HMPV outbreak: Has India panicked more than China?

Markets, shopping malls, and schools functioning normally in China’s Yiwu amid concerns of an outbreak. Pics/Tanmay Gokani

The outbreak of HMPV (Human Metapneumovirus) in China might have created more panic in the rest of the world than in China itself," says a Mumbai businessman settled in Yiwu in China's Zhejiang province (home to some 800 Indians) for the last 23 years. HMPV is a virus that causes upper respiratory infections.

Speaking to mid-day from Yiwu, he says, "China has not declared any state of emergency nor are schools [his 9-year-old son is in an international school in Std 3], shopping malls, or markets closed."

Tanmay Gokani, 41, with wife Bosky, 36, and their son in China

With the month-long Chinese New Year holidays starting January 15 to February 15, many Indians settled in China are keen to return to India on vacation, but are waiting for Chinese government alerts, if any, which were not issued until Sunday (January 5).

Mumbai to Yiwu
Tanmay Gokani, 41, moved from South Mumbai (Walkeshwar) in his early 20s and started an exports business. Today, he is amongst the 800 Indians settled in Yiwu. He stays with his wife Bosky, 36, who works with a law firm in Shanghai, and their school-going son Shaarav.

Markets, shopping malls, and schools functioning normally in China's Yiwu amid concerns of an outbreak. Pics/Tanmay Gokani

Dip in temperature
"Winter has set in, and the temperature in Yiwu is -1 degrees Celsius, whereas in the northern part of China, the temperature dips further, and it is but obvious that in such weather, people are bound to have cold, cough, and seasonal flu symptoms, but for the first time, we have come across any outbreak of HMPV through foreign media reports, including India. Though Chinese media have been mentioning HMPV, there are no official statements from the Chinese health authorities," said Gokani.

No health emergency in Yiwu
"We have no state of emergency declared by the local Chinese health authorities. Life is normal, and every business establishment, shopping mall, night market, and even school is functioning without any health alert," Gokani said.

"Schools in China are the first to raise a red flag in case of any health alert, and so far, none of the schools in Yiwu, or elsewhere, have made any such announcement," he added. The Gokani family lives in a tower in Yiwu and says that there has been not a single case of HMPV reported in their vicinity.

Frantic phone calls
The HMPV reports have brought back COVID-19 flashbacks in the minds of Indians settled in Yiwu and have left their relatives in India in a panic mode.
"I have been getting over 20 phone calls from my relatives in Mumbai and Gujarat and my business clients, inquiring about the outbreak of HMPV," said Gokani.

Awaiting health advisory
Tanmay and his family had already planned their yearly vacation to India, but this year, they want to put it on hold in case the Chinese health authorities issue any advisory on HMPV. "We have already made a vacation plan to India. But, in case of any advisory, I don't want to take the chance of travelling. I will have to be dependent on others, which I want to avoid," said Gokani.

No HMPV in India
Health experts in India have said that although no cases of HMPV have as yet been reported, the country needs to be careful. Experts suggest wearing a mask and advise that the authorities must screen all passengers at the airport arriving from China.

Dr Subhash Hira, professor of global health at the University of Washington and former advisor of WHO-TDR Geneva, who continues to be on the pandemic preparedness committee, said, "Preventing a respiratory pandemic involves a combination of public health measures, individual actions, and community engagement."

He says things that can help prevent the spread of respiratory infections, including surveillance and early detection using PCR and viral culture tests; public health communication; hygiene practices; social distancing and; improving indoor air quality; travel restrictions and monitoring; emergency preparedness; mental health support; vaccination, among others.

What is HMPV?

Human Metapneumovirus (HMPV) was discovered in 2001 and belongs to the pneumovirinae family. It is spread through droplets and direct contact. Those vulnerable to infection include people with low immunity, the elderly, and children. Symptoms of HMPV so far have not been severe and generally cause mild illness and seasonal flu symptoms - fever, cold and cough, runny nose, etc. - and take three to six days of incubation period. There is as yet no specific vaccine or medication for HMPV and treatment is mainly symptomatic.

Dr Subhash Hira, professor of global health at University of Washington-USA and former advisor of WHO-TDR Geneva, who continues to be on the pandemic preparedness committee, said, "Preventing a respiratory pandemic involves a combination of public health measures, individual actions, and community engagement."

He lists out some key steps that can be taken to help prevent the spread of respiratory infections:

1. Surveillance and early detection

- Implement robust surveillance using PCR and viral culture tests to monitor respiratory illnesses and early detection of outbreaks.

- Encourage reporting of unusual clusters of respiratory illness by healthcare providers.

2. Public Health Communication

- Develop clear communication strategies to inform the public about respiratory diseases and preventive measures.

- Use multiple platforms (social media, community meetings, local news) to disseminate information.

3. Hygiene Practices

- Promote regular handwashing with soap and water for 10 seconds, or the use of hand sanitizers.

- Educate on proper respiratory hygiene (e.g., covering mouth and nose with a tissue or elbow when coughing/sneezing).

4. Social Distancing and Quarantine

- Encourage social distancing of at least 6 feet in crowded or high-risk settings during outbreaks.

- Implement quarantine measures for individuals exposed to a known respiratory pathogen.

5. Use of Personal Protective Equipment (PPE)

- Recommend the use of face masks in crowded or enclosed spaces, especially during outbreaks and winters.

- Provide PPE to healthcare workers and those caring for infected individuals.

6. Improving Indoor Air Quality

- Promote ventilation in indoor spaces to reduce airborne transmission.

- Encourage the use of air purifiers and regular cleaning of floors and work surfaces.

7. Travel Restrictions and Monitoring

- Implement travel advisories and restrictions during outbreaks to limit spread.

- Screen travellers for symptoms of respiratory illness at points of entry.

8. Community Engagement

- Involve community leaders and organizations to reach diverse populations and promote preventive measures.

9. Research and Development

- Invest in research for vaccines, treatments, and diagnostic tools for respiratory pathogens.

- Support initiatives for rapid response to re-emerging infectious diseases.

10. Emergency Preparedness and Response Plans

- Develop and regularly update pandemic preparedness plans at local, national, and global levels.

- Conduct drills and training for healthcare workers and emergency responders.

11. Mental Health Support

- Provide resources and support for mental health during pandemics, as apathy, fear and anxiety can impact public response and compliance with health measures.

12. Vaccination-

Promote and facilitate vaccination against respiratory pathogens (e.g. influenza, COVID-19); especially children and elderly before onset of winters.

Meanwhile, Maharashtra health department, has issued directives to all collectors.