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Community transmission certainly not in India

Community Transmission is certainly not there in India so far. COVID-19 pandemic has infected 7.50 million and killed over 420,993  globally, and India is certainly not at the stage of the community transmission despite the steep hike in infections.

The US cases today topped 2022,488 cases and over 113,803 4 deaths. India’s coronavirus tally jumped to 2,86,579 this morning with 9,996 new patients recorded in the last 24 hours. A total of 1,41,029 patients have recovered so far too. Some reports indicate that India’s cases tally is inching fast to surpass the UK which is the fourth worst-hit nation.

Researchers at the Centre for Cellular and Molecular Biology (CCMB) have developed a new low-cost and low-tech required test for SARS-CoV-2 testing. This test is known as reverse transcription nested PCR (RT-PCR) test.

On the COVID19 pandemic’s community transmission stage in populous India, Mr.Balram Bhargava, Director General, Indian Council of Medical Research (ICMR), while releasing a key report. today commented there is a heightened debate around the term and then the WHO has not defined it. The prevalence is so low in our country, below 1%. In urban areas, it is a little higher and a little higher in containment zones. We are definitely not in community transmission. Community Transmission is the stage when the source of the infection is not known. in the community transmission, the contact trancing concept goes haywire.

The India cases are rising than ever,.Yesterday,#DMK MLA J Anbazhagan died of the infection in Tamil Nadu and hotspot #Mumbai surpassed Wuhan’s caseload. There is a heightened debate around the community Transmission and then the WHO has not defined it. People are scared of community transmission in India.

US top infectious disease expert Dr. Anthony Fauci has flagged concerns and noted, Coronavirus is “my worst nightmare,” in some ways more than Ebola or HIV. Ebola was scary, but Ebola would never be easily transmitted, Fauc, the director of the National Institute of Allergy and Infectious Diseases has commented, said. Ebola outbreaks are also always highly local. He was speaking via recorded video at the Biotechnology Innovation Organization International Convention. Many never felt threatened by the disease because it was always a threat “depending upon who you are, where you are, where you live.”.

The Covid-19 pandemic has triggered the most severe recession in nearly a century and is causing enormous damage to people’s health, jobs, and well-being, according to the OECD’s latest Economic Outlook.

Research is ongoing to determine how the virus that causes COVID-19 can be transmitted by people who show no symptoms of the disease, the head of the World Health Organization (WHO) told journalists on Wednesday.

The UN agency has clarified information shared earlier this week, noting that there is still much to learn about the new coronavirus.

“Since early February, we have said that asymptomatic people can transmit COVID-19, but that we need more research to establish the extent of asymptomatic transmission. That research is ongoing, and we’re seeing more and more research being done”, said WHO chief, Tedros Adhanom Ghebreyesus, speaking during his latest press briefing.

“But here’s what we do know: that finding, isolating and testing people with symptoms, and tracing and quarantining their contacts, is the most critical way to stop transmission. Many countries have succeeded in suppressing transmission and controlling the virus doing exactly this. (Community Transmission)

‘Learning as we go’
During the WHO briefing on Monday, epidemiologist Dr. Maria van Kerkhove, WHO’s technical lead for COVID-19, answered a journalist’s question about asymptomatic transmission, stating that it was “very rare”.

Dr. van Kherkove later clarified that this was based on a few preliminary studies and that she was trying to articulate what is known now.

“By definition, a new virus means that we’re learning as we go”, said Tedros. “We have learned a lot, but there’s still a lot we don’t know.”

He said communicating complex science in real-time about a new virus is not always easy, “but we believe it’s part of our duty to the world. And we can always do better.”

COVID-19 and seasonal variation
Although winter historically signals the start of flu season, health experts are not yet certain how the new coronavirus will react under the same conditions.

“Right now, we have no data to suggest that the virus will behave more aggressively, or transmit more efficiently, or not”, said Dr. Michael Ryan, head of WHO’s emergency program, responding to a journalist’s question about the start of winter in the southern hemisphere.

Similarly, there is no data on whether the virus will respond differently under summertime conditions.

Dr. Ryan said while warmer weather tends to draw people outdoors, air conditioning also allows them to spend more time inside.

“There may be risks that are driven by a climate that isn’t specifically related to the viruses themselves, but are more specifically related to the human behaviors that are driven by temperature or driven by the season,” he said.

