getting together a few experts, was the fact that neither of the last two coronaviruses that ravaged the world – SARS and MERS – had affected India that much. There were three cases of SARS and none of MERS in India.

This pre-pandemic phase (for India) in early January was also the time when epidemiologists from the Integrated Disease Surveillance Programme (IDSP) were engaged in discussions with the local WHO officials about the possibility of human-to-human transmission of the new infection in China. IDSP officials are India's disease detectives, whose job it is to identify, track and trace disease outbreaks in various parts of the country. They were concerned local authorities in China may have missed transmission of the infection between humans. The WHO didn’t think it was possible, but the IDSP sleuths thought there was no other explanation for the rapid spread of the disease – first in the Hubei province and then beyond.

The Disease Detectives

The leafy glades around the erstwhile residence of Field Marshal Sir Claude Auchinleck, the last commander-in-chief of the British Army in India, look like they might be holding many secrets, even shrouding a ballroom of yore. Which they do. But they do not look like they are home to one of the most advanced virology laboratories in the country and some of the best brains in the business of disease tracking.

Welcome to the National Centre for Disease Control (NCDC), one of the battlegrounds in India’s war against the Novel Coronavirus disease (COVID-19). It houses, among other things, the IDSP that has been the bulwark of the elaborate contact tracing and active case finding operations across the country for a host of diseases. It is the only programme of its kind with a battery of epidemiologists and public health experts trained in infectious diseases with presence in all Indian states and district level penetration. Though the district and state units are manned by state health officials, IDSP works as part of a unified central command.

Located on the main thoroughfare between the Interstate Bus Terminus at Kashmere Gate – the name a vestige from the time when Delhi was known as the city of seven gates – the unobtrusive campus is of little interest to the thousands that pass by every day. They neither care about the glamorous past that once existed inside nor about the cutting-edge science that is its present. In fact, the NCDC is among the most low-profile organizations under the umbrella of the Ministry of Health and Family Welfare (MoHFW), with an annual budget of a paltry ₹68 crore in 2016–17. NCDC has never been a very important cog in the government of India wheel. But that did not stop the men and women from quietly going about their jobs of tracking and tracing disease outbreaks. They had at their disposal state-of-the-art laboratory facilities, including the potential to do the molecular tests, which would prove to be so important in the fight against the SARS-CoV2 virus. In January 2020 the novel coronavirus though was yet to get its fancy moniker. Its ‘novelty’ remained its calling card.

If there was an Indian medical detective series on emerging infections, the epidemiologists from IDSP would certainly play starring roles. Their work is on par with that of a sleuth – painstaking, detail-oriented and analytical – think Kate Winslet in the movie Contagion. They are forever seeking clues, not to solve a murder mystery but to crack a disease outbreak, with every one of them armed with a compulsive need to investigate every lead.

Speaking to me in his modest office in the impressive NCDC campus sometime in the second quarter of the year, Dr Sujeet Singh, director of the NCDC and IDSP head, recalled the unease in the NCDC in early January about the situation unfolding in China. The unease largely stemmed from institutional memory and the experience of handling numerous outbreaks in the past, including the Nipah outbreak in Kerala in 2018, a Zika cluster in Ahmedabad, and the experience of tracking a clutch of diseases including malaria, dengue, swine flu and Japanese Encephalitis as part of routine functions. But nothing that the disease detectives at NCDC had seen in the past seemed to quite add up to what was happening in China, and brows were already beginning to furrow.

One meeting from this phase with officials from the WHO country office in India had deepened those creases even more. ‘This was sometime in the first week of January and they were still telling us that there was nothing to worry about the China situation as there were no cases of human-to-human transmission. Yet the numbers kept piling up and cases were being reported from provinces outside Hubei. Finally, I asked them in one meeting, How can you say that there is no human-to-human transmission? It is not possible for so many people from across China to be infected from one wet market in Wuhan. Either there are more wet markets in all these provinces from which the virus has emanated, independent of each other and all these cases are index cases, or there is human to human transmission,’ Dr Singh said to me.

Dr Singh would have known.

