NEW DELHI. — A veteran public health expert warned top Indian officials in early March that a new variant of the coronavirus was spreading quickly in a rural district in the heart of the country and that the outbreak required urgent attention.
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 optimizing 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. US 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.
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. — Reuters
