Once Upon A Time In INDIA (Untold Story About India’s Heroic Efforts)

Namaste🙏…..

This article will put light on the greatest efforts done by India (which you would later be surprise after reading this article) to fight a Threatening, Dreadful & more Deadly virus than Covid-19 in this decade. It will put light on the Unsung Warriors (Doctors, Nurses and the Management staff) who helped to control the spread of the virus.

So let’s travel back in time to May 2018………………

On May 1^st came the good news for soccer fans as Liverpool's Egyptian soccer forward Player Mohamed Salah becomes the first African to be named England Football Writers' Footballer of the Year. On 4^th May, California overtakes Great Britain to become the world’s fifth largest economy. On 7^th May, Vladimir Putin is sworn in as Russian President for another 6 years. On May 9 came the biggest news for Indian Eco-System as Walmart takes a majority stake in Indian online retailer Flipkart for 16 billion. People were in their mood & enjoying as also K-pop boy band BTS released their album "Love Yourself: Tear" which sold 1, 35,000 copies in the first week. On May 19, American actress Meghan Markle marries Prince Harry at Windsor Castle, making her a member of the British royal family. People in the world were enjoying the comedy of Dead pool 2 and were dying to see the next edition of Star War movie: Solo: A Star Wars Story. The world saw again the duo of Amitabh Bachchan and Rishi Kapoor after 27 years in 102 Not Out movie which sadly, was their last onscreen casting.

I think it was the best month of the decade due to the above reasons.

But around the 4^th week of May came the news which was shelved in one small corner of the newspaper and shown 1 or 2 times in digital & electronic media that NIPAH VIRUS has resurfaced in Kerala, India.

In the early hours of 17 May 2018, a critically ill patient was wheeled into Kozhikode’s Baby Memorial Hospital in the Indian state of Kerala. Suspecting a virus, which had not been seen before in the area, the doctors dispatched the samples to Karnataka’s Manipal Centre for Virus Research some 300 km away. The samples tested positive for Nipah virus. These results were subsequently confirmed by the National Institute of Virology (NIV), Pune. India notified the Nipah virus cases to WHO under the International Health Regulations, IHR (2005).

So let’s start by discussing:

1) What is NIPAH Virus?
2) Compare it with Current & Other Viruses?
3) How its outbreak was tackled?
4) How does this Incident Inspire & Guide the world?

Here are some Jokes/memes to uplift your mood in this current scenario…

1) What is NIPAH Virus?

The Nipah virus (NiV) is a type of RNA virus in the genus Henipavirus. The virus normally circulates among specific types of fruit bats. It can both spread between people and from other animals to people. Spread typically requires direct contact with an infected source.

The disease was first identified in 1998 by a team of researchers at the Faculty of Medicine, University of Malaya during an outbreak in Malaysia while the virus was isolated in 1999. It is named after a village in Malaysia, Sungai Nipah. Pigs may also be infected and millions of them were killed by Malaysian authorities in 1999 to stop the spread of disease, which has proven to be successful.

Fruit bats of the Pteropodidae family are the natural host of Nipah virus. Nipah virus infection in humans causes a range of clinical presentations, from asymptomatic infection (subclinical) to acute respiratory infection and fatal encephalitis

Transmission of Nipah Virus shown in a diagrammatic way

Diagnosis

The incubation period (interval from infection to the onset of symptoms) is believed to range from 4 to 14 days. However, an incubation period as long as 45 days has been reported.

The main tests used are real time polymerase chain reaction (RT-PCR) from bodily fluids and antibody detection via enzyme-linked immunosorbent assay (ELISA). Other tests used include polymerase chain reaction (PCR) assay, and virus isolation by cell culture.

Treatment

There are currently NO Vaccines or Drugs specific for Nipah virus infection. WHO has identified Nipah as a priority disease for the WHO Research and Development Blueprint. Intensive supportive care is recommended to treat severe respiratory and neurologic complications.

2) Compare Nipah With Covid-19 & other Viruses?

In the case of Nipah, the spread was most during the symptomatic stage when a person developed very high fever or severe cough. As you can see in the above image that the Death rate of Nipah Virus is much larger than that of current Covid-19 pandemic, hence people should not panic much and remain calm and composed in this Pandemic time.

3) How its outbreak was tackled?

Upon identification of the first case, the state health mechanism immediately swung into action, with a team of experienced multidisciplinary experts led by the Director of the National Centre for Disease Control arriving in the affected district on 19 May. Strong political commitment was key. The Union Health Minister and the Chief Minister of Kerala state led the day-to-day situation analysis and outbreak response.

