Coronavirus outbreak: The countries affected
Coronavirus cases in India: Confirmed, suspected and recovered
Thousands of suspected cases have been tested resulting in 28 confirmed coronavirus cases in India. Italians toruing in India have been tested positive for Covid-19 coronavirus. They have been quarantined at the Chawla Camp in New Delhi.
An employee working at DSM, a company based in Mindspace, Hyderabad, is detected to be positive for coronavirus, according to sources. Contact tracing and disinfection are being done currently. Mindspace and Brightspace offices in Madhapur have been closed temporarily, meanwhile. Hyderabad Metro trains are being disinfected as a precautionary measure starting from 04 March.
Similar measures are expected to follow suit in other metros such as Delhi Metro and Jaipur Metro.
The first three Indians tested positive for coronavirus are from Kerala and have been discharged, but home-quarantined.
A new case was confirmed on 03 March of a 69-year-old male Italian who arrived in Rajasthan. The first test yielded a negative result but a second test turned out to be positive for the novel coronavirus. His wife was also diagnosed to be positive later, on the same day.
On 02 March, two confirmed cases were reported including one in New Delhi and one in Hyderabad (Telangana). The confirmed in New Delhi was in a person who returned from Italy, while that in Telangana was in a person who returned from Dubai to Hyderabad. The crew of the Air India flight that carried the infected in New Delhi has been asked to self-isolate at their homes for 14 days.
Health officials have identified a total of 88 people including family members who came in contact with the confirmed case in Hyderabad and taken their samples for testing. Among the 88 people, 45 have been admitted to the state-run Gandhi Hospital.
The Ministry of Health announced on 03 March that samples taken from six people who came in contact with the confirmed case in New Delhi showed high viral loads. The samples have tested positive at the National Institute of Virology in Pune.
Suspected cases are being reported in Bengaluru, Maharashtra and Madhya Pradesh.
Indians on quarantined cruise ship Diamond Princess
The latest coronavirus cases in India are reported from the Diamond Princess cruise ship quarantined off the coast of Yokohama in Japan. A total of 16 people from India have tested positive for the virus on the ship as of 26 February. The infected persons are reported to be a stable condition. A total of 132 passengers and six crew members from India are reportedly on board the ship.
A total of 119 Indian nationals along with five foreign nationals who have tested negative for the virus were evacuated in a special flight on 27 February.
Coronavirus disease in India: Approved treatments
The Drug Controller General of India has granted approval to the Indian Council of Medical Research to use a combination of lopinavir and ritonavir in the event of the coronavirus disease in India turns into a public health emergency, reported the Economic Times.
Lopinavir and ritonavir have already been approved for the treatment of HIV.
Covid-19: Measures India has taken to control the Wuhan coronavirus spread
The Indian government has announced a number of preventive measures to minimise the entry and spread of coronavirus, as detailed below. India’s prime minister Narendra Modi is reviewing the country’s preparedness in combating Covid-19 coronavirus in India, if it spreads further in India, and has appealed to Indians to avoid mass gatherings.
Evacuation measures
The Indian government arranged for the evacuation of 366 Indian citizens from Wuhan in a special Air India flight on 31 January 2020. The passengers are placed under quarantine for a period of 14 days.
A second batch of passengers, including seven Maldivan citizens evacuated by the government, arrived from Wuhan on 01 February 2020. The repatriated passengers are currently being monitored. India evacuated 645 people by 11 February. The health condition of all of them is being monitored on a daily basis.
A total of 76 Indian nationals and 36 foreign nationals were evacuated in a special flight from Wuhan on 27 February.
Visas cancelled for foreign nationals travelling from China
India announced the cancellation of existing e-visas issued to all foreign nationals of China, on 05 February and advised Indians to avoid travelling to China.
Further, India announced that people travelling to China will be quarantined upon return. India temporarily suspended visa on arrival for Japanese and South Korean nationals on 27 February.
On 03 March, India announced the suspension of all visas issued to nationals of Italy, Iran, South Korea and Japan who have not yet entered the country. Visas issued to foreign nationals who travelled to China, Iran, Italy, South Korea and Japan who have not yet entered the country have also been cancelled.
The cancellation is not applicable to diplomats, officials of the international bodies, OCI cardholders and aircrew although medical screening is mandatory for all. Medical screening and submission of self-declaration form including travel history for all passengers arriving from the restricted countries are also mandatory.
Availability of coronavirus drugs in India
The Department of Pharmaceuticals is assessing the availability of drugs in the country due to the increase in cases of coronavirus infection. A report submitted by a committee formed by the department revealed that the existing stock of APIs will be sufficient to manufacture drugs for two to three months.
