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'Govt Adopted Dynamic Covid-19 Mitigation Strategy; Plans to Test 1 Lakh People a Day': Union Health Minister

File photo of Union Minister Harsh Vardhan.

File photo of Union Minister Harsh Vardhan.

In an interview with News18, Union Health Minister Harsh Vardhan spoke about a range of issues including, India's post-lockdown Covid-19 containment strategy and the Centre's response to the outbreak.

Union Health Minister Harsh Vardhan said that the government is presently testing 75,000 people in a day for Covid-19 and added that it was planning to scale up testing to one lakh individuals in a day in the near future. He added that, so far, 10,000 patients have recovered and less than 1% of the patients are on ventilators.

In an exclusive interview with News18, Vardhan spoke about a range of issues including, India's post-lockdown Covid-19 containment strategy, the Centre's response to the outbreak and faulty Chinese testing kits.

After testing about 10 lakh people, we have over three per cent positive cases. How do you read this graph?

Our graph has been steady and there is no steep hike. We have tested over a million people and only 3% have been found positive. Our guidelines say that we have to test all symptomatic patients. We are now testing all kinds of patients, including in unaffected districts. I am content with the data.

How do you evaluate our plan to bring down the rate of infection spread?

Covid-19 is infectious and it spreads fast. My concern is to identify everyone with infection early on and make sure he or she is tested. If positive, they should be shifted to a hospital. We should not have unwanted mortalities. As long as I can give them the best treatment, I am happy about it. Our data shows that 10,000 patients have recovered and majority of the patients are continuing to recover well. Less than 1% of the patients are on ventilators, less than 2% are on oxygen support and only 2-3% are in the Intensive Care Unit (ICU). We are committed to identifying the infected people early on and treat them.

Why has the number of deaths gone up in the last one week? Does stigma around Covid-19 have a role in some people not going to hospitals or getting tested?

It has nothing to do with stigma. Anybody and everybody who falls sick should and is reporting to the health system. We have carried out mass awareness programmes. As far as deaths are concerned, most deaths are amongst patients with co-morbid conditions. Our endeavour has been to diagnose early and transfer patients to hospitals for treatment. I want to ensure that no one dies in India because of the unavailability of health facilities.

Though we are ramping up our testing capacity, many argue that it’s less than developed countries. Do you agree with this argument? Also, what’s the optimum number that you are looking at and is there a timeline?

Our testing strategy is devised by ICMR and we have experts from all fields working in close coordination on this issue. We have been revising and modifying the strategy according to the evolving situation. From one lab in the country at the beginning, we now have 420 labs across the country, carrying out tests every day. We are testing 75,000 people a day and in total, a million tests have been conducted. We are now planning on testing one lakh people in a day. Anybody with symptoms must be, and will be, tested. We are testing in a judicious manner and results are for everyone to see.

Is the government looking to expand community-based random testing?

We are doing it regularly, across districts. Over 250 persons per district are being tested, especially in cases of respiratory illnesses. Some states like Karnataka and Odisha are doing it more aggressively. National Centre for Disease Control is monitoring these tests.

What’s the rationale behind classifying districts into various zones? Is it based on testing capacity?

To fight a disease, you need to have a well-defined strategy. Now that two stages of the lockdown have been completed successfully, thanks to huge sacrifices of people, we have detailed data and inputs for planning the way forward. As we have shared, 319 districts in India have zero cases, 284 districts have cases but there are no hotspots and in 130 districts hotspots are clearly identified. We have clear containment strategies for each of these categories. We need to have house-to-house survey and affected houses and neighbourhoods must be sealed. With relaxations for economic activities, we need to classify districts into three zones. This is the reason why there is differentiation in the relaxations. We must take care of the disease with a scientific approach while opening up the economy in a graded manner.

The case doubling rate varies drastically from state to state. Is it a cause of concern? Also, is there a sense that some states are under-reporting?

There is no denial of the fact that some states are performing well as compared to the national average. The situation in states like Maharashtra, Gujarat, Madhya Pradesh and Delhi is a cause of concern for us. We are monitoring them at all levels. I have personally been talking to their health ministers. We had central teams visiting all these states. They are trying their best but there is a need for more attention from the local authorities to ensure that containment strategies are implemented in true spirit. We get information about under-reporting from different sources in one state and have been pursuing this issue with the health secretary there. We expect everybody to report every positive case and mortality in their states.

