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New Delhi: India is among the countries that took Covid-19 “very seriously” from the beginning, World Health Organisation (WHO) chief scientist Soumya Swaminathan has said. In conversation with Editor-in-Chief Shekhar Gupta at the digital version of ThePrint’s Off the Cuff Saturday, the scientist lauded the Narendra Modi government’s efforts in containing the spread of infection until now.

Discussing India’s response, Swaminathan sought to highlight a timeline shared by Union Health Minister Harsh Vardhan during a meeting last week with counterparts from 194 nations.

“The timeline he presented was quite credible. It showed that, by 30 January, India had set up all the committees and states were already screening travellers from China,” said Swaminathan.

“Indian health authorities tracked the incoming passengers. They called these incoming passengers everyday for the next 14 days to check their symptoms. Probably this is how India was able to limit and contain infections and has been able to keep the curve really flat,” she added.

According to Swaminathan, India’s initial cases sneaked into the country because of “the inefficacy of temperature-screening machines”. “Also, a lot of people from Europe brought infections in the country around late March,” she said.

The Indian demographic, she added, had a role to play as well in India’s low tally of cases and deaths. “Infections are lower possibly because of the demographics as the population is younger. But scientists need to analyse the data to understand why India had lesser cases,” she said.

However, she sought to warn India that the numbers could begin to go up anytime, saying the government must continue its efforts.

“A spike in cases would be worrying in crowded places like urban slums. Physical distancing in Europe is different from developing countries of the world where people live in overcrowded cities,” said Swaminathan.

Countries such as India and some parts of Africa need a different and more balanced approach, she added. “They could pioneer a different approach and put in place sensible measures to contain the transmission. Also, community participation must be encouraged.”

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‘Govt data is genuine’

As of Sunday morning, India had around 26,500 Covid-19 cases and 824 deaths.

Asked if she trusted the data coming out of India, Soumya Swaminathan, who has earlier served as secretary to the union government for health research, said yes. The Indian Council of Medical Research (ICMR), India’s apex medical research body, could “never fudge” data, she added.

“The WHO does trust the data that we get from countries worldwide, including India and China,” she said. “ICMR trusts science,” added Swaminathan, a former ICMR director-general. “I do not believe they would fudge data or hide information.”

She also appeared to back the ICMR’s March advisory recommending the use of the anti-malarial drug hydroxychloroquine (HCQ) as a preventive among healthcare workers tending to Covid-19 patients – a move that has been criticised by health experts since the efficacy of HCQ vis-a-vis Covid-19 remains a matter of research.

“My personal feeling and WHO’s stand is that it is better to test it in a research setting. We don’t have any evidence to say HCQ has any protective effect against Covid-19, we can only decide after a few months of trials,” she said, adding that the advice to use HCQ “isn’t reckless”. “The drug has been safely used in the past,” she said.

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‘Lockdown should be lifted in graded manner’

Soumya Swaminathan, a Chennai-born scientist with over 30 years’ experience in the medical field, said the Modi government must weigh all options before lifting the nationwide lockdown, which is currently scheduled to end 3 May.

“The WHO can provide guidance and steps and checks-balances as India opens up. There should not be a sudden lifting of lockdown but a graded approach,” she added.

However, the WHO chief scientist predicted that life won’t be the same as it was before the onset of Covid-19.

“Now we need to do certain new things that we were not doing in the past. For instance: mass gatherings and sporting events won’t happen till a few more years. Also, people may travel only for essential things. Personal habits, such as shaking of hands, will change. Of course, in India, we already have the ‘Namaste’,” she said.

She pointed out that while India is a young country, the 10 per cent share of people aged over 60 years still translated into 13 crore – which is twice the population of Italy. “It means elderly people should be extra cautious. The youngsters going back to work post-lockdown should be extra careful around elders,” she said.

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‘Asia contained Covid-19 better than European nations’

Asia has been able to contain the spread of the disease and limit mortality better than European nations, said Soumya Swaminathan.

“Probably because of the former experience of tackling the outbreak of Severe Acute Respiratory Syndrome (SARS), countries such as Hong Kong and Singapore were able to contain the (Covid-19) spread better,” she said.

“In these countries, both the government and the public knew how to manage the viral outbreaks better than those countries who were never exposed to any such virus outbreak before,” she added.

Also, the European nations bore the brunt because the high life expectancy there meant a significant population of the elderly. “For instance: The average age of people who died in Italy was 81 years. Similar was the age profile in other European countries,” she said.

Swaminathan also noted that many countries did not take the disease seriously despite the WHO’s warnings.

“The WHO has been warning all countries, irrespective of income levels. It has been saying that it is not something to take lightly. Put in place the required mechanisms such as labs set-up, testing kits and activate public health machinery to quarantine, isolate and treat,” she said.

“But many countries did not take immediate steps at the right time. So, they were suddenly overtaken by events and the number of cases spiked, to which public health systems collapsed.”

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‘Test ayurveda, BCG for efficacy’

In India, there’s been a push from the Modi government to promote alternative medicine systems like ayurveda for boosting immunity amid the Covid-19 pandemic.

Soumya Swaminathan expressed support for using traditional medicine to boost immunity. Traditional medicine, she said, should be given a fair chance in either preventing Covid-19 infections or for treatment. “China has put in place a number of trials around their traditional systems,” she added.

“We must have an open mind about traditional medicines,” she said, when asked if she backed ayurveda. “Ayurveda has been known for its potential for boosting the immune system. They should go through the same clinical trials as allopathic drugs.”

A tuberculosis expert, she added the Bacille Calmette-Guérin (BCG) vaccine, whose potential as a Covid-19 preventive has evoked interest, was unlikely to protect against other bugs in adulthood unless one takes booster doses.

A study by medical researchers in the US and UK has found that “countries that do not have a BCG vaccination policy saw ten times greater incidence of and mortality from Covid-19, compared with those who do”.

However, Swaminathan said “it (BCG vaccine) is interesting for its non-specific effects on innate immunity which are similar to polio vaccine, but its protection against tuberculosis wanes into adulthood”.

“It is unlikely to protect against other bugs in adult life. However, the trials are ongoing for conclusion,” she added.

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