Call to avert acceleration of COVID-19 from India's Sabarimala pilgrimage of 25 million devotees

Second wave of COVID-19: emergency situation in India

The COVID-19 pandemic has so far infected 25 385 043 people and has taken 280 683 lives (18 May 2021). Several infectious variants are circulating in the country, including the B.1.1.7, B.1.351, B.1.617, and B.1.618. Preventive strategies may include a large-scale TTT approach, imposing IPC- 144 or lockdown in the hotspot areas, and mass vaccination.

Focus on international and domestic travellers are equally important for successful SARS-COV-2 mitigation: ecological comparison of emigrant and migrant travel patterns and COVID-19 trends in Kerala State, India

We posit from our ecological analysis of COVID-19 trends that the focus on returning international emigrants helped the Indian State of Kerala to successfully mitigate transmission from emigrants. However, the state’s failure to prevent SARS-COV-2 seeding by returning domestic migrants from other states of India led to extensive community transmission.

Public health emergencies of international concern: a historic overview

RATIONALE

The International Health Regulations (IHR) have been the governing framework for global health security since 2007. Declaring public health emergencies of international concern (PHEIC) is a cornerstone of the IHR. Here we review how PHEIC are formally declared, the diseases for which such declarations have been made from 2007 to 2020 and justifications for such declarations.

KEY FINDINGS

Six events were declared PHEIC between 2007 and 2020: the 2009 H1N1 influenza pandemic, Ebola (West African outbreak 2013-2015, outbreak in Democratic Republic of Congo 2018-2020), poliomyelitis (2014 to present), Zika (2016) and COVID-19 (2020 to present). Poliomyelitis is the longest PHEIC. Zika was the first PHEIC for an arboviral disease. For several other emerging diseases a PHEIC was not declared despite the fact that the public health impact of the event was considered serious and associated with potential for international spread.

RECOMMENDATIONS

The binary nature of a PHEIC declaration is often not helpful for events where a tiered or graded approach is needed. The strength of PHEIC declarations is the ability to rapidly mobilize international coordination, streamline funding and accelerate the advancement of the development of vaccines, therapeutics and diagnostics under emergency use authorization. The ultimate purpose of such declaration is to catalyse timely evidence-based action, to limit the public health and societal impacts of emerging and re-emerging disease risks while preventing unwarranted travel and trade restrictions.