'India is not in a position to say, we are in control'

Dr Nachiket Vartak is no stranger to the world of pandemics and diseases As a systems biologist who runs a research group at the Leibniz Research Centre in Dortmund Germany the alumnus of St Xaviers College and IIT Bombay has been using imaging molecular and cell biology to study liver physiology and diseasesTracking the Coronavirus pandemic closely since its outbreak earlier this year Dr Vartak on March 28 came up with concernworthy findings based on dataset that he pulled out from Johns Hopkins University for six countriesmdashGermany Spain Italy US India and South Koreamdashto understand the trajectory of the spread of the virusHis model which he prefers to call an exercise for curiosity was prepared based on data until March 27 His prediction is that by August there will be at least 625000 infections in India But the uncertainty means that it could go up to 13 billionmdashin the extremely unlikely worst case he shared on the blog emergentnoisecomDr Nachiket VartakAs of April 1 his prediction was that India would have 1522 infected individuals Incidentally the report that morning showed India stood at 1509 patients We reached out to Dr Vartak to help understand where India stands in the fight against COVID19Edited excerpts from the interviewYou chose to look at six specific countries to analyse your data WhyI chose the countries that are most relevant to me First India and Germany India is my native country and I am an Indian national Germany is where I work and have stayed for the last decade The US was chosen because like India it is a large country Spain and Italy represented countries that did not handle the pandemic well in the early stages South Korea on the other hand is a country that has actually managed to flatten the curve already Incidentally all these countries have instituted social distancing regulations in a democratic setup This is why China was excludedmdashtheir outbreak was largely localised to Hubei province and the government is not hindered by the democratic process when it comes to making policy decisionsFor your predictions youve used an equation called the Hill Function to explain and analyse the rise in the number of corona cases till until August Could you explain how it can help present a very accurate numberThe Hill Function is well known to biologists because it represents a selfenhancing steadystate process There are many selfenhancing processesmdashheres an example that Mumbaikars will intuitively appreciatemdashcars on the road Cars can be on the road or they can be parked and all through the day cars are continuously coming onto and off the road But every Mumbaikar knows that the more cars there are on the road the slower they can move and the longer the car remains on the road At a particularly busy traffic junction having even one oddly positioned extra car can block the entire flow and cause a traffic jam And the more cars there are the more chances that this will happen If we study how many cars come on the road every hour and how many leave we can capture this into a calculation and make a prediction about how many cars will end up on the road at some time in the future and whether a traffic jam will occur or not The spread of a disease is also like thatmdashsome people get infected and people also recover But the more people there are infected the higher the chances that tomorrow even more people will be infected The process of infection enhances itself So using the Hill Function we can calculate how many people will be infected on a given day The goal is to find out if we will ever exceed the capacity of the road and cause a traffic jam which is if we will exceed the capacity of our hospitals and doctors and cause a health crisisThe Hill Function is a mathematical representation of this kind of pattern and as in all these cases the more data there is to show how the curve has changed over the last days the more accurately it can estimate what will happen in the future If you want to prevent the traffic jam health crisis there are two things we can domdashget the cars off the road fast develop a cure for the disease and make people recover faster or restrict the number of cars that can get on the road social distancing and lockdown Developing the medicines and vaccines is an effort that is already underway but this will take at least a few months to design develop and mass produce Eventually it will happen Social distancing we can all do immediately and thats what we are doingWhat according to you is most striking about your findingsThe most striking thing is how much of a delay there is with the rise of infections for India While most countries I included are already in the rapidrise part of the epidemic India will reach this part only in midMay The other good news is that the lockdown seems to be working The way the virus is spreading right now is similar to the way it has spread in other countries which means that like other countries we will be able to control this disease if we take the appropriate measuresIndia is the only country that is at the beginning of the curve and has not experienced exponential growth Yet youve predicted these numbers could go up to 625000 by August Why so Also are you considering the lockdown factor in your findingsIndia has also imposed strict measures from the start and we are even doing slightly better than Spain and Italy in controlling how the infection spreads The data includes some of the period since lockdown started The reason why India has a higher number than other countries is because we have a higher population and population density than other countries So we expect that more people will be infectedYouve said that the uncertainty around this means that the cases could go up to 13 billion This means the entire populationThe uncertainty tells us how well the data can be used to estimate the future This indicates that at the moment we are not in a position to relax and say everything is fine we are in control If we do the things we are doing right nowmdashlockdown curfew then we will have infections in less than 0005 of the population But if we drop the ball then the situation can spiral out of control While indications are positive we still have to be vigilantmdashthe storm has just begunIn a report in the Science Dr Ramanan Laxminarayan founder and director of the Center for Disease Dynamics said that India is probably the first large developing country and democracy into which this pandemic will arrive And unlike China or any of the other countries included in your data we are still not well equipped to handle this fight How best on the basis of your own findings do you think India can flatten the curveI completely agree with Dr Laxminarayan The Indian system does not have the clout of the Chinese in controlling the population and neither is the medical setup in India sufficient for our large populationDr Laxminarayan says There will have to be a uniquely Indian response to COVID19 I think in India what people do by themselvesmdashwhether they understand the risks seriousness and follow the guidelinesmdashis much more important than it was for any other country This is what will be unique about the Indian response I am optimistic that we will manage to slow it down and flatten the curve eventually but it has to be a committed response Even a few people who dont follow the current restrictions can keep the disease alive and demolish the efforts of those who are doing their bestI read in the news that there was a congregation of 9000 people out of which 400 ended up being infected This is criminal and dangerous to all of us It is blatant disregard of public effort and the people who make such assemblies are threatening the lives of every single one of usWhy is understanding and analysing data so important to understanding the way this pandemic is spreadingPandemics tend to be similar in some respects but different in their details This particular one is a disease that is slow to start and mild for most people Most people do not feel very sick even if they have it so it is very likely to be ignored It flies under the radar so to speakmdashby the time you see them cough the person may have spread the disease already for the last 14 days And yet for about 10 per cent of the infected people especially the elderly and children it does become lifethreatening In a large and densely populated country even 10 per cent is a number larger than entire populations of other countries The denser the population the faster a disease spreads from person to person In a country like ours if we are halfhearted in our reaction the spread will get out of hand This is why we need to keep a very detailed track of what is happening with the disease It tells us how effective we are at stemming the spread how much time we have to prepare our medical facilities And thats the important point People will get infected but as long as our medical facilities can cope with the number of infected individuals on any given day we will eventually win Thats what makes this a numbers gamemdashnumber of infections number of tests we do number of hospital beds number of doctors625000Number of Indians Dr Vartak estimates will be infected by AugustCatch up on all the latest Mumbai news crime news current affairs and also a complete guide on Mumbai from food to things to do and events across the city here Also download the new midday Android and iOS apps to get latest updates