Sometime ago, you said that India has been able to avoid stage three of transmission because of the lockdown. How confident are you now about us not being in stage three of coronavirus spread?

Not only did I say this, the World Health Organization (WHO) also endorsed my views on India not being in the community transmission phase. As per WHO’s definition of community transmission, we have checked at many places on several occasions through random sampling. We couldn’t find a significant number of people who were infected with the disease whose contact tracing couldn’t be done successfully. I am reiterating that the lockdown saved the country from going into stage three of transmission.

Our urban centres like Mumbai, Delhi, Chennai, Indore and Pune have emerged as another area of concern. These places have a high population density and are centres of the country’s economic activities. What went wrong in these cities?

It’s very difficult to pinpoint the cause of them not performing well even at this stage. They had the maximum number of international travellers coming in, and they have huge slums where it’s not practically possible to implement social distancing guidelines. I also have a feeling that people in these cities have not followed lockdown principles adequately. Rural India behaved more responsibly than urban India. We saw some of the best examples from panchayats and village heads who were training and motivating people. When migrant labourers returned to villages, we saw villages all over the country co-operating.

There has been a lot of misinformation and confusion around rapid testing kits. What is the government planning to do?

These antibody tests are used for surveillance purposes, epidemiological studies and research purposes. To assess the extent of infection in the community, we had planned on using them in our hotspots. We procured kits for the whole country and distributed them to the states. But when we got reports that their efficacy was under doubt, we withdrew them after testing them in our own labs. As soon as we get quality kits, we can restart antibody tests.

Who was responsible for the fiasco around the import of faulty testing kits from China? There were allegations of profiteering as well. Both the ICMR and empowered committee are blaming each other.

ICMR and the empowered committee have followed the procedure for procurement of the kits and they had given the contract to the lowest bidder. Unfortunately, kits coming from China were ineffective. As soon as we came to know about it, we stopped using them. Also, we have not paid anything to China for these kits.

In United States, the Food and Drug Administration (FDA) has allowed the use of Gilead's Remdesivir for emergency cases. Many are calling it the biggest hope for treatment. Now, the debate is how to bring it to India. Gilead has recently said that it's open to partnering with an Indian company. How soon can we expect that to happen?

It’s an important subject that is being discussed at the highest level in the government. Scientists at ICMR and CSIR are also deliberating upon this issue. Right now, we are in a position to participate in WHO's solidarity trial and have received some 1000 odd doses given by the global health body. We will be able to use them for clinical trials in patients in some states in India.

India’s supply of hydroxychloroquine (HCQ) to the world when it needed them the most stood out. Some foreign policy observers even termed it ‘HCQ diplomacy’. What are we doing to be able to mass manufacture and supply medicines for treatment and vaccine? Is there a special government push for this?

We have always been very large-hearted. There is a strong push from the government to support the industry. We have been supplying HCQ to 97 countries of the world now, while saving an adequate amount for ourselves. We are supplying Paracetamol to 103 countries in the world. The government, in its exit plan for the lockdown, is supporting and handholding the industry to improve the production of various drugs because a large number of drugs are exported from India to some of the less-developed countries.

Even though India is among the leaders in the manufacturing of generic drugs, we are heavily dependent on China for the import of Active Pharmaceutical Ingredients (API). What can be done to become self-reliant vis-a-vis APIs and how is India planning to achieve that?

India has done so well in the pharma sector. Our only drawback had been that we have been importing these APIs from countries like China. But now endeavour of the government is to attain self-sufficiency in APIs also. And that’s a significant reform that is taking place in this industry right at this moment.

Many economists are making the argument that since our mortality rate is so low, we should open up the economy in one go and treat people as and when the cases come. The view is quite contrary to that held by most public health experts' who are advising the flattening of the curve, much like South Korea. You have a view and understanding of both sides, what's the way forward for India. MHA has shown the path for the next two weeks. What after that?

Our government’s thinking is very clear. It has been elaborated by the Prime Minister himself when he said that jaan (life) and jahan (material wellbeing) both are important. For me, as the health minister, the foremost duty is to save each and every life in India. We have adopted a dynamic strategy to mitigate Covid-19, but you have seen that we are now lifting the lockdown. That has been done by the home ministry to make sure that we are able to take care of the economy and help those people who have suffered because of the economic slowdown post the lockdown.