China’s initial cover-up of the novel coronavirus outbreak for nearly a month invited worldwide condemnation. Similarly, there were concerns when the U.S. was reported to be barring leading scientist, Anthony Fauci, from speaking publicly about the COVID-19 outbreak without approval. Dr. Fauci has been the director of the National Institute of Allergy and Infectious Diseases since 1984 and has helped combat many novel viruses including SARS, H1N1, MERS and Ebola. Therefore, it is troubling that instead of advocating transparency during a pandemic, the Indian Medical Association (IMA), representing over 3,25,000 doctors, has said that India should adopt the same opaque manner of functioning while dealing with the outbreak.
The World Health Organization (WHO) holds a daily press briefing on COVID-19. It shares data on the number of cases and deaths country-wise every day. The Union Health Minister and the Kerala Health Minister also share data daily, which is commendable. But the IMA does not want the government to share data with the public daily as it says people are “clueless as to what is expected of them” and the release of data daily has “created panic”. However, ironically, it also says that “awareness, self precautions, contact tracing and self isolation are the public health measures required”. Secretary General Dr. R.V. Asokan said to The Hindu that the government should consider releasing data “once in three or seven days”. It should not mention the numbers of those infected, but use terms such as ‘low’, ‘moderate’ or ‘high’ to give a sense of the spread, he said. “Why should people know the numbers? This pandemic will escalate and people will scrutinise the numbers minutely,” he said.
Maintaining trust
While dealing with a public health crisis, especially a pandemic, complete transparency is paramount. It is information that helps build trust in society and puts people at ease. How does the IMA expect people to cooperate, practice self-isolation, and take basic precautions when they are not taken into confidence? As Dr. Anant Bhan, a researcher in global health and bioethics, says, “When the government is transparent, it gives people the confidence that it is in control and is taking all the necessary steps to control the outbreak. The trust factor should not be broken.”
Responses across the world
Many countries responded quickly to the unfolding pandemic. South Korea shared data on the number of cases and deaths even as the numbers steadily increased. On March 5, the U.K. added COVID-19 to the list of notifiable diseases and added SARS-CoV-2 to the list of notifiable causative agents. As a result, doctors are now legally bound to report all cases to Public Health England.
The Indian government has made some efforts to this end but can do much more. It could take a leaf out of Taiwan’s book, for instance. In Taiwan, the public were kept informed about COVID-19 every hour through television and radio programmes. They were informed about how SARS-CoV-2 spreads, the importance of washing hands with soap, when to wear a mask, etc. They learnt about the symptoms and spread of the disease. This helped Taiwan trace contacts easily. People also cooperated in cutting the transmission chain — for instance, parents checked their children for a fever before sending them to school.
The right approach
This is not the first time that the IMA has made an embarrassing statement. Some time ago, it admonished The Lancet for the journal’s stand on the dilution of Article 370 in Jammu and Kashmir. Its dangerous advice at a time like this raises questions about whether the IMA and its office bearers are aware of the best public health practices during a disease outbreak, particularly a pandemic. It is not transparency and data, but opacity and lack of public awareness that cause panic. The right approach would be for the government to constantly educate the public on various aspects of SARS-CoV-2 and the precautions to be taken.
prasad.ravindranath@thehindu.co.in