He had, after all, started his career with the NCDC in 1992 as a young epidemiologist fresh out of college, training under Dr K.K. Dutta, one of NCDC’s most illustrious directors. He conceptualized the IDSP that began in 1996–97 as a pilot project – the National Surveillance Programme for Communicable diseases, first in five districts, then in 101 districts. Dr Singh was among the first batches of officers assigned to the IDSP and had been a part of the team that dealt with some of the biggest disease outbreaks in the country. The need for a national programme for the surveillance of communicable diseases was felt after the plague outbreak of Surat in 1994, and the almost-annual dengue outbreaks in Delhi. The specialized corps of epidemiologists, zoologists, microbiologists, entomologists, clinicians and public health professionals started expanding; by 2004, the programme had a pan-India presence (in varying degrees in various states). Dr Singh had worked his way up the ranks to become the director of the NCDC in 2018 and was, by far, the most experienced man in the government when it came to tackling infectious diseases in the field. The IDSP eventually became the backbone of India’s COVID-19 fightback as the only programme of its kind in the country with tentacles everywhere, down to the district level.

The Central Surveillance Unit (CSU), often loosely referred to as a control room, is administratively and financially integrated with the NCDC in Delhi. There is one State Surveillance Unit (SSU) in each State/UT with a regular officer identified as the State Surveillance Officer (SSO). The person is supported by seven contractual staff members. The District Surveillance Unit (DSU) has one regular officer as District Surveillance Officer (DSO), supported by three contractual staff members. In normal non-pandemic times, the IDSP tracks dengue, chikungunya, Japanese Encephalitis, meningococcal meningitis, typhoid fever, diphtheria, etc. It also tracks dog bites, snake bites, and any other State Specific Disease and Unusual Syndromes. For the duration of COVID-19, almost the entire resources were diverted towards one disease. So much so that data on diseases like flu and dengue was not even updated for the many months of the pandemic. The preoccupation of the health system with COVID caused many other diseases to be neglected throughout the duration of the pandemic. It was only at the fag end of the year that occupancy in private hospitals started picking up under Ayushman Bharat – the flagship health programme of the NDA government under which the eligible families get an annual health insurance of ₹5 lakhs.

Where it all began

Dr Dutta now lives a quiet life. Sitting in his home in Kolkata during the lockdown, he recounts how the IDSP started. ‘The idea was really initiated at some point in the late 70’s or 80’s when I used to wonder if there was a way for me to have the entire country’s disease data on my table every morning to make the process of spotting and fighting epidemics easier. After all, time is of the essence during outbreaks and a lot of crucial time is lost trying to gather enough data to connect the dots. Later, when I became the director, it started as a pilot project, with some funding from the CDC – I do not remember how much it was but probably around ₹1 crore. The idea was to detect and intervene in outbreaks quickly. The normal health system has the data, but they lack the analytical component of understanding that data. Initially, we were just looking at measles, jaundice, cholera and polio. We knew it would be difficult to explain some of these diseases to the people in the villages. So, we devised a system. Health workers would go door to door with postcards showing photos and asking people if they have seen a patient with such symptoms,’ he said. IDSP and the Indian citizenry have come a long way from those postcard days. The role postcards played back then is now played by television, radio, and Whastapp – the latter in particular spreading just as much misinformation as information.

For generations of Indian epidemiologists, Dr Dutta is really the father of epidemiology in India. Epidemiologists trained by him are now amongst the senior-most people in the NCDC and played a pivotal role in shaping and implementing India’s COVID-19 battle strategy. He still stays in touch with them, occasionally giving them a call to share his assessment of a particular outbreak. ‘You know, he was all about field-work.. He would tell us to go, just go to that place and contain the outbreak, whatever you need to do. Stay for a month if you have to, but do not come back till it is contained,’ recalls Dr Singh. In a rare moment, his stern face is animated and he adds, ‘you know this reminds me. I got a missed call from him some time ago, I should call him back. Maybe he has some inputs on this’. The only other time I saw him that excited was when his interviews played on TV – that was before he was debarred from media interactions. Health Secretary Preeti Sudan told the Ministry’s media wing that people should ‘work on containing the COVID pandemic instead of giving interviews’. She was the biggest practitioner of that. Throughout the time that she held office during the pandemic, including her three-month extension, she gave only a handful of interviews in the dying days of her tenure, including the one to me for ThePrint. The fact that Sudan got an extension – a very unusual occurrence in the National Democratic Alliance government of Prime Minister Narendra Modi – shows how important she was in government’s pandemic scheme of things. But hobnobbing with the media was never her strong suit and she preferred it that way.

An officer and a lady

Sudan’s ability to keep her head down and get on with her work, sometimes working into the wee hours of the next day, made her an ideal choice for leading the country when an unprecedented pandemic hit. It is important to get a sense of how things unfolded from the time the first case in India was reported in Thrissur, Kerala, to understand the role she played, and the unusual powers vested in her in the early days of the pandemic.

