COVID-19 In India: The Rise In R-Value Is A Cause Of Concern, Says Dr Randeep Guleria, AIIMS

New Delhi: India has once again started to see a rise in daily COVID-19 cases with majorly southern states including Kerala, Karnataka and Tamil Nadu reporting a huge spike in daily fresh cases. The concern here is the R-factor, the factor which indicates the speed of the COVID-19 infection spreading in the country. Overall, the R-factor has shot up to 1. NDTV speaks to Dr Randeep Guleria, Chief of AIIMS, to know how worrying is the current R-factor overall for India and then for Southern and North-eastern states as well?

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It’s a cause of concern because as you have rightly said, R0 (pronounced as R naught) has gradually started going up. Starting from .96, and going all the way up to 1, the rise in R-Value is a cause of concern. Simply put, this means that the chances of infection spreading from a person, who has Covid, to others have gradually gone up and you will see an increase in the number of cases. If the R0 increases, the number of people one person can infect starts becoming more, and then it has a cascading effect, said Dr Guleria.

Further talking about the measures to contain the spread of the COVID-19 disease, Dr Guleria stressed ‘aggressive action’ in areas where the R0 is going up. He said,

The government of India has already put actions in place many weeks ago in terms of limited lockdown, containment strategy, very aggressive surveillance, testing, tracking, treating and making sure that we don’t allow the cases to go out of control in that area and also that it doesn’t spread from one area to the other.

“The areas where R0 is going up, we need to act early rather than late so that we don’t allow the situation to go out of time”, he added.

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R number refers to the effective reproduction number of COVID-19. In simpler terms, it denotes a disease’s capacity to spread. The R number is of three types – R0 (pronounced as R naught), R (eff), and Rt. While R0 measures the average number of people who are infected by a COVID-19 person when no control measures are implemented, R (eff) measures the average number of people that would be infected by a single infectious person, taking into account the public health interventions implemented to contain the spread of the virus.

When asked if it would be right to say that R-factor is the one thing that gives you the sign of the onset of COVID wave, Dr Guleria said, it’s one of the factors and added,

As a matter of fact, R0 is not the correct word to use. We can use what is known as R (eff) or efficacy because R0 is used predominantly when we are talking of individuals who have not been vaccinated. Now, we have a population that is susceptible but, part of them have also been vaccinated and therefore, are protected to some extent. Secondly, the important issue is also to look at the positivity rate and also the number of people being admitted to hospitals with COVID-19 infection and whether that is rising or not. That will give a comprehensive picture of how serious the problem is because we may have a situation where you may have the R0 still being borderline but a large number of people getting sick and coming into hospitals and that also needs to be factored in.

Also Read: Delta Variant Of COVID-19 May Spread As Easily As Chickenpox, Cause More Severe Infection: Reports

Last week, reports quoting the Centers for Disease Control and Prevention (CDC), the US health authority, said that Delta variant of the coronavirus may cause more severe illness than all other known versions of the virus and spread as easily as chickenpox. Explaining the statement, Dr Guleria said,

Measles or chickenpox used to have R0 of 8 or more, which means one person could infect eight others. That suggests that coronavirus is highly infectious. We saw that during the second wave in India because entire families were getting infected. This happens with chickenpox also. In a similar manner, when one person has Delta variant, the whole family is vulnerable.

Talking specifically about states like Kerala reporting over 20,000 new cases daily, for the last five days, Dr Guleria called to evaluate the surge in infections. Elaborating on change in COVID-19 situation in Kerala, the doctor said,

In the beginning, Kerala had set a precedent for others by managing the pandemic well. They also had an aggressive vaccination drive. Yet despite that, are witnessing a spike in a way that’s different from other parts of the country. This needs to be evaluated. Also, is there a variant behind the surge? Are containment strategies being aggressively followed – all this needs to be evaluated.

Neighbouring states like Karnataka and Tamil Nadu also need to adopt an aggressive testing strategy to break the chain of transmission, he added.

Also Read: Third Wave Inevitable, COVID-19 Cases To Surge In Mid-August: Experts

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