Coronavirus: India shuts Taj Mahal as experts fear lack of testing could mask extent of virus outbreak

Despite WHO advice to test as widely as possible, India has chosen a different tactic – taking random samples from those with acute respiratory problems

India has ordered the closure of the Taj Mahal, its most popular tourist attraction, amid mounting concerns that a lack of testing could mask the scale of the country’s coronavirus outbreak.

Visitor numbers to the 17th century monument outside the city of Agra were already down after the Indian government ordered a ban last week on all visas for foreign tourists.

Some visitors who entered the country before the travel ban came into force were pictured in tears outside the closed gates on Tuesday. The Taj Mahal – built by the Mughal emperor Shah Jahan as a grand tomb for his favourite wife – normally attracts as many as 70,000 people every day.

Its closure, and that of all the other 3,690 monuments and historical sites run by the Archaeological Survey of India nationwide, come amid increasingly strict measures taken by the government to try and stave off a Covid-19 epidemic.

From midday on Wednesday, the travel ban will be extended to cover all passengers coming from the UK, EU and Turkey, and will even include Indian nationals wanting to travel home from those countries, a senior source in the Indian foreign ministry confirmed.

The official said the advisory, issued amid some confusion on Monday, “does not make any distinction between Indian and foreign nationals”.

Asked whether this would potentially mean Indians being stranded in European countries, even if their visas had expired, the official said: “These are extraordinary times due to the pandemic and a temporary measure. Our missions will facilitate the visa extension and we hope the same will be agreed to by the EU countries.”

India, a country of almost 1.4 billion people, has had just 137 confirmed coronavirus cases, and on Tuesday reported only its third death – a 64-year-old man in Maharashtra, the worst-affected state.

But experts have expressed concerns that many infections could be going undetected, with the government’s limited policy on testing meaning only 11,500 people have had proper lab checks.

One British woman who was both experiencing symptoms and had suspected contact with a Covid-19 case left India for France after the authorities refused to test her. It is India’s policy that people will only be tested if they have suspected contact with a case or have travelled abroad, and then are still showing symptoms after 14 days of home quarantine.

One reason for the protocol – which goes against World Health Organisation advice and experiences of several countries that are testing as many people as they can – is the cost of conducting a test.

Officials are of the view that the Rs 5,000 (£56) it costs the public health system to test for Covid-19 would be better spent on longer standing health problems like tuberculosis, malnutrition and HIV/Aids, where that amount of money goes a long way in South Asia.

Instead, the Indian Council of Medical Research (ICMR) – the country’s top medical research body – is using random sample testing to monitor for what it calls “community spread”, the threshold whereby a country is experiencing new infections where there is no history of travel or contact with people who have travelled abroad.

At a news conference, ICMR experts said that no Covid-19 cases were detected among a sample of 1,000 patients with acute respiratory problems in February. Preliminary data for the first week of March, from a sample of 500 tests, didn’t show a single coronavirus case.

Balram Bhargava​, the ICMR’s director, said testing “indiscriminately” would be “premature” for India, where “we are still in stage 2 [local transmission]. Therefore it creates more fear, more paranoia and more hype,” he said.

But not everyone is agreed on the approach, or the conclusions drawn by the ICMR. “Given the pattern of disease in other places, and given our low level of testing, then I do think that community transmission is happening,” said Dr Gagandeep Kang, the director of the Translational Health Science and Technology Institute.

“Community spread is very likely” in a country like India, where more than 400 million people live in crowded cities and many do not have the regular access to clean water needed to follow hand-washing guidance, said Dr Anant Bhan, a global health researcher in Bhopal, central India.

“But the only way to know for sure is through more expansive testing,” he told the Associated Press.

City authorities are not waiting for cases to rise before taking action over social mixing. From Delhi to Mumbai to Bengaluru, India’s largest metropolises are closing schools, banning large gatherings and asking people to work from home where possible.

Yet there are also major shortcomings in public compliance with anti-virus orders. Health officials have struggled to maintain quarantines, with people fleeing from isolation wards complaining of filthy conditions.

In the central state of Maharashtra, five people, one of whom had tested negative and the rest who were awaiting test results, walked out of an isolation ward last Saturday.

And while India has implemented a 19th century epidemic law that empowers officials to punish those who flout containment measures, there is only so much the authorities can do without public compliance.

Aditya Bhatnagar, an Indian university student who was studying in Spain, described unsanitary conditions at an isolation ward where he and 50 others passengers on a Barcelona flight have been kept since landing in Delhi on Monday.

Rooms shared by around eight people lacked basic hygiene features such as clean bed sheets and bathrooms, and the group was not provided with masks or hand sanitiser despite still awaiting their Covid-19 test results.

“I don’t think these measures would be enough to contain the pandemic,” Bhatnagar said.

Additional reporting by agencies