Shouldn't India issue a travel advisory against trips to the US?

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First, a caveat. The author is no authority on viruses, and has based his arguments on the basis of material available on the WHO and CDC websites, and after a few discussions with doctors.

Secondly, this article is not to malign any country.  It is an attempt to bring in more rational judgement when dealing with epidemics or with diseases.

The immediate provocation for this article is an announcement by India that all visas of Chinese who have been to China stand cancelled – irrespective of whether they tested positive or otherwise for the Coronavirus (2019-nCov). This is the first time the government has taken such a stand. It has not done so with any of the outbreaks in the past.  It was certainly bizzare, and even defied logic.

Defining Epidemics 

To better appreciate the issues involved, let's begin with the definition of an epidemic. It is the rapid spread of infectious disease to a large number of people in a given population within a short period of time, usually two weeks or less. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic (Principles of Epidemiology, Third Edition (PDF). Atlanta, Georgia: Centers for Disease Control and Prevention. 2012 and  Green MS; Swartz T; Mayshar E; Lev B; Leventhal A; Slater PE; Shemer Js (January 2002). "When is an epidemic an epidemic?". Isr. Med. Assoc. J. 4 (1): 3–6. PMID 11802306)

Now, consider the number of people who died because of coronavirus. It is only 427.  Other virus strains have caused more deaths, like the H1N1 Swine Flu.  India did not do anything then. So, why this incredible reaction now?

The worst virus attack the world has seen (according to the WHO) was the 1918 influenza pandemic. It "was caused by an H1N1 virus with genes of avian origin. Although there isn’t any universal consensus regarding where the virus originated, it spread worldwide during 1918-1919.  In the United States, it was first identified in military personnel in spring 1918. It is estimated that about 500 million people or one-third of the world's population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States".

The coronavirus accounts for the lowest of mortality rates from the virus attacks listed above.  So, has the Indian administration overreacted?  Has it lost its nerve?

In fact, if there should be any travel advisory to be issued, it should be against the US as more deaths through the 'flu virus' occur there – not just this year, but year after year.  Last year, the US witnessed over 34,000 deaths on account of this virus.  Is the pot now calling the kettle black?

So, why have India's officials not issued a seasonal travel advisory against visits to that country during the flu season?

One more thing.  Viruses are not the biggest killers in the world.  According to the WHO, the biggest killers lie elsewhere (see table).  India should be using such emergency powers for any outbreak of diarrhoea and tuberculosis than the Coronavirus outbreak in China.

A final remark.  China has been doing a lot more than most countries have done to contain the spread of the virus.  Just watch the amazing speed with which it built the Leishenshan Hospital and the Huoshenshan Hospital both within 10 days.

India does not even bothered setting up isolation wards at the speed and scale than China has. Acts of cancelling visas and blocking out a country cannot be is insanity and panic. Bureaucrats should be more level-headed, not prone to panic attacks.

(The author is Consulting Editor with Moneycontrol)