State officials have also said anyone breaking home quarantine would be forcibly sent to an isolation facility, and that it is a punishable offence to refuse compulsory quarantine.
This follows reports people are fleeing isolation facilities in the region over poor conditions in them. On March 15, Scroll.in ran an article saying people in India were fleeing isolation wards. One woman refused to go because the conditions were so unhygienic it “made her wretch,” her brother told the Times of India.
According to the Johns Hopkins dashboard tracking the coronavirus pandemic, India has 152 cases of COVID-19, with three deaths. Most of these have been in the state of Maharashtra. According to the Deccan Herald, 16 of the country’s states have confirmed cases, with half reporting less than five.
India is the second most populated country in the world, after China, with over 1.3 billion people. It is also very densely populated, with 1,202 people per mile square, according to worldometer. In comparison, worldometer has the U.S. population density at 94 people per square mile.
Despite its huge population, the country has one of the lowest reported number of coronavirus cases.
When the outbreak of COVID-19 began, India took a number of steps to prevent it spreading across the country. It closed its borders and suspended visas. According to the New York Times, authorities in the state of Kerala tracked one family believed to have been infected using CCTV and mobile phone records. They then quarantined almost 1,000 people who they had been in contact with.
A number of the country’s mobile networks are also now playing a health information alert before the start of every call to help spread information on the virus.
However, these measures may be ineffective because of the lack of testing. Al Jazeera reports the low level of testing taking place may mean there are many cases going undetected. Only people who have been in contact with a confirmed case and shown symptoms after quarantine, or those who have traveled from impacted countries, have been tested. The Associated Press reports India is performing about 90 tests per day, even though it has the capacity to carry out 8,000.
Conditions in the isolation facilities may also be adding to the problem. On Monday, a woman fled a hospital in Gurugram and checked into a private healthcare facility. She was being tested for the virus as she had recently returned from Malaysia. Five people suspected of having COVID-19 escaped from a Nagpur hospital last Friday. Three have since been found and returned. According to India Today, the ward is now being guarded by police. On Tuesday, 11 people left a hospital in Maharashtra, having returned from Dubai.
An online petition to improve conditions has now been launched by Rhea Bhalla, a student studying in the U.S. who was taking part in an exchange program in Spain. She was advised to return to India after Spain went into lockdown over rising COVID-19 cases. When she arrived in New Delhi, she was quarantined at a center where staff made them feel “like prisoners.” Bhalla has called on the government to improve the hygiene of the centers.
Bhalla’s mother shared images of the conditions at the center on Twitter. After initially receiving abuse for the criticism, she was soon contacted by other people who had experienced similar conditions at quarantine facilities in India.
Speaking to Newsweek, Bhalla’s mother, who did not want to be named, said the family was fine with her being quarantined: “I realize how important it is for the safety of the nation, and I would expect it for others too,” she said, explaining that she told her daughter she had no option but to go to the facility.
“All hell broke loose once she reached the facility. Staff at the airport were abusive, but still I told her to take it in her stride. She started sending us pictures and crying [please] get me out of here. [There was] no water, no food. [The place was] filthy. No running water in toilets.
“When she asked for water the staff told her drink from the tap. We all know anyone consuming that water is bound to fall sick. All other kids with her slowly started to lose it on seeing the pathetic conditions.”
She said her daughter was treated like an “untouchable,” telling her to stay away and that they would put her in jail. After raising the issues on Twitter, people called her a liar and an anti-national.
“But soon family members of others got in touch saying you are not alone and you are not telling a lie,” she said. “More and more people took to Twitter to speak the truth in spite of being abused.”
Eventually, the family was able to move Bhalla to a paid-for quarantine, where she has been since. Staff are monitoring her temperature and symptoms, but she appears to be healthy. Bhalla’s mother said people were not aware of the conditions at the facilities, but she believes once the government is made aware she is sure they will take steps to improve them.
In a statement from the Ministry of Health and Family Welfare released Wednesday, the government said a high level review was being carried out to assess hospitals and care relating to the containment and management of COVID-19.
It said Health Minister Harsh Vardhan “reviewed in great detail the quarantine facilities for the evacuees including the ones at the airports/other key transit points,” and that he has directed teams to carry out regular inspections to ensure amenities and facilities are being provided. “The Minister stated that he shall be reviewing the same everyday with the aim of improving them,” the statement said.
Bhallas’ mother is confident COVID-19 will not grow and spread. And others have praised the country’s efforts to curb the spread. Henk Bekedam, the India representative for the World Health Organization, told The New York Times: “I have been quite impressed with India. From the onset they’ve been taking it very seriously.”
Others, however, are urging caution. Speaking to Scroll.in, T Sundararaman, the former executive director of the National Health Systems Resource Centre, said India’s health system would not cope with a large outbreak: “If fortunately the crisis passes us by we may be saved a catastrophe,” he is quoted as saying. “But if it hits India, the way it is playing out in Italy, and there is a surge of patients seeking care in public hospitals, it could be an unprecedented disaster.”
Hygiene advice
Clean hands frequently with soap and water, or alcohol-based hand rub. Wash hands after coughing or sneezing; when caring for the sick; before; during and after food preparation; before eating; after using the toilet; when hands are visibly dirty; and after handling animals or waste. Maintain at least 1 meter (3 feet) distance from anyone who is coughing or sneezing. Avoid touching your hands, nose and mouth. Do not spit in public. Cover your mouth and nose with a tissue or bent elbow when coughing or sneezing. Discard the tissue immediately and clean your hands.
Medical advice
If you feel unwell (fever, cough, difficulty breathing) seek medical care early and call local health authorities in advance. Stay up to date on COVID-19 developments issued by health authorities and follow their guidance.
Mask usage
Healthy individuals only need to wear a mask if taking care of a sick person. Wear a mask if you are coughing or sneezing. Masks are effective when used in combination with frequent hand cleaning. Do not touch the mask while wearing it. Clean hands if you touch the mask. Learn how to properly put on, remove and dispose of masks. Clean hands after disposing of mask. Do not reuse single-use masks.