“But at this point, just to be clear, we have no indication as yet how the disease will behave in the future.”

Latin America remains a concern
Meanwhile, WHO remains deeply concerned about what Dr. Ryan called the “persistent and progressive” increase in COVID-19 cases in Central and South America.

“We need to focus on containing and stopping and suppressing that disease. And if changes in the climate assist in that, that’s great news”, he said, underlining the value of public health measures aimed at halting further spread.

“But we cannot rely on an expectation that the season, or the temperature, will be the answer to this.”

Building on flu research
Dr. van Kerkhove explained how influenza surveillance is informing understanding of the new coronavirus through a decades-old network that unites laboratories across the globe.

“More than 90 countries right now are utilizing their influenza system to also test for COVID-19”, she said.

“This is incredibly helpful for us to build on that platform so that we understand where the virus is within the community.”

However, Dr. van Kerkhove highlighted the need to continue flu testing, which has declined in several countries.

No COVID-19 vaccine testing on African ‘guinea pigs’
The WHO chief also refuted the rumor that African countries are being used as a testing ground for COVID-19 medicines.

Tedros was responding to a reporter’s question about poorer nations being targeted as “guinea pigs” for vaccine research.

WHO is currently running a “solidarity” trial of four medicines, and Tedros reported that the nearly 40 countries taking part are all using the same protocols.

“When it comes to vaccines, WHO’s position is the same: using the same protocol in the whole world; the same protocol in all countries involved. And we don’t tolerate any targeting of a continent or a country to do a trial, or using it as a testing ground”, he said.

Tedros added that vaccines currently on the front line of research will soon move to clinical trials, adding that “we will make sure that the same protocols and the same guidelines are applied.”
India has reported a spike of 9,996 more COVID-19 cases in the last 24 hours, taking the country’s COVID-19 count to 2,86579, according to the Union Ministry of Health and Family Welfare. 357 deaths were reported in the last 24 hours taking the total death count to 8102.

In Tamil Nadu, opposition party MLA J Anbazhagan died of the disease tragically on his birthday yesterday. There are about 1,00,000 cases in Maharashtra with Mumbai is a major hot spot while the state has reported 3438 deaths and 94041 cases.vis-a-vis -32810 cases and 984 deaths in Delhi.

The recovery rate now stands at 48.88%.
With the addition of 2,259 new cases, Maharashtra’s COVID-19 tally has surged to 90,787. According to the state health department, the state has reported 120 deaths with the toll now standing at 3289.

The number of patients who have recovered stands at 42,638 with 1663 discharges in the last 24 hours. Mumbai, on the other hand, recorded 1,015 new cases with the total rising to 50,878. The city recorded 58 deaths more leading to a toll of 1,758. The number of reported cases in Mumbai has now crossed that of Wuhan in China, where the Corona  Virus outbreak began. The silver lining is that the doubling rate in Mumbai has increased to 23 days and in Asia’s largest slum, the doubling rate has increased to 48 days. Moreover, no deaths have been reported from Dharavi during the last seven days.

Delhi Deputy Chief Minister Manish Sisodia has told media that 5.5 lakh COVID-19 cases are expected in Delhi by July 31 and 80,000 beds will be  He said By the Delhi government’s estimates, by June 15 there will be 44,000 cases, one lakh cases by 30 June and 2.25 lakh cases by July 15.

According to Johns Hopkins University, There are 7400,013 COVID-19  pandemic infections and 417,133 deaths globally so far. In the US, The pandemic virus has infected 2000,464 people and killed 112,924  It includes 30542 deaths.

WHO  has said there was no time to take the foot off the pedal.“More than six months into this pandemic, this is not the time for any country to take its foot off the pedal”,  said WHO chief Tedros Adhanom Ghebreyesus.

With millions taking to the streets in anti-racism protests, WHO is underlining the importance of remaining safe during mass gatherings. Demonstrations have been taking place in several cities across the globe, sparked by the 25 May death of George Floyd, an African American, while in police custody, in Minnesota.

Even in the US, the cases are rising after the relaxation in lockdowns and laxity in the social distancing mainly during the current protests.

The Russian Federation has reported 501,800 Cases with 6522 deaths. According to the latest figures from Johns  University on the World coronavirus situation, In Bangladesh, over 78052 cases were reported and it has lost 1049.

