Coronavirus update: Has Covid-19 entered Stage 3? Experts, government disagree
Covid-19 update: According to the ICMR, the apex biomedical research body in the country, there are four states of the disease. Stage 1 is getting imported cases, stage 2 is local transmission when a person whose been to a global hotspot infects a local resident, stage 3 is community transmission and stage 4 is an epidemic.
Authorities in several states across India are racing to figure out how individuals with no travel history or documented contact with a Covid-19 patient contracted the infection in what several experts have termed as the deadly third stage of the disease.
Such cases have been reported from all over the country: a 29-year-old rail employee in Bihar, a young political leader in Kerala, a 60-year-old bank officer in Odisha and a 57-year-old man in West Bengal being just a few examples. In none of these cases have authorities been able to find a confirmed source of the contagion.
This has triggered fears that India has slipped into the community transmission phase of the disease, when the virus rapidly spreads within a community and a person with no travel history to a Covid-19-hotspot or known contact with previous patient gets infected.
In this phase, undiagnosed cases infect others, making it difficult for doctors to trace, isolate and treat patients. As a result, infection clusters spiral out of control and turn into epidemics.
According to the Indian Council of Medical Research (ICMR), the apex biomedical research body in the country, there are four states of the disease. Stage 1 is getting imported cases, stage 2 is local transmission when a person whose been to a global hotspot infects a local resident, stage 3 is community transmission and stage 4 is an epidemic.
Despite a number of cases of people with no known contact to an infected person or travel history, the ICMR has insisted that India is still in stage 2 as the infection is largely limited to people with a travel history and their close contacts.
“There is no community transmission in India as of now, as by definition community transmission means when there is a large number of cases where you cannot trace the source. A few cases in a large country like ours where contact/source is not known doesn’t meant community transmission, it means more effort needs to go in contact tracing. It is not a simple process and at times takes time,” said Lav Aggarwal, joint secretary, ministry of health and family welfare.
But experts are not convinced. They point out that because testing norms are stringent in India, and the number of tests are low – the country has one of the lowest rates of testing per capita in the world – the number of suspected community transmission cases are not likely to be high.
“Unless you test, you won’t know. In the initial phase of the epidemic, there are very few cases, but once it begins, its spreads like wildfire. So testing more people holds the key. It will determine whether we go the way of Italy, or Korea,” said a senior public health expert, requesting anonymity.
In the case of Italy, the country waited for too long to test people and isolate clusters. The European country now has the highest Covid-19 fatality rate in the world. In contrast, South Korea acted quickly after the first instance of community transmission and tested thousands of people every day, even setting up drive-by testing centres where people could pull up in their cars and get diagnosed.
In the United States, when the first case of a person in California with no relevant travel history or exposure to another known patient showed up, it was termed a “possible instance of community spread of Covid-19 in the United States” by the US Centers for Disease Control on February 26.