“The rapid and comprehensive response mounted both by the central and state governments clearly highlights the importance of strong health systems and such a need has never been stronger than now, especially in view of the emerging and re-emerging viruses,” said Dr. Poonam Khetrapal Singh, Regional Director for WHO South-East Asia Region. Key elements were a focus on infection prevention and control measures based on isolating patients, using personal protective equipment and decontaminating surfaces.

Surveillance was critical: more than 2,500 contacts of Nipah patients were monitored by the state surveillance system. Even though cases were reported from only 2 districts of Kozhikode and Malappuram in Kerala, the surveillance net was rapidly scaled up to neighboring districts as well. Advisories were issued by the Government, and updated on the Ministry website, and shared with all states. A total of 18 confirmed cases were identified, of whom 16 had died. One additional suspected case had also came in but the person couldn’t be check for Nipah Virus as he was declared dead already.

Information sharing also played a key role. A 24-hour helpline took queries from the concerned community, while the state government used all available channels of communication, including traditional, online and new media to counter rumors and inform people what the risks were and how to protect themselves.

Health workers and officials all worked almost without a break, successfully preventing a further wave of human to human transmission. The outbreak response illustrates how effective, strong, and connected health systems – in close cooperation with animal health and wildlife sectors – are proven to be of boon in those tough times.

The outbreak was managed by the state government and central government agencies and has been acknowledged as a success story.

The outbreak was officially declared over on 10^th June 2018.

Immediate Response Actions done by the State.

On 23 May 2018, Kerala Health Department issued a travel advisory asking travelers to the Northern districts of Kerala to be extra cautious.

On 23 May 2018, State of Kerala, requested a medical advisory from Malaysian Health Department (Kementerian Kesihatan Malaysia), for treatment and medicines for Nipah virus.

On 25 May 2018, Sharing of Information of Virus Posted in the WHO EIS on at Malaysian Time.

On 30 May 2018 construction began on the Institute of Advanced Virology, Kerala, which was founded in response to the outbreak.

Kerala, which is one of modest income states in India, is known for achieving impressive health outcomes. Kerala relied on the strengths of its healthcare system to contain the outbreak.

4) How does this Outbreak Inspire & Guide the world?

Within a span of merely 25 days, the people of India(which included doctors, nurses, management and logistics staff, government officials) were not only be able to break the chain of the virus but also declared the state Nipah Virus Free and stopped it from becoming pandemic or an epidemic also.

We can already feel the tremendous pain & anxiety due to current Covid-19 virus & we should be feeling very lucky, that we didn’t go through this same hardship in 2018. So this story should be remembered by each and every Indian as well as other Nations too.

Recognizing the importance of documenting and sharing the Kerala experience, the Kerala government requested WHO to conduct an external review and documentation of the response. SEARO HIM team led a joint RO & WCO team to review the programmatic response to the outbreak and document successes and challenges faced during the response to enable better understanding with respect to future readiness for such high threat pathogens.

The public health response and its performance were reviewed along with three domains of inquiry:

Coordination structure & mechanisms that were in place and that was established anew in response to the outbreak.
Performance of surveillance and interventions including non-technical support functions.
Assessment of reduction of transmission and impact of interventions.

The leadership and commitment of all levels of Indian health authorities (state authorities, MoHFW, NCDC, EMR, ICMR (NIE, NIV)) and private sector (inside and outside Kerala) were witnessed.

Excellent level of Co-ordination was found between the different levels of Governments. Both the district co-ordinated with the Health Department of Kerala in a sophisticated manner. Arrival of the health department teams in both the districts in 2 days also helped to contain the virus. Surveillance, along with online availability of data also helped the government to monitor it locally and remotely. A dedicated 24-hour helpline assisted the people to remain calm and not panic. Social Media surveillance helped to curb the rumors and fake news. These all efforts working in synchronization helped India to beat down the Deadly Nipah Virus.

So while fighting Coronavirus we should be more Confident, Calm, Co-ordinated and Collected. We should all think that This Tough Time Shall Pass Too but it will not pass if we don’t give our fullest to it.

The Unsung Heroes of this huge Containment Program

Kerala's efforts in containing the outbreak under the leadership of chief Minister Mr. Pinarayi Vijayan, Health Minister K. K. Shailaja Teacher and Additional Chief Secretary Rajeev Sadanandan (who has now earned the moniker “Nipah Rajeev”) and the then district collector were lauded by many, including the Kerala High Court and Robert Gallo of the Institute of Human Virology, Baltimore.

Kerala Government gave early increments to 61 people to reward them for their efforts in tackling this outbreak: 4 assistant professors, 19 staff nurses, 7 nursing assistants, 17 cleaning staff, 4 hospital attenders, 2 health inspectors, 4 security staff, 1 plumber, and 3 lab technicians. Twelve junior residents and two senior residents were also awarded gold medals of one sovereign each.

