Outbreak Alerts
Novel coronavirus, also known as SARS-CoV-2 linked pandemic, started
from Wuhan China during December 2019 (Guo et al., 2020 ).
Transmission from the original place took place long before the World
Health Organization (WHO) declared it a public emergency on 30th January
2020. As of 12th April, WHO has confirmed 1,614,951 live infected cases
and 99,887 deaths in around 200 countries. In India, the first
coronavirus positive case was reported from Kerala on 30th January 2020
(Ministry of Health and Family Welfare, 2020d ). Later, the
positive cases in India came from Delhi dweller who returned from Italy
and a man from Telangana who returned from Dubai. After that, some
positive cases were detected within Italian tourists and their tour
guide in Rajasthan. Overall, the virus spread in the country has
primarily occurred due to foreign travelers or Indian travelers coming
from abroad.
Currently, India is standing up in the initial stage of community
transmission. As per 30th March 2020 Ministry of Health and Family
Welfare, Government of India has announced 1224 COVID-19 cases from all
over the 27 states and union territories with maximum from Maharashtra
(192 cases) and Kerala (202 cases) (Ministry of Health and
Family Welfare, 2020a ). The trend of COVID-19 in India has marked slow
increase with the primary reproduction number R0 value 1.5 as compared
to China (R0 value 2.3), Italy (R0 value 2.34) and Iran (R0 value 2.73)
during their 3rd week from the onset of initial SARS CoV-2 positive
cases (Cereda et al., 2020; Mandal et al., 2020; Zhao et al.,
2020 ). On average, each patient transmits the infection to an
additional 2.2 individuals. Based on data from the first cases in Wuhan
and investigations by the China CDC, the incubation time can be from 3
to 7 days and up to 2 weeks as the longest time (95% CI, 9.2 to 18)
(Singhal, 2020 ). As per the WHO 70th situation report, most of
the European regions like Italy, Spain, France are dealing with up to
11%, 7.8%, 6.2%, of case-fatality rate, even more than China (4%)(Onder, Rezza, & Brusaferro, 2020; World Health Organization,
2020 ). Globally, the case-fatality rate is around 2-3% however,
severely affected patients may die due to excessive alveolar damage,
which leads to progressive respiratory failure as evident from many
countries, including Italy and China. SARS-CoV-2 is the seventh
coronavirus known to infect humans. Along with SARS-CoV, MERS-CoV, and
SARS-CoV-2 severe symptoms causing epidemics whereas HKU1, NL63, OC43
and 229E are associated with mild symptoms (Li et al., 2020;
Yang et al., 2020 ).
For now, more than 500 whole-genome sequences of different strains of
SARS-CoV are reported. Out of these, around 160 isolates have been
reported in recent outbreaks mostly from China, Italy, Iran, the USA,
Japan, Australia, France, and two from India as well. Two known Indian
isolates SARS-CoV-2/166/human/2020/IND (GeneBank: MT050493.1) of 29,851
bp and SARS-CoV-2/29/human/2020/IND (GenBank: MT012098.1) of 29,854 bp
are deposited by National Institute of Virology, Pune, Maharashtra.
Although both strains are isolated from swabs of infected patients from
Kerala, the sequencing of more isolates should be carried out regional
wise across major infected areas. Further, systematic gene-level
mutational analysis of local strains will enable researchers to identify
several unique features of the SARS-CoV-2 genome and the development of
more efficient therapeutics and vaccines.
Several properties of SARS-CoV-2 make its prevention difficult, namely,
non-specific features of the disease, the infectivity even before the
onset of symptoms, transmission from asymptomatic people, and long
incubation period. Hence, the Indian Government has projected proactive
measures to inhibit the spread of SARS-CoV-2 from initial careers coming
from abroad to the local community. Implementation of 21 days lockdown
all over the country has greatly helped to flatten the logarithm spread
within the community (Government of India, 2020) .
Meanwhile, to meet the requirement of personal protection equipment,
masks and ventilators, and other essential items, the government is
allowing domestic companies and manufacturers clearing quality tests to
come-up with more supplies. The supply of N95 masks has been ramped up
to 1,00,000/day by local manufactures mostly and DRDO (Ministry
of Health and Family Welfare, 2020b ).
Moreover, total government laboratories approved and supported by Indian
Council of Medical Research (ICMR) to provide diagnostic kit for
SARS-CoV-2 testing has been increased to 123 all over the country(Indian Council of Medical Research, 2020b) . The government-led
awareness programs based on WHO, CDC, and FAO recommendation on COVID-19
has been enforced to all the states (Ministry of Health and
Family Welfare, 2020c ). Besides, the state government issued
instructions on the closing of all schools and colleges, malls, and any
form of the public gathering. As per reports, a widely-used drug
Chloroquine, has recently been reported as a potential broad-spectrum
antiviral drug. It blocks the virus infection by increasing endosomal pH
required for virus/cell fusion, as well as to interfere with the
glycosylation of cellular receptors of SARS-CoV (Savarino, Di
Trani, Donatelli, Cauda, & Cassone, 2006; Wang et al., 2020; Yan et
al., 2013) . Indian government has allowed restricted use of Chloroquine
among doctors and other staff members coming in direct contact with
severe patients to avoid transmission (Indian Council of Medical
Research, 2020a ). Besides, the Central Drugs Standard Control
Organization approved constricted public health use of
lopinavir/ritonavir combination amongst symptomatic COVID-19 patients(Bhatnagar et al., 2020 ).