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May 27, 2020 00:00:00 | Dr. Yasmeen Jan

Boiling Broth: Need to simmer to prevent overflow

Covid-19, a disease much dreaded with no vaccine, no effective treatment known for taking its own cause that too without uniformity. Asymptomatic/presymptomatic/mild symptoms/moderately symptoms/severe symptoms: all included in spectrum without much evidence on medical front as to how different people will come up with once SARS-CoV-2 positive status is known (Duly excluding the co-morbid conditions).

Much debated lockdown, with countries resorting to it sooner or later was taken up promptly by India as well and lockdown was implemented not once but thrice and currently the country is in partial lockdown phase. Looking at lockdowns, it is evident that it did indeed slow down the transmission of disease. The epidemiological curve although on a rise, exponential growth of 40-60% was never seen in India as was experienced by some of European countries.

The linear growth of the curve although slow due to lockdown, is still seen and will still occur. Here is the catch that needs to be explained to masses at large. Why we went for Lockdown if the curve is not flattening or going down. This could be explained in two ways; either the containment was not good and contact tracking was not done meticulously or more important than that the virus has found its way out in the community despite all measures.

A community spread! Community Spread in current scenario with 80% cases being asymptomatic (declared by ICMR also) is not “Impossible”.

For we tested people who were close contacts of SARS-CoV-2 but not the casual contacts like fruit vendors, veg. vendor or casual associates. Recall bias on part of Covid-19 case could explain that.

For those with casual contacts considered in Epidemiology as low risk and superadded on the fact the trend of 80% Covid-19 positive being asymptomatic could be very much the initiators of community spread, where no link to Covid-19 case is traceable.

The question remains that despite all measures, is Community Transmission Inevitable? The answer is simply is big yes. We have evidences. Pregnant women coming positive from, non- red zones can be a proxy indicator of the same for general population.

Just that they are provided with the opportunity to get tested, the status is known, but for the rest without ILI/SARI most of the cases are hidden. Police personnel coming positive with no contact of COVID-19 case, but evidently coming across many people while managing the lockdown, provides further proof.

So the broth is already cooked. The only thing that can help in this situation is the Preventive Measures not only to save the general population but high risk population that have the highest risk of mortality following Infection. The stage of Denial of Community Transmission has gone.

Time has come where the general population has to be made vigorously aware of importance of preventive measures and protection of high risk groups, in wake of Inevitable Community spread.

Social distancing, hand hygiene, wearing of masks and protection of high risk population groups by minimal exposure to community gatherings are the Needs of the hour. Better act now by effective communication and let broth simmer to dry rather than letting it overflow.

 

The views expressed in the article are author’s own and bear no association with the place of work

Archive
May 27, 2020 00:00:00 | Dr. Yasmeen Jan

Boiling Broth: Need to simmer to prevent overflow

              

Covid-19, a disease much dreaded with no vaccine, no effective treatment known for taking its own cause that too without uniformity. Asymptomatic/presymptomatic/mild symptoms/moderately symptoms/severe symptoms: all included in spectrum without much evidence on medical front as to how different people will come up with once SARS-CoV-2 positive status is known (Duly excluding the co-morbid conditions).

Much debated lockdown, with countries resorting to it sooner or later was taken up promptly by India as well and lockdown was implemented not once but thrice and currently the country is in partial lockdown phase. Looking at lockdowns, it is evident that it did indeed slow down the transmission of disease. The epidemiological curve although on a rise, exponential growth of 40-60% was never seen in India as was experienced by some of European countries.

The linear growth of the curve although slow due to lockdown, is still seen and will still occur. Here is the catch that needs to be explained to masses at large. Why we went for Lockdown if the curve is not flattening or going down. This could be explained in two ways; either the containment was not good and contact tracking was not done meticulously or more important than that the virus has found its way out in the community despite all measures.

A community spread! Community Spread in current scenario with 80% cases being asymptomatic (declared by ICMR also) is not “Impossible”.

For we tested people who were close contacts of SARS-CoV-2 but not the casual contacts like fruit vendors, veg. vendor or casual associates. Recall bias on part of Covid-19 case could explain that.

For those with casual contacts considered in Epidemiology as low risk and superadded on the fact the trend of 80% Covid-19 positive being asymptomatic could be very much the initiators of community spread, where no link to Covid-19 case is traceable.

The question remains that despite all measures, is Community Transmission Inevitable? The answer is simply is big yes. We have evidences. Pregnant women coming positive from, non- red zones can be a proxy indicator of the same for general population.

Just that they are provided with the opportunity to get tested, the status is known, but for the rest without ILI/SARI most of the cases are hidden. Police personnel coming positive with no contact of COVID-19 case, but evidently coming across many people while managing the lockdown, provides further proof.

So the broth is already cooked. The only thing that can help in this situation is the Preventive Measures not only to save the general population but high risk population that have the highest risk of mortality following Infection. The stage of Denial of Community Transmission has gone.

Time has come where the general population has to be made vigorously aware of importance of preventive measures and protection of high risk groups, in wake of Inevitable Community spread.

Social distancing, hand hygiene, wearing of masks and protection of high risk population groups by minimal exposure to community gatherings are the Needs of the hour. Better act now by effective communication and let broth simmer to dry rather than letting it overflow.

 

The views expressed in the article are author’s own and bear no association with the place of work