In Sri Lanka,1869 cases came into light with 11 deaths only. Nepal today reported fifteen deaths while its cases touched the 4614 marks. Bhutan has reported 47 cases and no deaths. Pakistan has 113,702 cases and 2255 deaths. Afghanistan, the case figures stand in 22,890 and 426 deaths.

Cases in Peru are spiking. Visuals show to scramble for oxygen cylinders. Peru has reported about 208,823  and over 5903 deaths. The biggest rise in caseloads can be found in Brazil, Colombia, Chile, Peru, Mexico, Haiti, Argentina, and Bolivia.

Brazil now has the second-highest number of cases globally. It has registered more than 39680 deaths and 802,828.

The UK has reported a total of deaths 291,588 cases and about 41213 deaths. Spain has so far reported 242,280 cases, and 27,136 deaths while Itlay’s death toll is 34,114 and cases mounted to 235,763.

In Germany, there are 186,525 cases and over 8768. France has reported 192,068 cases and 29,322 deaths against Japan’s 17,182 cases, and 922 deaths.

Sweden has reported more than 46814 cases and 4814 deaths. Canada has reported 98720 cases and 8038   deaths. In Norway, there are 8594 cases and 242 deaths.

Likewise, Belarus has reported 51816 cases and 293 deaths. Mexico has reported 129,184 cases and 15335  deaths.

China which was the epicenter previously has reported a total of 84,209 cases and 4638 deaths. South Korea has reported 11,947 cases and 276 deaths.in the current, World coronavirus situation, South Korea has got some fresh cases while the country has been credited globally for combating the menace effectively.

Singapore has 39,387 cases and 25 deaths. Vietnam has reported 332 cases and no death against Taiwan’s reportage of 443 cases and seven deaths to date. South Africa has reported 55,421 cases and 1210 deaths

In Saudi Arabia, 112,288 cases surfaced with 819 deaths. Iran has reported a total of 8506 deaths and 180.156  In UAE, The death toll is 284 and cases are 40,986

#Community Transmission
In India, the government said the Recovery rate of COVID-19 in India is increasing and it stands at 49.21% today. As on June 11, 2020, India has 1,41,028 individuals who have been cured and recovered from COVID-19. A highly positive development is that the number of recovered patients has exceeded the number of active cases at present. This was informed by Joint Secretary, Ministry of Health & Family Welfare, Mr. Lav Agarwal at a media briefing on actions taken, preparedness and updates on COVID-19, at National Media Centre in New Delhi today.

The Joint Secretary observed that many a time while comparing the COVID-19 situation in India, vis-a-vis other countries, we look at absolute number of cases in various countries. In this context, Mr. Agarwal emphasised that this comparison can be somewhat misleading and misconstrued at times. We should look at the countries having equivalent population as that of India. This comparison should not be done with countries having a much smaller population than India.

DG, ICMR Prof. (Dr.) Balram Bhargava informed that the cases per lakh population in India is amongst the lowest in the world. Similarly, the number of deaths per lakh population in India is also amongst the lowest in the world. He said this finding has been corroborated by the serosurvey undertaken to monitor the trend of SARS-CoV-2 infection transmission. The presentation given by the DG can be found here.

The DG, ICMR presented the results of Part-I of the survey, aimed at estimating the fraction of the general population who has been infected with SARS-CoV-2:

  • 0.73% population in the districts surveyed had evidence of past exposure to SARS-CoV-2
  • Lockdown/containment has been successful in keeping the infection spread low and preventing rapid spread in 3 months.
  • It however means that a large proportion of the population is still susceptible.
  • It has also been found that the risk of infection is slightly higher in urban areas (1.09), higher in urban slums (1.89) in comparison to rural areas.
  • A positive side is that the infection fatality rate is very low at 0.08%.
  • Infection in containment zones was found to be high with significant variations and data related to this is still being gathered.

Prof Bhargava concluded that:

  • Since large proportion of the population is susceptible and infection can spread, non-pharmacological interventions such as physical distancing, use of face mask/cover, hand hygiene, cough etiquette must be followed strictly.
  • Urban slums are highly vulnerable for the spread of infection
  • Local lockdown measures need to continue as advised by the Central Government, especially in containment areas.
  • High-risk groups, that includes elderly population, people with chronic morbidities, pregnant women, and children less than 10 years of age need to be protected.
  • Efforts to limit the scale and spread of the disease will have to be continued by the strong implementation of containment strategies by the states
  • The states cannot lower their guard and need to keep on implementing effective surveillance and containment strategies.

