|
 Federal health authorities failed to respond adequately to that
warning, Dr Subhash Salunke, who has 30 years of experience in
public health in India, Indonesia and the United States, told
Reuters.
The variant, now known as B.1.617, triggered a catastrophic wave of
coronavirus cases in India and has since spread to more than 40
other countries. In May, the World Health Organization (WHO) termed
it a "variant of concern," citing its high transmissibility.
The variant's first impact was detected months earlier in the
Amravati district of the western state of Maharashtra, where health
authorities recorded a rapid increase in coronavirus infections in
early February, even as cases fell elsewhere in India.
Salunke, a former WHO official advising the Maharashtra government,
said he alerted some of India's most senior health officials in
early March, speaking on the telephone to Prime Minister Narendra
Modi's main coronavirus adviser, V.K. Paul, and the head of the
National Centre for Disease Control (NCDC), Sujeet Kumar Singh.
Salunke told Reuters he warned both Paul and Singh that the virus
was showing signs of mutating in Amravati, that its transmissibility
was increasing, and requested federal help in sequencing more
samples to establish how the variant was behaving. Reuters could not
independently confirm what was said in those conversations.
"In spite of a public health person like me giving them a sound
warning, they did not take heed," Salunke told Reuters.
In response to Reuters’ questions, Paul said he spoke with Salunke,
but described the conversation as Salunke conveying information
rather than issuing a warning.
He rejected Salunke’s accusation that he did not take heed, saying
he requested that India’s National Institute of Virology (NIV) study
the variant more closely, and told the Maharashtra state government
to intensify its existing response to the virus.
Reuters could not determine if the NIV carried out any such study.
The NIV directed Reuters’ questions to the Indian Council of Medical
Research, which did not respond.
“The government strengthened the sequencing and clinico-epidemiological
studies,” Paul told Reuters. “The government intensely, repeatedly,
from multiple fora, emphasized the need for containment using all
the tools even more vigorously, and optimising testing.”
NCDC’s Singh and India’s health ministry did not respond to
questions from Reuters about Salunke's warning.
Despite Salunke’s flagging of the problem, and a further warning in
early March from a forum of scientific advisers that the new variant
was taking hold in the country, the federal government allowed
election rallies, religious festivals and other mass gatherings to
proceed, and failed to take measures to halt the spread of the
virus.
Within 80 days, the variant went from Amravati to dozens of
countries around the world, including Britain, the United States and
Singapore, presenting a setback to global efforts to contain the
disease.
It is impossible to say exactly how many infections in each country
have been caused by the new variant, because very few samples from
positive tests have been sequenced. U.S. authorities estimated last
week that the variant accounted for 6% of coronavirus infections
there.
In India, the dramatic rise in infection numbers from April onwards
- partly driven by the variant, according to public health studies -
overwhelmed the country's health system, causing hospitals to run
out of beds and oxygen and causing crematoriums and graveyards to
overflow. India’s health minister, Dr Harsh Vardhan, said last month
that the variant was identified in about 20% of samples in the
country that had been sequenced.
A SUDDEN RISE
In late January, when India's daily count of coronavirus infections
had fallen to around 12,000, Modi all but declared victory at a
World Economic Forum event, saying the country had "saved humanity
from a big disaster by containing coronavirus effectively."
That sense of optimism was sweeping large parts of India, including
Amravati, where cases had dropped to a trickle, according to local
health officials. The district, home to 2.9 million people, had
reported only dozens of COVID-19 cases daily through much of
January, according to government data.
"Everyone was relaxed," said Shyamsunder Nikam, Amravati's civil
surgeon, who supervises public health matters in the district.
But case numbers started suddenly rising in late January, alarming
Nikam and other local officials. New infections rose to around 200 a
day by Feb. 7 and reached 430 a day a week later, as the virus tore
through the district's rural interior that had been largely
unscathed during India's first wave in 2020.
[to top of second column] |
A task force set up by the Maharashtra government to guide its
pandemic response ordered a probe. Dr Rajesh Karyakarte, who was
part of the investigation, said he analysed four positive samples
from the region and found they all contained a mutation called
E484Q, a sign that a variant was likely at play.
Karyakarte told Reuters he presented the findings to the Maharashtra
task force in a video conference on Feb. 16. Reuters could not
independently confirm if he did so or how the task force responded.
Dr Tatyarao Lahane, a member of the task force, did not respond to
questions from Reuters.
RAPID SPREAD
The discovery of the new mutation and spiking case numbers in
Amravati alarmed Salunke. He said he travelled to Amravati in late
February and conducted coronavirus tests on nearly 700 people.
Around half of them turned out positive for COVID-19.
Within a few days, he told Reuters, state health authorities sent
samples from Amravati to the NCDC for further genetic sequencing to
establish if a variant was present. The NCDC did not respond to
questions from Reuters about what it did with those samples.
Meanwhile, federal health officials played down the potential role
of new variants in the spike of infections.
"There is no direct relation between the recent surge in COVID-19
cases in Maharashtra and some other states with the mutant virus
strains N440K and E484Q of COVID-19," India's health ministry said
in a media statement on Feb. 23.
Modi’s coronavirus adviser Paul said that assessment was based on
the data authorities had at that time.
“We knew that something had been spotted but we didn’t know the
significance thereof at that point,” Paul told Reuters. “True
significance of variants emerges with time. Scientific data has now
led us to understand the role of these variants.”
In late February, federal and local officials had a meeting to
discuss the spike in Amravati, according to a senior government
scientist who attended it.
At the meeting, Maharashtra's State Surveillance Officer Dr Pradip
Awate said the rise in cases was due to voters flocking to local
elections held in January rather than any kind of new variant, the
scientist who attended the meeting told Reuters.
Federal officials, including from the Indian Council of Medical
Research, appeared convinced by that explanation and did not press
for further investigation, the scientist said.
"At that time there was certain confusion," Awate told Reuters,
which made it hard to assess exactly why cases were rising.
'MAJOR MISTAKE'
The emergence of the new variant was not treated with the urgency it
deserved, said Salunke.
"What happened in Maharashtra is a natural phenomenon. And it should
have been addressed on a war footing, as an absolute emergency," he
said. "It was ignored and the entire focus was on the elections," he
said, referring to a series of state elections that were held
through March and April, drawing crowds of thousands to rallies by
Modi's party as well as opposition politicians.
Missing the rise of the variant in Amravati in late February was a
"major mistake", said the scientist who attended the Maharashtra
meeting.
State health official Awate said Maharashtra could have imposed
stricter lockdowns and restricted inter-district travel much sooner.
Instead, lockdowns were imposed in Maharashtra and other major
cities such as New Delhi only in mid-to-late April.
Between March and April, the federal government allowed the Kumbh
Mela Hindu festival to proceed in northern India, drawing millions
of people from around the country for a holy dip in the Ganges, many
of whom travelled back home carrying the virus, according to public
health officials.
Even as it spread across India, the variant was carried to other
countries where it also sparked a rash of cases.
In Britain, a related variant - called B.1.617.2 or Delta by the WHO
- was found in areas where many people travel back and forth to
India, according to experts.
(Reporting by Devjyot Ghoshal and Zeba Siddiqui in NEW DELHI;
Additional reporting by Alistair Smout in LONDON and Chen Lin in
SINGAPORE; Editing by Euan Rocha and Bill Rigby)
[© 2021 Thomson Reuters. All rights
reserved.] Copyright 2021 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content |
