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Prof. (Dr.) Tabrez Ahmad, Pro Vice Chancellor and Dean at Galgotias University: Scenario of Covid-19 in India

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Dr Tabrez Ahmad

In the current lockdowns, if the proper physical distancing or compliance is not properly followed, the total number of cases (asymptomatic, hospitalized and symptomatic) can even touch a massive figure.

In the most likely (Medium) scenario with moderate to full compliance but no change in virulence or temperature/humidity sensitivity, the numbers of total cases can swell up to few lakhs.

The optimistic (low) scenario constitutes decreased virulence and temperature/humidity sensitivity.To reach these numbers, Johns Hopkins and CDDEP — a public health research organisation — used India SIM, a well-validated agent-based model of the Indian population, which has been published widely over many years and has been used for government decision-making. According to the report, hospitalised cases can reach up to 25 lakh people in the High scenario, 17-18 lakh people in Medium scenario and 13 lakh people in Low scenario.

In what could spell real trouble for the country in the next three months, a new report from prestigious Johns Hopkins University and the Centre for Disease Dynamics, Economics & Policy (CDDEP) has predicted that 21-day lockdown may be ineffective to stop the COVID-19 peak arriving in April-May-June — infecting few lakhs Indians in an optimistic (low) scenario.

Dr. Ramanan Laxminarayan, director of the US-based Centre for Disease Dynamics, Economics and Policy, and an advisor to the World Health Organisation (WHO) and World Bank, had previously warned India that In a worst-case scenario, India would experience a novel coronavirus high infection rate, which would see approximately majority of confirmed cases of COVID-19 across the country, leading public health expert estimates. India’s jam-packed cities and heavily crowded public transport also throws a unique challenge to social distancing, which is necessary to curb the spread of novel coronavirus.

Now, in view of the effective enforcement of lockdown measures and countrywide curfews that were recently enforced by the Indian government, that worst-case number will not be very high. Furthermore, an overwhelming majority of these infections are likely to be extremely mild.

In case if a high number of people becomes ill, with few lakhs requiring intensive medical treatment would put an immense strain on India’s healthcare system. In a worst-case scenario, estimation is based on how transmissible the novel coronavirus would be in India. If citizens fail to follow the social distancing, the virus would be as transmissible as it has been in Italy, USA, Spain and Iran, which will effectively take the worst-case numbers to higher side.

There are various agencies, who have been consistently updating the countrywide COVID-19 infection status and deceased, but in-fact due to less testing in the country the real number of confirmed cases is significantly higher.It is almost impossible that this [community transmission] could not have happened in a situation where about tens of thousands of people travelled from different places of the world could not properly tested during entry in the country and to imagine that none of them carried the coronavirus.

We are required to upgrade themedical facilities, expand testing, and spread awareness to promote careful prophylaxis than to politicise the issues and irrationally connecting the spread of the disease to a particular community. Now the role of media is very important to provide the real picture and solace to the community than to play dirty politics to improve their TRP. Rather than they should encourage the community in seriously preparing for the mitigation, which would require making several thousands of beds available in advance.

The Covid-19 is going to testify few things about India like our health system capacity; our system of governance on how much people listen to what the government is saying; and our social structure, whether people are going to support and cooperate each other.[1]

As per the reports and estimations, the Ventilator demand in India may go up to1 million while the current availability in India is estimated to be between 30,000 and 50,000 ventilators. People could need ICU treatment; India needs to urgently import ICU equipment, ventilators and a range of medicines.

The possibility of infection to doctors and nurses could further increase deaths in the general population. Healthcare workers need personal protective equipment like masks and gowns to protect themselves. In lack of the proper support they may get sick and challenging, the potential of the health support system.

As per the current WHO reports, the number of coronavirus, cases until2April 2020 have crossed two thousand in India and 10 lakhs globally while the death toll crossed 60 in India and 47,000 globally.[2]However, April is the month when peak may begin and delays in testing are seriously reducing the ability of the people to protect themselves. This is the most important way in which we can reduce the epidemic. A real number of detected cases in the short term could encourage the people to take social distancing more seriously and may reduce the panic compared to a big challenge later on.

Learnings from China provides that higher temperature and humidity may likely to lower the transmission rates but it is not very clear that how this will affect the Indian scenario. However, the best strategy is to be prepared for multiple peaks and should be ready for any emergency happening later. People who will show symptoms next week are already infected and incubating the virus. