India says it won’t hide the truth from its public if it enters what’s called the community transmission stage, or Stage 3, of the coronavirus outbreak. But what exactly does that mean? Here’s a detailed explainer.
The government recently said that if India’s coronavirus outbreak reaches the community transmission stage, “we will tell people so that we can step up the level of alertness and awareness.” We explain what that term means. (Photo by Reuters/Taken in Mumbai, on March 28, 2020)
- India’s caseload crosses 1,000; over 2 dozen dead
- Lockdown till April 14; migrant worker exodus a worry
- Community transmission: We take a closer at a key concept
India’s coronavirus caseload is growing fast — over 1,000 people now have, or have had the virus — but experts from the Indian Council of Medical Research (ICMR) say evidence of community transmission is scarce.
But what exactly is that?
Well, it’s got to do with our ability to tell how patients got infected.
At the community transmission stage (the “Stage 3” you keep hearing about), a disease spreads in the population is such a way that people don’t know how they were exposed to the contagion: they haven’t travelled to a part of the world that’s currently battling an outbreak, or haven’t been in contact with someone they know has the coronavirus.
Chezney Schulte, a public health official in the US state of Missouri, put it like this to local channel KMIZ:
“You are racking your brain thinking, I must have gotten it out in the community by going about my day-to-day life…I just don’t have that person I can pinpoint it down to where I would have gotten it.”
‘If India enters that stage, we won’t hide it’
Back home, the Press Trust of India reports that three people who were found to be infected with the coronavirus — after the ICMR announced a major expansion of its testing criteria — had no exposure history.
But ICMR’s Head of Epidemiology and Communicable Diseases, Raman R Gangakhedkar, said there were “some sporadic cases where people are not revealing their exposure history”, but the numbers weren’t “significant enough to assume that the virus is spreading rapidly”.ADVERTISEMENT
“We can consider that we are in the community transmission stage only when there are about 20 to 30 per cent cases with no clue on how they got the virus.”
– India’s Ministry of Health and Family Welfare
CORONAVIRUS: QUICK FACTS
- Previously unknown type called Sars-CoV-2. First detected in China.
- Causes potentially fatal respiratory disease called Covid-19.
- Elderly and patients with pre-existing conditions at greater risk.
On March 19, a few days before India imposed an ambitious nationwide lockdown to enforce social distancing, the ICMR said more than 800 random samples tested to detect community transmission had come out negative.
“We can consider that we are in the community transmission stage only when there are about 20 to 30 per cent cases with no clue on how they got the virus,” said Lav Aggarwal, a joint secretary in the Ministry of Health and Family Welfare, later in the week.
“If India enters that stage, we will not hide it. We will tell people so that we can step up the level of alertness and awareness.”A Mumbai street with squares painted on it to promote social distancing, seen on March 28, 2020. (Photo: Reuters)
But a report by the Centre for Disease Dynamics, Economics and Policy (CDDEP), a public health research group based in Washington D.C. and Delhi, paints a starker picture.
The nonprofit says community transmission “most likely” began in India in early March, and that are likely to be 300 to 400 million infections — albeit mostly mild ones — by July in the absence of interventions.
“At the peak (somewhere between April and May 2020), 100 million individuals will be infected. Of these, approximately 10 million will be severe and about 2-4 million will require hospitalisation. This is the most critical period,” the CDDEP says.
CDDEP’s use of the logo of Johns Hopkins University in its report has been in the news this week after the varsity said it did not provide authorisation.
Migrant worker exodus
An area of particular concern that’s emerged with respect to community transmission in recent days is the mass exodus of migrant workers from cities shut down to increase social distancing.
Haunting images of large crowds waiting to board buses or even walking to their hometowns have raised fears of — as one senior opposition politician put it — “a catastrophe in the making.”
“Epidemiologically, reverse migration is dangerous because if any one of them is infected with coronavirus, then the deadly disease is going to reach our villages where healthcare infrastructure is extremely poor,” said Jugal Kishore, Director at the Vardhman Mahavir Medical College and Safdarjung Hospital.
Another expert, Dr Subhank Singh, who recently retired from Gurugram’s Medanta Hospital, said the exodus from Delhi was “like a ticking time bomb of super-spreaders”.Migrant workers crowd up as they wait to board buses to return to their villages, in Ghaziabad, on the outskirts of New Delhi, on March 28, 2020. (Photo: Reuters)
India will remain under lockdown until April 14 — and it is not the only nation to have taken such a drastic step to fight the coronavirus.
The World Health Organisation has laid stress on the importance of other measures, such as identifying the sick and their contacts, and isolating them, to prevent a resurgence of cases.ADVERTISEMENT
“The danger right now with the lockdowns…if we don’t put in place the strong public health measures now, when those movement restrictions and lockdowns are lifted, the danger is the disease will jump back up,” said Mike Ryan, the WHO’s executive director, in an interview with the BBC. “Once we’ve suppressed the transmission, we have to go after the virus.”
“We have to take the fight to the virus.”
source : India Today