New Delhi: India surpassed 22 lakh coronavirus cases on Monday morning with over 62,000 new patients recorded in the last 24 hours, the government said today. Moreover, this the third consecutive day when the country has reported more than 60,000 fresh coronavirus cases. The union health ministry said that more than 44 thousand deaths linked to the highly contagious illness have been recorded since the beginning of the pandemic. In the last 24 hours, 1,007 patients have died in different parts of the country. On the other hand, over 15.3 lakh COVID patients in the country have recovered so far, the Union Health Ministry stressed that the recovery rate stood at 69.33 per cent.
NDTV speaks with Director of AIIMS, Dr Randeep Guleria to understand India’s COVID numbers and why is the country experiencing this continous surge.
NDTV: India has the highest new COVID-19 cases as compared to the world, what explains the spike?
Dr Randeep Guleria: India is experiencing the spike, from past four days, the country HAS more coronavirus cases as compared to any other country in the world and that is basically related to the fact that our population is very huge and now COVID cases have shifted to smaller or rural areas and the cumulative number is quite big. On the other hand, India is also testing much more, we have crossed, more than 6 lakh tests per day, so that is also adding to the load. Overall, the spike in COVID-19 numbers can be attributed to these things – firstly, we are picking up more as we are testing more and more people, secondly, the virus has shifted to smaller cities or areas in multiple states and that is also accounting for the huge spike. Talking about the good part, India’s number of cases per million population is still low, even the mortality rate is low as compared to other countries.
NDTV: Could monsoon in India be linked to the country’s surge in coronavirus cases?
Dr Randeep Guleria: We know that many viruses can survive for a longer time in the environment if it is humid and it is classically known for H1N1, swine flu, as we see more number of cases in monsoon or whenever the rain period starts in India, usually from the south – Maharashtra and Karnataka and goes up as the monsoon progresses. However, coronavirus is a relatively new virus but like most viruses, it can survive for a longer period of time and therefore the chances of infection in this environment become higher. Now, the second reason is that because of flooding, people tend to crowd as they go in large numbers to rescue homes or other areas which are safer. The problem comes in a situation like this one can’t keep the physical distancing, so automatically the chances of the spread of the virus become more. So, in some way or the other, we can say there is a correlation between the surge in coronavirus cases and monsoon in India.
NDTV: Flattening the curve of coronavirus IS not a permanent phenomenon as we are seeing with the rise of coronavirus cases in areas which a few months ago were being tagged as states that have managed COVID-19 well?
Dr Randeep Guleria: Yes, India will continue to see this fluctuation in coronavirus cases. Flattening the curve doesn’t mean that the pandemic has ended in that area, it means that the situation is much better in the area and the panic is over. If we talk about Delhi only, the panic we saw months ago in terms of ICU Beds, hospitals and oxygen beds has come down in the national capital. Now, we have in Delhi large numbers of beds that are empty but at the same time we need to know that the virus has not gone away and if we don’t have what we call COVID appropriate behaviour like we don’t maintain a physical distancing, we don’t wear a mask, we start having crowds then we will again have a spike and that’s what we have learned from this virus. We have seen this happening in the USA and other countries as well, so we need to be very very vigilant when it comes to coronavirus.
NDTV: Why does Maharashtra continue to be the worst-affected state in India and it is still seeing the spike in its COVID numbers?
Dr Randeep Guleria: Maharashtra is a very big and populated state, so it is normal that it is still seeing a lot of coronavirus cases. Secondly, initially, the focus was on Mumbai, we had huge spikes in rural and urban areas of Mumbai, which now has come down drastically. And now the pandemic has moved from large cities to smaller ones and that is also accounting for large numbers of COVID cases. I think, what we need is aggressive micro-planning like we did for large areas like Delhi and Mumbai, we need to do same things for these smaller areas. We need aggressive containment zone policies, isolation, testing, quarantine facilities and also trying to find out areas where there are large numbers of clusters developing. So, unless we do all this aggressively and actively, we will not be able to control the spike in the smaller areas.
NDTV: Can a relapse of COVID-19 be more severe?
Dr Randeep Guleria: So, what happens is that sometimes the COVID test comes out to be false or misleading as no coronavirus test is full-proof. We have two types of testing – Rapid Antigen Test and RT-PCR test. The antigen test has very low sensitivity, so, if you are tested negative for COVID with the test that doesn’t mean you are negative. It needs to be backed with a RT-PCR test. Secondly, if you don’t take the sample properly and I have in some areas where the technician is not trained properly, they don’t go deep inside the nose to take the sample, it needs to be taken from the nasal faring, if you simply take the sample from the upper part of the nose or the beginning of the nose, you will not get the good sample and same is with the throat swab. So, the technique needs to be perfect. It has been our country’s biggest challenge as well that we have seen that the person has not been tested positive but the CT Scan or clinical picture shows that the person is positive. No test for COVID-19 is foolproof, so, I personally feel that with the test one also needs to see the clinical file of the patient and if the clinical file shows the patient as a possible COVID patient then doctors need to treat him/her as a COVID patient, rather than denying the treatment to the patient on the basis of the test.
NDTV: Is it imperative to take both nasal and throat swab for the testing process?
Dr Randeep Guleria: Initially we were putting the nasal strap in only one nostril while doing a Rapid Antigen Test, then we realised that if you take the sample from both the nostril the positivity rate will be high and that was also a study done by us initially to understand the coronavirus testing procedure and that’s what led to the change of the protocol for the Rapid Antigen Tests and this is what we are trying to teach the rest of the country as well because more the samples received, the chances of positivity will be high. Now, similarly, for RT-PCR test, we recommend that both nasal and throat swab is taken as more material you will get there will be a higher chance of the test being right.
NDTV: Should healthy people get tested and what type of test they should go for?
Dr Randeep Guleria: Now, there are two things, it depends on the kind of the situation the healthy person is going through. If they are taking care of an infected person or if they have in recent past come in contact with the person who has had COVID, then they should definitely get tested. Also, the time for testing is also very crucial, if I have come in contact with the infected person and today is Day 1 then ideal time for me to get tested is Day 6 or Day 7 because that much time the virus will take to incubate, so if the person gets tested himself on Day 1 itself then chances of the result coming negative will be very very high and again that will be misleading. Secondly, if you feel, you are an asymptomatic patient but you fall in the category of the vulnerable group or are undergoing treatment for some other disease say for example chemotherapy then you can get tested for the virus to be on the safe side.
NDTV: Can COVID-19 permanently damage the lungs of the patients?
Dr Randeep Guleria: This is the sad part and now we are also doing a study to understand the long-term effects of COVID on a patient’s body. There are a lot of cases/data emerging in the country in which we are seeing long terms effects of COVID. I have also seen many CT Scans of patients, after 3 months also, there is a lot of scarring in the lungs, some patients are still feeling breathlessness and in some cases, patients are needing the support of oxygen as the lungs are not being able to function properly and the exchange of gases not taking place. Moreover, we are also now starting to find what treatment should be given to the patients to treat the long term effects like Pulmonary fibrosis.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.