UNCLAS SECTION 01 OF 02 MUMBAI 000333

SENSITIVE
SIPDIS

PASS AIAG FOR AMBASSADOR ROBERT LOFTIS, HELEN REED ROWE, AND
CRAIG SHAPIRO
SDA PASS APHIS AND FAS
DOT PASS SHATLEY
FAA PASS TNASKOVIAK

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL
PINR, EAGR, IN
SUBJECT: MAHARASHTRA GOVERNMENT TAKES STEPS TO CONTROL SPREAD OF
H1N1

REF: New Delhi 1671

MUMBAI 00000333 001.2 OF 002



1. (SBU) Summary: After a series of deaths due to the H1N1
virus in Maharashtra, the state government has taken steps to
control the spread of the disease, including temporarily closing
schools, malls, and cinemas, as well as pulling anti-flu drugs
off retail shelves. With the media fanning fears, the shutdowns
and accompanying scare have had a dampening effect on some
sectors of the economy, though daily life seems to be going
about as normal. Mumbai's medical infrastructure is inadequate
to handle the rush of patients seeking testing and treatment,
and so steps have been taken to open up additional testing
facilities, as well as to allow private hospitals to treat H1N1
patients. End Summary.



H1N1 Arrives in Maharashtra

--------------




2. (U) On August 3, Maharashtra recorded its first death
caused by the H1N1 virus, in Pune. Since then, 14 others have
died in Pune and Mumbai. Currently, 15 of India's 20 H1N1
fatalities have been in Maharashtra. The number of reported
infections has crept up as testing rates increase; at present,
1,203 individuals in India have tested positive for the disease.
The World Health Organization reports that school-age children
are at greatest risk of catching H1N1, a fact which was borne
out when the disease spread rapidly through Pune schools.




3. (U) The Maharashtra state government stepped into the H1N1
fracas on August 12, asking all schools and colleges to close
for a one-week period and all malls and cinemas to close for a
three-day period. Many public places (chain stores, gyms, etc.)

have implemented their own flu policies, either requesting that
sick/coughing/sneezing individuals stay away or else temporarily
shutting down operations. The Mumbai public, having recently
experienced bubonic plague, SARS, and avian flu scares, is not
panicking over H1N1. However, individuals are taking steps
perceived as protecting themselves and their families, including
wearing surgical masks and keeping close to home. The media has
exacerbated fears by publishing photos of parents rushing
children to hospitals and widely criticizing the efforts - and
competence - of Maharashtra state officials.




4. (U) Mumbai's medical infrastructure is currently unable to
handle the rush of patients seeking testing and treatment. At
present, only one medical facility in the city is able to
collect the throat swabs used to detect the H1N1 virus (the
samples are further sent on to the National Institute of
Virology in Pune for testing). The government plans to expand
both sample collection and testing capabilities in the Mumbai
area soon. Private hospitals have been given authorization to
accept H1N1 patients (previously, only government hospitals had
this right), but the hospitals must first be "certified" by the
government, a process which could take up to a week. The
government has banned the retail sale of Tamiflu, fearing that
the public may make a run on the anti-viral drug, but claims to
have stockpiled enough of the drug to treat three million people.

MUMBAI 00000333 002.2 OF 002






5. (U) The National Institute of Virology announced August 12th
that it cannot be relied on for diagnostic testing as it is
receiving over 800 samples a day, 600 more than it can process.
As a result, the government has instructed hospitals to start
Tamiflu treatment for individuals with severe influenza symptoms
rather than waiting for a positive or negative H1N1 test result.




6. (U) The pandemic is having a dampening effect on the
economy, especially in the countryside, where it is exacerbating
the impact of the current drought. Stock prices for major
retailers and movie chains fell after news of the three-day
shutdown, while stock prices for pharmaceutical manufacturers
rose. On the surface, business in Mumbai is continuing on
largely as usual, though the government has requested that
stores tone down advertising and discounts for upcoming sales in
order to prevent large gatherings of people. Footfalls in malls
and other shopping centers have reportedly fallen, as has air
travel.




7. (U) The outbreak is being felt in political and cultural
circles as well. Organizers of events surrounding the "Dahi
Handi" Hindu festival, in which hundreds of thousands gather to
celebrate the birthday of the Krishna, have voluntarily scaled
back their August 14th festivities. The Maharashtra Chief
Minister has also exhorted people to scale back celebrations of
the extremely popular Ganesha festival, which starts on August
24th. Political activists from the Shiv Sena and other parties
agitated for the closure of schools, and fanned fears of an
epidemic. The Maharashtra government surely had its eye on the
upcoming state elections in seeking to react quickly to the
epidemic.




8. (SBU) Comment: Currently the mortality rate for H1N1 in
Maharashtra is very low, especially compared to the panoply of
other diseases faced by the general population. Its presence
and spread in schools and other public places, however, has
parents spooked, and the media has played on these fears instead
of introducing notes of calm. The Maharashtra government's
intervention into the crisis is welcome, though many wonder if
the state government would have the resources or competence to
address a real public health emergency, should the situation
worsen. End Comment.
FOLMSBEE