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COVID-19 can be contained

by Dev Lewis

Welcome to issue 10 of ChinaIndia Networked.

If you’ve been receiving past issues you would have read about the COVID-19 “new normal” sucking F&B businesses dry and forcing work, study, and play online in issue 8, and how China is using big data to help contain the epidemic in issue 9—including a translation of a detailed lecture by an academic from the Internet Society of China, which I highly recommend checking out if you have not already.

Watching the global reaction to the epidemic feels like being transported back in time to when China was kicking into quarantine about two months ago. When every conversation with a friend, and everything you read or watch, is about the coronavirus. Future travel plans were cancelled, rules were changing daily, and news coming out of Hubei was a daily depressant. In a matter of weeks everything seems flipped on its head. Yesterday for the first time ever China reported more imported cases than local ones, and is now diverting its efforts to contain people flying into the mainland. Even the lock down in Wuhan is being lifted partially following Xi Jinping’s symbolic visit last week.

China’s experience, along with South Korea, Singapore, and Taiwan, is evidence that that COVID-19 can be contained. The winning formula is clear: temporary quarantine, rapid testing, and close contact tracing, writes Maximilian Mayer and Otto Kolbl in their paper distilling learnings from China. Once these measures are in place normal life can resume without fear of an outbreak.

Early containment is the only strategy for India, any other scenario risks crushing the national healthcare system. I dont claim any expertise in epidemiology but living through the epidemic for the past two months I have been reading smart people who do.

Nicolas Granatino, in his Coronadaily newsletter, writes:

The virus continues its inexorable exponential and lethal ascent as countries scramble with the right policy. At the moment in most countries, the number of deaths approximately doubles every 2.2 days. That is the nature of an exponential epidemic. To put it simply, very soon after an outbreak and unless urgent and immediate policies to curb it are put in place AND clearly communicated to the public, take the number of death today in your country and multiply it by 16: that is your country fatality number in 9 days. Ponder that and act accordingly.

At the time of writing there are 114 confirmed cases and two deaths.

That would put India at 32 deaths on March 23, and 512 deaths by the end of the month unless serious social distancing takes place. But we do not know how far off this may be from the true number, unless testing for the virus rapidly increases.

This chart and methodology by Tomos Pueyo (h/t Exponential View) explains how true number of coronavirus cases is likely between one and two orders of magnitude higher than is officially reported. Therefore if India has 114 confirmed cases today the true number of cases may be upwards of a 1000 already.

Indian claims (not officially) that all cases are imported, their ‘close contacts’ (about 4,000) quarantined, with is no community spread observed. But that could also be because almost all the people tested are international travellers from high risk regions. People walking in to hospitals anywhere in the country with the flu like symptoms are not being tested.

With India’s high population density community spread seems inevitable, especially if reports of people skipping out on quarantine are true. Rapid testing is the demonstrated way to quickly diagnose and contain. South Korea was testing up to 20,000 per day. The Indian Council of Medical Research (ICMR) on their website say that 52 government laboratories and 57 medical facilities are equipped to test for the virus— testing just 5,900 individuals as of March 13.

Private hospitals are not permitted to to test which may result in a major bottle neck, argues Nitin Pai. India still has a window of opportunity to practice social distancing and contain the spread. Mumbai can look to Shanghai— a city of 25 million people with just 350 cases since the onset of the epidemic. Containment is possible and social distancing does not have to last longer than 2-3 weeks but it needs everyone to recognise the threat and act now before we reach a stage where we actually need to panic.

This issue is a light one without the usual translation. I’ve been occupied with thesis writing among other deadlines. But given the current situation I wanted to share some of what i’ve been reading. Stay well, stay at home, and lets everyone shout: CoronaGo!

This article first appeared in Dev Lewis's ChinaIndia Networked newsletter. Dev is a Fellow at Digital Asia Hub and Yenching Scholar at Peking University, where he's conducting research on the Social Credit System. Reproduced with permission.

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