Coronavirus Outbreak
With Limited Testing And Current Preventive Measures Can India Prevent Community Transmission Of COVID-19?
Currently, India is in stage two of transmission, where the coronavirus infects people directly in contact with affected patients who returned from abroad
New Delhi: India, the world’s second most populous country, with a population of 1.3 billion people currently (March 19) has 173 total coronavirus (COVID-19) cases. While the World Health Organization (WHO) has praised India for its efforts to fight against the novel coronavirus which has affected over 100 countries across the world, experts believe that limited tests might be masking the true toll of the disease in the country. Though WHO has stressed upon testing as many citizens as possible, India was only testing people coming from foreign countries and showing symptoms of coronavirus involving fever and dry cough.
Now the government has changed the policy and even those who are asymptomatic are being tested and quarantine of two weeks has been made mandatory for them, said Dr Anup Kumar, Professor and Head of Department of Urology at Safdarjung hospital.
Currently, India is in stage two of transmission, where the virus infects people directly in contact with affected patients who returned from abroad. According to Dr Anand Kumar Gupta, Associate Professor at Department of Pediatrics at Indira Gandhi Institute of Medical Sciences (IGIMS) in Patna, India has only 20-25 days to contain the virus in stage two.
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If COVID-19 in India enters stage three which is called community transmission, the number of infected people will spike. The virus will transmit into the local population which has no travel history or had contact with anyone who travelled abroad and as such, the chain of transmission becomes impossible to trace.
Now, the question is, with current measures in place, can India prevent community spread of COVID-19? Talking about the progression of coronavirus in India and how close or far we are from entering stage three, Dr Swapneil Parikh, a practicing physician in Mumbai and co-author of The Coronavirus, said,
We do not know. We might already be there. We have to stop thinking that we have only 130 cases in India. We have 130 ‘confirmed’ cases. There may be many others who we have not tested, who might be infected, and who we don’t know about.
Further talking about India resorting to the policy of limited testing and how aggressive testing helped countries like South Korea, Dr Parikh said,
A country like India which has a population of 1.3 billion is only doing somewhere around 4 tests per million people whereas a country like South Korea which has really managed to control this disease has a population of about 50 million and has done so many tests (over 3,000) per million. We cannot know how much a disease is spreading in a country if we are testing few patients.
On Tuesday (March 17), the government announced that private laboratories will be roped in for testing of coronavirus. With this move, the rate of testing in India will increase significantly and will give a better picture of the spread of the pandemic.
The Indian Council of Medical Research (ICMR), which is the nodal agency for the drive against coronavirus, recently did coronavirus test on 500 random samples of patients with symptoms of pneumonia and chest infection. The results have turned out to be negative. ICMR will be testing another batch of 500 samples.
At a time when there are asymptomatic carriers as well, testing becomes even more vital. Talking about when an individual should get tested, Dr Anand Kumar Gupta said,
Sneezing is not a prominent feature of COVID-19, it can be due to any viral disease or allergy. If you have a travel history or have come in contact with a suspected or confirmed case of coronavirus and have symptoms like dry cough, fever and breathing difficulty, then you should get tested else you can consult your physician.
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Further talking about the increase in cases of coronavirus in India, Mr Parikh said,
When Italy was reporting 1,000 cases in their country, mathematical models suggested they had 4,000 cases. When Iran was reporting about 3,000 cases, mathematical model suggested they had 18,000. So, more than just the number of cases, what we have to look at is the rate at which they are increasing. If they are growing very quickly that’s a bad sign. In India, the cases have been doubling in every five to six days. This is what we call exponential growth.
The spread of the coronavirus which has been titled as a global pandemic by the WHO has created a panic like situation in various parts of the world because of which supermarkets and pharmacies are running out of hand sanitisers, masks and other essentials. According to the experts, ensuring hand hygiene by washing hands with water and soap or using an alcohol-based rub is one of the basic steps towards preventing the spread of COVID-19. But at a time when hand sanitisers are out of stock, what should one do? Suggesting an easy and low cost way of making sanitiser at home, Dr Anup Kumar said,
Buy 100 per cent alcohol which comes at very cheap price. Take 70 ml of 100 per cent alcohol and dilute it with aloe vera gel or normal saline and add some fragrance.
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To contain the spread of the virus, the Ministry of Health and Family Welfare (MOHF&W) has issued an advisory on social distancing and preventive measures like the closure of all educational establishments, suggesting employers to consider work from home for their employees, asking people to avoid social gathering, among others.
Talking about how social distancing and self-quarantine will help break the chain, Dr Gupta said,
The virus has taken the droplet route which means when an infected person coughs or sneezes, the virus travels upto 3 meters. For instance, there are 1000 people in a park, including an infected person. If an infected person will sneeze, he can infect at least 500 people. Currently, the mortality rate is only 3 per cent, but if we don’t do anything to contain it, this virus will infect around 70 per cent of the population and then imagine the number of deaths it will cause. This will put a large burden on our healthcare sector.
Till today (March 19), in India, 20 of the infected patients have recovered. But, in China cases of relapse have been recorded. Talking about the whether coronavirus can happen twice and in what time frame Dr Parikh said,
Early reports from New York and Italy are suggesting that there might be a biphasic pattern – patients seem to recover for a while, they get a little better for a short while and then the situation suddenly worsens. We also see this in diseases like dengue and during that period, the levels of virus in secretions may decrease temporarily. So, if a test is done, it may appear negative and then if you test again later it may appear positive, again. However, we don’t know yet whether they are biphasic or if there are reinfections.
Currently, there is no vaccine available for coronavirus and this is what makes the disease even more deadly.
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