Various government organisations including the National Pharmaceutical Pricing Authority and Drugs Controller General of India have been instructed to ensure adequate supply of APIs and check black-marketing or illegal hoarding. The organisations have also been asked to monitor the availability of APIs and drugs.
The Directorate General of Foreign Trade (DFGT) has been instructed to restrict the export of 13 APIs and formulations, the majority of which are made in Hubei, China. According to the latest reports, many Chinese pharmaceutical companies have partially resumed production and expected to resume full production by end of March. Logistics, however, have not resumed fully, which may delay the availability of APIs.
Coronavirus screening, testing and quarantining at Indian airports
Thermal screening has been installed at 21 airports including those in Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, and Cochin to check for coronavirus in India. Universal screening has been mandated for flights from China, Hong Kong, Singapore and Thailand at the aero-bridges ear-marked for the purpose.
Screening measures have also been implemented at 12 major seaports and 65 minor seaports and land borders.
The Ministry of Health announced on 06 February that all 645 evacuees from Wuhan tested negative.
Two quarantine centres have been set-up to isolate any passengers showing symptoms of the infection. One centre is located at Manesar, Haryana, and is managed by Armed Forces Medical Services, while the second is located at Chawla Camp in New Delhi and is managed by Indo-Tibetan Border Police (ITBP).
A total of 406 evacuees who were quarantined at the ITBP facility were discharged and allowed to return home on 19 February.
Labs testing for coronavirus in India
The NIV and 15 other laboratories under the Indian Council of Medical Research’s (ICMR) Viral Research and Diagnostics Laboratories network are equipped to test samples.
The labs are equipped with reagents to test up to 25,000 samples. The government noted that 19 more labs will be operational soon to test samples.
A total of 3,245 samples have been tested so far, out of which five have tested positive and 23 are pending results.
Travel restrictions by India in the wake of Covid-19
The Indian government issued a travel advisory on 17 January 2020 to the general public to refrain from travelling to China and avoid contact with anyone with travel history to China since 15 January 2020.
The government also temporarily suspended e-Visa facility for Chinese passport holders and noted that already issued e-Visas are temporarily invalid. Online application for physical visa from China has also been suspended.
Any persons trying to visit India under compelling circumstances have been advised to contact either the Indian embassy in Beijing or the Indian consulate in Shanghai or Guangzhou.
The Indian government is expected to announce more travel restrictions with the fresh cases reported in Delhi and Telangana.
Coronavirus impact on India
Coronavirus is expected to present both opportunities and challenges to Indian pharmaceutical manufacturers, while trade with China is also expected to be hit.
Impact on India’s trade with China
With China under lockdown, India is expected to witness a major impact on imports and exports in various industries including pharmaceuticals, electronics, mobiles, and auto parts.
China is the biggest exporter to India, followed by the US and UAE. In 2018, China exported goods worth $90.4bn to India and accounted for 14.63% of the exports.
In 2017, telecom instruments, electronics components, computer hardware and peripherals, industrial machinery for dairy, and organic chemicals were the top five items imported by India accounting for 46% of the imports from China.
How the Covid-19 outbreak impacts the Indian pharmaceutical industry
Bulk drugs and drug intermediates accounted for $1.5bn or 3% of India’s imports from China.
According to the Trade Promotion Council of India, approximately 85% of active pharmaceutical ingredients (APIs) imported by Indian companies are from China.
India’s overdependence on China for APIs exposes it to raw material supply disruption and price volatility. Another major hindrance to the Indian pharmaceutical industry is its low capacity utilisation, according to a report from the Ministry of Commerce and Industry (MCI). India has a capacity utilisation between 30% and 40% as against 75% of China.
Opportunities for Indian pharmaceutical manufacturers
Although the Wuhan coronavirus outbreak could have a significant impact on the Indian pharmaceutical industry unless it is brought under control over the next few months, it also provides an opportunity to India’s pharmaceutical manufacturers to grab share from their Chinese competitors.
Indian pharmaceutical companies currently have two months’ stock of APIs and intermediates, quoted the Economic Times. In the absence of a major disruption due to the outbreak, the existing stocks may address the issue of shortage, it added.
The report from MCI, however, noted that improving the overall capacity utilisation of existing manufacturing plants in India as a short-term solution to such supply disruptions. The report noted the need for assured purchase agreements from the government for the existing manufacturing plants.
It also noted that the government should absorb the price differential to improve capacity utilisation.
Export ban on protection equipment
The DGFT issued a ban on the export of personal protection equipment such as respiratory masks and protective overalls, on 31 January. The exact reason for the ban has not been notified, though.