On 14 January, according to the WHO COVID-19 timeline, ‘WHO’s technical lead for the response noted in a press briefing there may have been limited human-to-human transmission of the coronavirus (in the 41 confirmed cases), mainly through family members, and that there was a risk of a possible wider outbreak. The lead also said that human-to-human transmission would not be surprising given our experience with SARS, MERS and other respiratory pathogens.’

The first big decision from the Government of India followed three days later, when it braved repeated denials from the WHO and risked the displeasure of its usually cantankerous and mighty neighbour to issue a travel advisory for Indians wanting to travel to and from China. By then, there were reports of ‘imported’ cases in both Thailand and Japan. On 17 January 2020, a statement from the Government of India said, ‘an infection with a novel coronavirus has been reported from China. As on 11 January 2020, 41 confirmed cases have been reported so far, of which one has died. Only travel related cases have been reported (one each) in Thailand and Japan. The clinical signs and symptoms are mainly fever with a few patients having difficulty in breathing. The mode of transmission is unclear as of now. However, so far there is little evidence of significant human-to-human transmission. Although, as per WHO’s risk assessment, the risk for global spread has been stated as low, as a matter of abundant precaution, the travellers to China are advised the following…’.

In hindsight, the Indian government’s advice was pretty basic – hand washing, coughing and sneezing etiquette, keeping a watch for symptoms. And, ‘avoid contact with live animals and consumption of raw/undercooked meats. Avoid travel to farms, live animal markets or where animals are slaughtered. Wear a mask if you have respiratory symptoms such as cough or runny nose.’

This was also when the screening of international travellers from China was started at designated airports – Delhi, Mumbai and Kolkata – using thermal scanners. These scanners were a novelty, just like the virus that necessitated them. The aura wore off soon enough.

An aside here, that I am sure is unique to the people we are.

It took many more weeks, multiple appeals from the prime minister and threats from state governments for Indians to take to masks. Coughing and sneezing etiquette may take a little while longer – we aren’t exactly the fastest learners in the world. But what happened immediately after word got out about ‘corona’ (India’s way of referring to COVID-19 throughout the pandemic, probably because that is the name that was used to introduce the country to the disease) was that north Indians quit eating non-vegetarian food and those in the eastern parts – where I come from – quit eating chicken. Chicken prices crashed in Kolkata, and mutton prices skyrocketed. This was probably national memory from the bird flu days at work.

By the time the travel advisory came, there had already been two review meetings on COVID-19 – on 8 January and 14 January – of a joint monitoring group convened under the chairmanship of the Director General of Health Services (DGHS).

The PIB statement of January 17 reads: ‘Secretary, (HFW) (reference to Preeti Sudan) stated that the public health preparedness is being reviewed on a day-to-day basis and the core capacities to timely detect and manage importation of the nCoV (novel coronavirus) into the country are being strengthened further. The Health Ministry has issued necessary directions to all concerned on laboratory diagnosis, surveillance, infection prevention and control (IPC) and risk communication. Integrated Disease Surveillance Program (IDSP) is geared up for community surveillance and contact tracing. The NIV Pune, ICMR Laboratory is coordinating the testing of samples for nCoV in the country. The hospital preparedness with regard to management and infection prevention control facilities has been also reviewed during high level meetings and advisories, and IPC Guidelines have been shared with the states. Adequate stocks of logistics including PPE is available. State governments have also been advised on the necessary precautions to be taken up on the issue. Ministry of Health is also in touch with Ministry of External Affairs, and the immigration officers at the said airports have been sensitized."’

It was an unremarkable statement – but some of the claims made there stood busted about eight weeks later when India imposed a lockdown, shut itself from the world and stared at a crippling shortage of PPEs, amongst other things. PPEs are essentially coveralls, masks, gloves, shoe covers, etc., that healthcare workers need to have when they come in contact with confirmed and/or suspected COVID-19 patients. They are crucial to ensure that hospitals do not turn into COVID-19 hotspots and that healthcare workers, who are so crucial to the disease management plan, do not fall prey to the disease and move out of the workforce – thereby stretching India’s already limited human resources in healthcare further. Or worse still, spread the disease to some of their other patients.

17 January is an important date in India’s COVID-19 battle, not only for the country because the first shot against the enemy had been fired, but also for Sudan – an Indian Administrative Service (IAS) officer from the 1983 batch belonging to the Andhra Pradesh cadre. Due to retire in April, Sudan, at this time, was, for all practical purposes, in exit mode, planning her retirement, talking about her house in Hyderabad where she would eventually retire and the book she always wanted to write. It was to be a book for kids, a compilation of the penguin stories she would tell her much younger brother when he was a little boy.

