Given that India is routinely reporting over 200,000 new COVID-19 cases per day (which is likely to be a vast underestimate) and given the fact that several dangerous variants have emerged in India, I believe it is prudent for us to institute a temporary full travel ban to all travelers coming here from India. At the same time, travel to India should be stopped to all but the most essential (and vaccinated) personnel. All routine flights to and from the U.S. should be immediately cancelled.
On Friday, President Biden signed a travel restriction, limiting travel to permanent legal residents, spouses and close family members of U.S. citizens, while barring entry to most foreigners who have been in India in the past 14 days. The restrictions went into effect on Tuesday, May 4. This should have been done weeks ago, and the question now is whether this is too little or too late to stop the spread of cases here. In fact, as I suggested in early April, we need to completely halt flights to and from countries with larger outbreaks than ours, at least until more of our own citizens are vaccinated.
Consider that just last week a flight from New Delhi to Hong Kong ended with a third of all travelers contracting COVID-19. Like Israel, or the United Kingdom, today’s success stories will be most useful to the rest of the world if we can control our own COVID-19 numbers here at home, rather than importing thousands more cases. We need to take a lead from Australia, which has suspended all flights from India until at least mid-May. We need to do the same here.
Meanwhile, the U.S. is now sending raw materials to India for vaccine manufacturing.
While this is a useful gesture, and while the U.S. is also planning on sending overseas more than 60 million doses of the AstraZeneca vaccine that we may never use here — with 20 million of these doses going to India — consider that these gestures are really just a drop in the bucket. Consider that India makes the most vaccines in the world and has the world’s largest vaccine manufacturer, the Serum Institute of India (SII). In fact, SII is making millions of doses of the AstraZeneca vaccine a month under the Covishield program. But Dr. Anoop Misra, chairman of the Fortis-C-DOC Center for Diabetes, Metabolic Diseases and Endocrinology in New Delhi, and one of the top community outreach physicians in the country for decades, told me in an interview that much of India’s own vaccines were being exported, despite that country’s current crisis, but there are some reports that this is now being reversed.
Misra identified the larger problem as vaccine non-compliance rather than lack of vaccine availability. He told me that “quacks” are fanning the flames of COVID-19 in the rural areas of India by creating false fear of the vaccine. Meanwhile, hospitals in India are overloaded and there is a shortage of oxygen and other primary supplies.
What about the World Health Organization? The answer is that the WHO is continuing its politicking in lieu of providing effective leadership or resources. A senior WHO official told me that “WHO has focused its discourse and politics on poor aid-dependent countries with its COVAX effort, largely ignoring the epidemiological patterns, which showed the development of the epidemic in large middle-income countries including India. The effort of the WHO is a drop in the 1-billion-people ocean that is India. This exposes the WHO lack of epidemiological and data skills.”
Throughout the pandemic, even as India was trying (and, for the most part, succeeding) to control its own COVID-19 outbreaks, skirmishes between China and India occurred along the Sino-Indian border. So it is somewhat ironic that now China is offering its assistance and blaming the U.S. for being slow to provide the raw materials. At the same time, China’s own vaccine, Sinovac, has come under worldwide criticism for underperforming.
What should the U.S. do beyond sending supplies and vaccines? The U.S. has a long history of epidemic intelligence officers, known as “disease detectives,” helping to inform and control disease outbreaks, including Ebola. The Centers for Disease Control and Prevention (CDC) was not allowed into China at the onset of this pandemic, but it certainly can do a lot of good in India now. As the White House announced last week, “The U.S. CDC, working with USAID, will urgently deploy a strike team to India which will include public health experts to work in close collaboration with our embassy, with India’s health ministries and experts, and with India’s Epidemic Intelligence Service staff.”
The plan is for the strike team to work with India’s experts in laboratory services, surveillance and epidemiology, bioinformatics for sequencing and modeling of the disease, infection, prevention, control, vaccine rollout and risk communication. Perhaps most importantly, the strike team will include CDC epidemic intelligence officers.
Hopefully, the CDC’s presence can help overcome the absence of the WHO and help to counter the superstition, poor information, as well as vaccine resistance, especially in rural areas, which Dr. Misra pointed to as the heart of the problem.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”