India must gear up to face community transmission of COVID-19: Health expert

Bengaluru: India must gear up to face the
possibility of community spread of the COVID-19, a prominent
health expert said on Friday, cautioning that there could be
more widespread transmission of the novel coronavirus due to
easing of the lockdown.
On some experts suggesting that there is already
community transmission (stage 3) of the virus in the country,
President of Public Health Foundation of India, Prof. K
Srinath Reddy maintained that it is a matter of definition.
Because, if one looks at the spread to people without
history of travel or history of contact, certainly there are
several such cases, he said.
“But most of them are concentrated around the original
points of entry of the foreign travellers or the travel routes
of their contacts. So, these people who are describing it as
stage 2 still are saying this is traceable local transmission,
it is not unpredictable community transmission, he told PTI.
Therefore, we are avoiding the term community
transmission. It is a matter of definitions and language; we
need not debate that really, Reddy, who formerly headed the
Department of Cardiology at All India Institute of Medical
Sciences (AIIMS), said.
But he said it should be recognised that community
transmission has occurred in virtually every country which
experienced this pandemic in a major form and India should
also be prepared for it and act as though it is happening and
take all precautionary containment measures.
There is not only risk and but actually threat of
community transmission, said Reddy, who presently serves as
an Adjunct Professor of Epidemiology at Harvard.
According to him, nations in South East Asia, including
Malaysia, and India in particular, have kept the COVID-19
death rates per million of the population low compared to
countries where the pandemic broke out around the same time.
He said the low death rate in India could be the benefit
of multiple factors such as younger age group, more rural
population, temperature and climatic conditions as well as the
benefits the containment measures which preceded lockdown, and
then got much more consolidated with the lockdown.
“Its quite possible that all of these factors have been
helpful and we have seen that benefit, Reddy said.
But we need to continue to consolidate that. There are
some risk factors, when the lockdown opens there will be much
greater mobility of people, there could be more widespread
transmission of the virus, so we have to maintain as much as
possible physical distancing, continue practices like wearing
masks and hand-washing as precautionary measures, he said.
Things are going to be difficult in overcrowded areas,
especially slum areas.
We will have to try and provide as much facilities as
possible, particularly for elderly people and to people with
co-morbidities, whether they can be provided temporary
shelters elsewhere with good social cares.
Fortunately, he said, most of the infections are
restricted to large cities and areas radiating around them.
Referring to return of migrant workers, he said care
must be taken to see that they themselves will not be victims
of the epidemic, and at the same they dont infect others.
“But most important thing is to protect the rural
areas (from COVID-19) because two-thirds of India is in rural
areas, and the transmission of the virus is low there because
mobility is low, Reddy said.
Several precautionary measures have to be taken in order
to contain the virus because the risk of transmission will
certainly increase with the lifting of the lockdown.
We must recognise that this virus is going to stay on
for some time and we have to make sure that at least for the
next one year, we try and keep the virus as slowly moving as
possible by physical distancing and other protective measures
like masks and handwashing.”
Evolutionary biology of the virus says that when the
movement is greatly restricted and its chances of transmission
are greatly reduced, the virus actually can turn into a milder
virus, said Reddy, who is also an Adjunct Professor of the
Rollins School of Public Health, Emory University and Honorary
Professor of Medicine at the University of Sydney.
So, we will have to do everything to reduce the
transmission, speed and number, at the same time try and
moving it towards milder form to our own defensive measures.
So, while there are threats, there are also opportunities for
us to protect ourselves and even control not only the spread
of the virus but also the virulence of the virus, he added.

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