‘I write very well you know,’ she once told me, during one of the rare occasions when she was in a chatty mood. A workhorse, if there ever was one, Sudan believed in leading from the front. A straight shooter and a people’s person, she inspired great loyalty and hard work from those around her. With Sudan, a motherly woman who could burst into a rage one minute for a perceived slip and be extremely caring in the next, being a woman always fetched one brownie points. Having granted me access to the ministry’s COVID-19 war room later in the year, she told me, ‘Now all my girlie gang will want to go there.’

Another time, at the peak of the COVID-19 battle, when the officers dealing with infectious diseases were working late nights almost every day, Sudan accidentally came to know that there was no food available at Nirman Bhawan – the building that houses the Health Ministry. One night, when it was almost 11 p.m., joint secretary Lav Agarwal, also an Andhra Pradesh cadre officer and the man who went on to become the face of the Government of India on COVID-19 in the following weeks, told Sudan, after a marathon discussion, that he would go home and finish the rest of the work there since he was very hungry. A surprised Sudan asked him, ‘But don’t you get food here?’ Agarwal replied in the negative.

From the very next day, packed lunches and dinners were available for the entire COVID-19 team, including the personnel from sundry private agencies manning the war room.

Sudan did not know this on 17 January, but she was about to become the most important bureaucrat in the Indian government for the next many weeks. However, she would remain, till the very end of her tenure, the one least heard of even though she was the engine that pushed the ministry to work monstrous hours at breakneck speed.

On 11 March, the Ministry of Home Affairs brought out a short order. It read: ‘In exercise of the powers conferred under Section 69 of the Disaster Management Act (DMA) 2005, Union Home Secretary, being chairman of the National Executive Committee (NEC) hereby delegates its powers under clauses (i) and (I) under sub section (2) of Section 10 of the Disaster Management Act 2005 to Secretary, Ministry of Health and Family Welfare, Government of India, to enhance the preparedness and containment of the Novel Coronavirus (COVID-19) and the other ancillary matters connected thereto. This order shall be deemed to have come into effect from 17 January 2020.’ The disaster management act had already been invoked, which meant that Sudan was the pivot in the government’s COVID control strategy.

For most of the evening of 11 March, my colleagues and I could not understand the importance of 17 January. This lasted till I received Sudan’s reply via WhatsApp to my question about why the order came into effect retrospectively. ‘I issued my first advisory on 17 January. Did it on my own :D,’ she replied late at night. It was many weeks later that this status of Sudan as the fountainhead of government decision making would change.

It was also around this time that she wrote to all the states to stay prepared, identify gaps and strengthen core capacities in the areas of surveillance, laboratory support, infection prevention and control, logistics, risk communication and, in particular, hospital preparedness, in terms of isolation and ventilator management of critically-ill patients of severe acute respiratory illness (SARI). In the coming weeks, two acronyms, SARI and ILI (influenza-like illnesses), would become household terms across the country.

While this took place behind-the-scenes, most of the country was more focused on whether the convicts of the Delhi gangrape of 2012 – the ‘Nirbhaya’ case – would hang and when. They were debating whether Pakistan would wriggle out of the Financial Action Task Force (FATF) grey list. With protests against the Citizenship (Amendment) Act (CAA) continuing in various parts of India, all eyes were on how Prime Minister Narendra Modi, in his inimitable style, was tearing the Opposition apart for spreading ‘lies’. At this point, we were also told – once again – that adequate stock of PPE was being maintained by the Medical Stores Organization.

All it seemed, was hunky dory.

Airport screening of passengers from China and Hong Kong remained the primary strategy for the greater part of the pre-lockdown period. By the end of January, it had increased to 21 airports for all passengers coming in from China and Hong Kong. These were Delhi, Hyderabad, Mumbai, Cochin, Bangalore, Ahmedabad, Amritsar, Kolkata, Coimbatore, Guwahati, Gaya, Bagdogra, Jaipur, Lucknow, Chennai, Trivandrum, Trichy, Varanasi, Vizag, Bhubaneswar, and Goa.

Samples from suspected patients were sent for testing and would come back negative. It was all falling into a routine pattern and we were just beginning to relax from that taut wait of the initial days of the disease coming into India. Then, on the afternoon of 30 January, at 1.33 p.m., there came the terse announcement: ‘One positive case of Novel Coronavirus patient, of a student studying in Wuhan University, has been reported in Kerala. The patient has tested positive for Novel Coronavirus and is in isolation in the hospital. The patient is stable and is being closely monitored.’ The patient was in the General Hospital in Thrissur. SARS-CoV2 had officially entered India.

