India next corona hotspot?

New Delhi: India could become the next global hotspot for virus cases, with experts warning containment measures that proved successful elsewhere in Asia may not work in the world's second-most populous country.

India, which has so far reported over 150 infections and three deaths, is trying to contain the coronavirus by closing its borders, testing incoming travellers and contact tracing from those who tested positive.

Despite ICMR claims about the tests on the pandemic, some experts in the nation of 1.4 billion people say that won't be enough to contain the spread.

Other measures like widespread testing and social distancing may be infeasible in cities with a high population density and rickety health infrastructure in the nation.

While growth in total numbers has been slow until now, "the number will be 10 times higher" by April 15, said Dr T Jacob John, the former head of the Indian Council for Medical Research's Centre for Advanced Research in Virology, a government-funded institution.

"They are not understanding that this is an avalanche," said John, who was also chairman of the Indian Government Expert Advisory Group on Polio Eradication and chief of the National HIV/AIDS Reference Centre at the Christian Medical College in Vellore. "As every week passes, the avalanche is growing bigger and bigger."

So far India has been relatively unscathed by the virus compared with other countries in Asia. The Central and state governments have been doing their best to fight the spread of the virus in the country.

A key concern in India is Maharashtra, the state with the highest urbanization in India and home to the financial capital Mumbai. It's reported the biggest spread of the infection with 40-plus cases.

Its government has called for a virtual lockdown of cities on Monday -- shuttering all public places, putting off university exams and asking government offices and private companies to ensure at least half their staff work from home.

"Maharashtra is in the second stage at the moment," Rajesh Tope, Maharashtra's Health minister told reporters in Mumbai. "But if we don't curtail or stop the infection from spreading this contagious disease, we could slip to stage three and that would mean a spike in the number of infections," he said.

Apart from its sheer size, India's other challenge is the density of its population: 420 people live on each sq km, compared with 148 per sq km in China.

India's population "makes it extremely difficult," said Dr K Srinath Reddy, adjunct professor of epidemiology at the T H Chan School of Public Health at Harvard University and president of the New Delhi-based health think-tank Public Health Foundation of India.

"Social distancing is something often talked about but only works well for the urban middle class," he added. "It doesn't work well for the urban poor or the rural population where it's extremely difficult both in terms of compactly packed houses, but also because many of them have to go to work in areas which are not necessarily suitable for social distancing."

India has announced that state-authorized private laboratories would be allowed to conduct tests. But the government has yet to release the list of authorized labs, according to Dr Lokesh Kumar Sharma, spokesman for the Indian Council of Medical Research said.

Mahindra and Mahindra Group chairman Anand Mahindra has asked the government to allow the private sector to start testing for coronavirus. Currently, the government has only established 62 testing facilities for COVID-19.

Mahindra, in a tweet, said, "India has done a fine job, so far, of managing the crisis. Pre-emptive measures for containment have been lauded the world over."

Mahindra mentioned that the testing rate for coronavirus could be India's "Achilles Heel". He then requested the government to allow the private sector to begin testing for coronavirus as this would drastically increase the capacity and number of test centres.

More than 5,200 potential cases have been identified through contact-tracing and put under surveillance in India, the Health ministry said. Last week it suspended most visas and decided to limit international traffic through land crossings.

The country's response to the coronavirus spread is driven by the limitations of its public health system, Reddy said. India's health-care spending is among the lowest in the world -- just 3.7% of gross domestic product.

That's left it with a patchwork of overcrowded public hospitals, and private ones that are unaffordable for many people.