India’s vast population heeded prime minister Narendra Modi’s appeal for a voluntary “people’s curfew” to curb the spread of the coronavirus as the government shut down the rail system to stop people fleeing cities.
New Delhi’s India Gate, the site of a war memorial that draws thousands of people on weekends, was deserted on Sunday, while Mumbai’s Marine Drive, an arterial road normally jammed with honking cars, stood empty.
As the number of cases in the country surged to more than 300 on Sunday and the death toll rose to six, Mr Modi’s government ordered a halt to all long-distance intercity trains — which normally carry 23m daily — until the end of the month.
The government also suspended suburban trains in Mumbai and Kolkata and the Delhi Metro was closed until the end of the month. It also urged states to restrict non-essential services in 75 districts with confirmed coronavirus cases.
“India is moving much more rapidly than it was before,” said global health researcher Anant Bhan, speaking from Gurgaon. “We will have to see if this makes a major impact.”
Mr Bhan said the next week was critical for India to assess the severity of the crisis by ramping up testing and readying hospitals for a surge in patients. “There is a possibility of a sudden flood in cases,” he said. “As it is, India is stretched to capacity and existing ventilators are occupied.”
India’s health authorities maintain that the country is still in stage two of the outbreak with all confirmed cases either imported by travellers or transmitted by returned passengers to direct contacts such as family, friends and colleagues.
But the emergence of at least three Indian coronavirus patients with no known link to travellers has fanned fears that the country has entered stage three — community transmission — where the virus is circulating freely.
The discovery of 12 confirmed cases in Bhilwara, a town in the state of Rajasthan with a population of about 400,000, has underlined how the pathogen has spread to the country’s vast hinterland, where weak medical infrastructure could quickly be overwhelmed by a crisis.
Experts fear that India has underestimated the rate of infection by limiting diagnostic testing. The world’s second-largest country of 1.37bn has tested fewer than 20,000 people as of Sunday, far below the 160,000 that Germany is testing weekly. South Korea, which is conducting 15,000 tests daily, has been held up as an example of a country that has managed to get the outbreak until control.
Over the weekend, authorities widened coronavirus testing criteria from travellers with symptoms to all hospitalised patients with acute respiratory infections, along with direct contacts of confirmed patients, a measure that will dramatically increase the pool of tests.
K Sujatha Rao, India’s former health secretary and the author of a book called Do We Care: India’s Health System, says community transmission appears well under way.
“Finally [Indian Council of Medical Research] has woken up to expanding testing. But it continues to sing the same song of no community transmission defying all logic or reason when in one day we have clocked 100 cases. We need to prepare for the worst.”
After a day of eerie silence across India’s usually bustling cities as a result of the shutdown, at 5pm Indians took to their yards, balconies and roof tops to bang pots and pans, blow horns and sing the national anthem in a show of support for people working to end the outbreak.