The first Indian patient had returned to the country before airport screening begun. The 20-year-old medical student from Wuhan had taken a China Eastern flight on 21 January, 2.45 p.m. from Kunming to Kolkata. The flight landed in Kolkata at 11.45 p.m. on 23 January. She took an IndiGo flight to Nedumbassery the same day with more than 20 students from her college. Her parents and brother accompanied her in the family car from Nedumbassery to Punakkabazar. On the way, they stopped for dinner at a restaurant near the Shantipuram petrol pump, before reaching home around 10 p.m.

As per protocol, she reported to the local primary health centre the following day and then went back home since she had no symptoms. She was mostly in her room, only coming out for meals. This ensured that when the maid, a neighbour, and a friend of her 18-year-old brother came visiting, they did not come in contact with her. Her father continued to go to work and her brother went for his tuitions, etc. till 27 January when she developed a dry cough. Her sample (throat swab) was taken. Her reports took three days to arrive.

On a slightly different note, it is an ode to the blistering pace at which things moved over the next three months that India was doing 75,000 tests a day by 1 May, with a capacity to do around a lakh just a week later. By September–October, India was doing a million tests a day and more.

Following the arrival of the first patient’s reports, the district administration in Thrissur traced the 49 people she came in contact with during her journey, and 45 others in the community after she reached home. Talking about the scale of contact tracing operations during a press conference the following week, Health Minister Dr Vardhan scrupulously avoided naming the student or her family, but inadvertently named the family’s domestic help. As Sudan, who was seated beside him, made her displeasure apparent at this violation of privacy, Dr Vardhan replied, in what he evidently thought was a ‘smart’ recovery, ‘Never mind it’s just the maid (chaliye maid ka hi naam liya hai)’.

This disdain in the highest echelons of the government for those on the lowest rungs of society was exhibited with far graver consequences two months later when India went into a 40-day lockdown with a four-hour notice, bringing the country’s migrant labour force to its knees.

When India’s case zero happened, samples of symptomatic people in the airport screenings were already being sent out for testing. Till 30 January, 49 samples of people who had returned from China had been tested. All the others were negative.

As on 30 January 2020, a total of 7,711 confirmed cases had been reported by 31 Chinese provinces, including 1,370 serious cases, 170 deaths, 124 discharged and cured cases and 12,167 suspected cases. The number of reported confirmed cases abroad were Thailand (14), Singapore (10), Australia (5), USA (5), Japan (8), South Korea (4), Malaysia (7), France (4), Vietnam (2) Canada (2), Nepal (1), Cambodia (1), Sri Lanka (1) Germany (4), UAE (4), Hong Kong (10), Macao (7), Taiwan (8), Finland (1), Angola (1) and India (1) – a total of 21 countries.

By this time, the Health Ministry had revised its travel advisory and asked Indians to avoid all ‘non-essential’ travel to China. On 30 January, WHO Director General Dr Tedros Adhanom Ghebreyesus, in a controversial statement, said that not only did the WHO not recommend travel restrictions to China, it was actually opposed to such an idea. He would draw much flak in the days to follow from many countries but particularly from US President Donald Trump who became critic-in-chief of the WHO throughout the pandemic, even withdrawing US funding for the organization. On the same day, the International Health Regulations (2005) Emergency Committee, while urging countries to stay prepared, added: ‘The Committee does not recommend any travel or trade restriction based on the current information available.’ It was, at a later date, based on the advice of this committee that the disease was declared as a Public Health Emergency of International Concern.

Preparations were also on in full swing for the evacuation of Indians from Wuhan – most of them being students. This was, of course, with the proviso that anybody with flu-like symptoms would not be allowed to travel and every person would have to complete the mandatory 14-day quarantine once they landed in India. ‘Government of India has made elaborate arrangements for the evacuation of 366 Indian citizens from Wuhan city in response to the emergency situation that has arisen due to outbreak of Novel Coronavirus in China. A team of doctors, public health specialists and para medical staff have been sent in the aircraft of AI. The incoming Indian passengers will be quarantined for 14 days at the two Quarantine Centres set up in Manesar (managed by Armed Forces Medical Services) and Chawla Camp (managed by ITBP). All proposed male passengers (approx. 280) are proposed to be sent to Manesar Camp and families/females (approx. 90) can be housed in the ITBP camp,’ read the Press Information Bureau (PIB) statement from 31 January.

Ayush claims

While all of this was happening in India and the world, the Ministry of AYUSH, that deals with Indian/alternative systems of medicine such as Ayurveda, Siddha, Homeopathy, kicked up a mini-storm of its own by