An infectious diseases and public health systems expert at Harvard Medical School has warned that the risk of India seeing an Ebola patient is “very, very high,” and predicted that India may well have “at least a few cases before the calendar year is over”.
In an exclusive email interview with The Hindu Ashish Jha, Professor of International Health at Harvard’s School of Public Health and Director of Harvard Global Health Institute, said, “As long as the outbreak continues in West Africa, the chances that someone will end up in India and then, develop symptoms is very high.”
His remarks came even as India’s Health Ministry announced its plan to conduct mock drills simulating treatment for a potentially infected patient, and World Health Organisation Director-General Margaret Chan said, “The whole world is put at risk” by the deadly virus spiralling out of control. WHO’s India office, in a statement, underscored India’s “active screening of passengers at international airports and hospital preparedness in major cities for referral of potential suspected Ebola cases for investigation,” noting the Health Ministry’s screening of 21,799 passengers between August 1 and October 12, of whom 55 were deemed high risk but no positive cases had emerged so far.
Yet Professor Jha noted that in terms of preparedness to deal with a potential epidemic “The bottom line is that India is probably not as prepared as it should be.”
He said that when the first case crops up it would likely be at a public hospital in some mid-size or large city, where there may be serious questions about whether the institution had provided sufficient training to manage someone, even temporarily, until substantial expertise could be brought in.
In this regard a WHO spokesperson also said to The Hindu that it would “not be surprising to see sporadic cases emerge in other countries as we have seen in Senegal, Nigeria and the U.S.,” though she added that if precautions were put in place, these sporadic cases do not lead to outbreaks.
On the question of preparedness Prof. Jha said he would want to know about whether the hospitals had “proper protective equipment they need to care for [an] Ebola patient,” adding that he “worried” about whether hospitals across the country, even those designated as regional centres of excellence in each state were “really getting the training they need to be safe and effective.
The WHO echoed the concerns surrounding preparedness, with Isabelle Nuttall, the agency’s Director for Global Capacities, Alert and Response, explaining that there was a difference between an Ebola case arriving in a country and spreading in that country.Dr. Nuttall said, “It is possible that a case will arrive in a country and what WHO is doing is getting countries that may see some of these imported cases… prepared, [with the objective] to stop the transmission from occurring in these countries.”
More generally Prof. Jha argued that eradicating Ebola once cases emerge in a country will require meticulous case management and public health skills, and India has “way too few of these kinds of people for a nation of its size and complexity”.
He suggested that India may need to turn to agencies such as the U.S. Centre for Disease Control and the National Institutes of Health in helping it managing the condition.