Explaining the process and objectives of serosurvey, DG, ICMR explained that blood samples are collected from general population and tested for IgG antibodies. If the antibody test is positive, it means they were infected with SARS-CoV-2 in the past. Explaining the expectations from serosurvey, Prof Bhargava stated, it presents the percentage of the general population who are at a higher risk of getting infected and thereby, the areas needing more strengthened containment efforts. The objective of conducting a serosurvey is to provide a scientific guidance from time to time.  Being guided by this principle, a survey has been conducted and multiple such surveys will be done as we progress, further stated DG, ICMR.

In Part I of the survey, a total of 28,595 households were visited in the 83 districts surveyed for this purpose. Blood samples along with data was collected from 26,400 individuals in the survey. The survey was conducted in collaboration with the state health departments, NCDC, and WHO in May 2020 and represents the situation that prevailed in April 2020. The second part of the survey aims to estimate the fraction of the population who has been infected with SARS-CoV-2 in containment zones of hotspot cities. This part of the survey is in progress.

After obtaining written consent and ethics clearance, 3-5 ml of venous blood was collected from some individuals in the survey areas, and then their sera were tested for IgG antibodies and infection using COVID KAVACH ELISA. The ELISA test is also being made available to the states to conduct serosurvey in different groups of individuals. On the basis of the number of reported COVID-19 cases detected by RT-PCR test, the districts were divided into 4 groups for the purpose of the survey. These groups are based on cases per million population – zero cases, low incidence (0-5 cases), medium incidence (5-10 cases), and high incidence (more than 10 cases). Taking 15 districts from each group, 400 individuals were studied from each district. Further, 10 villages/urban areas were selected randomly and one adult from every household was studied from a total of 40 adults enrolled from each village/urban area.

Dr. V.K. Paul, Chairman, National Task Force on COVID-19, and Empowered Group-I observed that the COVID-19 sero survey by ICMR shows that less than 1% of the population in the studied districts has been infected. In this context he stated, it is a very big achievement that we have been able to contain the infection to this level, especially in a big nation as ours. Stating that the central goal in managing any pandemic is to minimize loss of life, he said, COVID-19 sero survey shows that we have been successful in keeping the mortality rate very low. He further said, the battle against COVID-19 will continue for many more months, hence we need to continue and strengthen our containment efforts and behavioral changes which we have begun to take.

Replying to a media query, Dr. V. K. Paul said: “The containment principles for COVID-19 faced around the world are essentially the same. Once the virus went out of China, the entire world was to face the pandemic in a very different way, because it came through travel at multiple points in every nation, including ours. India is doing pretty well in containment, virus has the nature of traveling very rapidly, but the nation has demonstrated that it can be lessened, contained, and suppressed.”

In reply to a media query on the heightened debate on community transmission, Prof Bhargava stated, India is such a large country, but the prevalence of COVID-19 infection is so slow and it is still less than 1%, as shown by serosurvey conducted by ICMR. Hence, India is definitely not in the stage of community transmission, he concluded.

Speaking on ramp-up of COVID-19 tests by ICMR, Prof Bhargava stated, starting with a single lab in January, we have more than 850 labs in the country now. He further said, COVID-19 testing guidelines are calibrated and presently there is a capacity of doing up to 2 lakh tests per day.  Our testing strategy so far has been successful, said the DG, ICMR.

In reply to a media query, Shri Agarwal said, we have requested states to further streamline their process of dealing with COVID-19 patients on the basis of the seriousness of cases and symptoms, provide additional guidance to patients by means of call-centres and also use technology, as far as it is feasible, to display online the availability of beds in various COVID hospitals. The lockdown period has been utilised to ramp up infrastructure and beds. Sufficient beds are available and it is further being increased on basis of needs. States have also been told to use railway coaches for COVID-19 patients as per requirement, he further said.

Responding to another query, the Joint Secretary said that many state governments have held discussions with private hospitals and decided upon a price for COVID-19 tests, while some state governments are in the process of doing it. – News Abode