Lini Puthussery, a 28 year old nurse at the Perambra Taluk hospital who fell victim to Nipah was hailed on social media as a hero for her sacrifice. A note she had written addressed to her husband Sajish was widely circulated on social media. Kerala Government Hospital Development Society (KGHDS) employees union instituted an award in Puthussery's name to an outstanding person in the sector. The "Best Nurse in Public Service Award" was instituted in memory of Puthussery. Jim Campbell, the Director of the Health Workforce of World Health Organisation also paid tribute, tweeting "Remember them, lest we forget: Razan al-Najjar (Gaza); Lini Puthusserry (India), Salome Karwah (Liberia)".

Kerala Government also lauded many others from the medical fraternity and administration for their contributions in tackling this outbreak.

Still after giving so many awards and recognition to these superheroes, only a few people in India as well as in World know about these heroic efforts.

Though the first case of Covid-19 was from Kerala, they have been able to curb the virus by taking the experience & solutions from the past Nipah Virus .We can make it out from below news articles…

(Screenshot from the web)

Kerala Response to Covid-19

Three days after reading about the new virus in China, and before Kerala had its first case of Covid-19, Shailaja (Health Minister of Kerala) held the first meeting of her rapid response team. The next day, 24 January, the team set up a control room and instructed the medical officers in Kerala’s 14 districts to do the same at their level. By the time the first case arrived, on 27 January, from Wuhan City, the Kerala state had already adopted the World Health organization protocols.

Nipah prepared Shailaja for Covid-19, she says, because it taught her that a highly contagious disease for which there is no treatment or vaccine should be taken seriously.

So before Ending, I really salute to all Healthcare service member, Policeman, Government and people like these from the bottom of my heart and want to tell that you are the REAL Avengers of our world. We will forever be in Debt to all of you.

So I hoped you take these 3 points from the Article

a) If we could fight Nipah in so ease then fighting Covid-19 is also possible.

b) Lauding India’s Leadership For containing the Nipah Virus at Low Level & also not allowing it to spread other state also.

c) Salute to all Covid-19 Frontline Warriors : Doctors, Nurses, Wardboy, Sweepers, Policemen, Social Service Members etc

Homework for You guys

To show how the outbreak of Nipah virus took place in Kerala, a movie had been made known as VIRUS in 2019.

Click Here to watch the VIRUS movie trailer

We know that the whole world is putted into a Lockdown. We all are getting Frustrated, Irritated and demotivated due to it. We should not let this Lockdown Lock our emotions, feelings, memories, self-esteem and excitements but we should unlock our feelings towards our grandparents, sit again with the whole family and play games. Do Video Call with your friends and loved ones. Do your Karma by donating to a relief fund. Relive those old moments by seeing your childhood photo albums. Learn things which no one teaches but only our grandparents can teach us. Spend time with them and enjoy stories of their childhoods and get inspired from their struggles. Watch Family Movies with the whole family. Let’s unlock our singing, dancing potential and again draw painting using Crayons Colors. This Lockdown has given us many opportunities which we always neglected in our whole Lifetime.

And before closing it …A humorous reality right now…

That’s all folks from my side, hope you find this article very resourceful and I am grateful to you since you read my article. Any doubts please ask in the Comments section and will try my level best to reply as early as possible.If you liked my article please share it with all and let them also know about this Heroic effort of India and Add your Email ID in the bottom of the page to receive my article directly to your Inbox.

The below are the following websites whose reference I had taken to give you a complete truthful information about Nipah Virus and I think that all will now acknowledge the heroic efforts of India during Nipah Virus.

Shukhriya……

Ujwal

#Nipah#NipahVirus#Nipahmay2018#IndiafightsNipah#KeralafightsNipah#Keralamay2018#Indiafightscovid

Bibliography:

https://www.onthisday.com/date/2018/may

https://www.bollywoodmdb.com/movies/bollywood-hindi-movies-list-of-2018-1

https://www.who.int/news-room/fact-sheets/detail/nipah-virus

https://en.wikipedia.org/wiki/Nipah_virus_infection

https://www.who.int/news-room/detail/30-07-2018-effective-containment-of-the-nipah-virus-outbreak-in-india-highlights-the-importance-of-a-strong-health-system

https://www.who.int/southeastasia/outbreaks-and-emergencies/health-emergency-information-risk-assessment/surveillance-and-risk-assessment/nipah-virus-outbreak-in-kerala

https://en.wikipedia.org/wiki/2018_Nipah_virus_outbreak_in_Kerala

https://www.thenewsminute.com/article/kerala-nurse-who-fought-nipah-virus-now-treating-covid-19-patients-gulf-125275

https://theprint.in/theprint-essential/how-keralas-experience-in-tackling-nipah-in-2018-will-help-it-contain-coronavirus/359037/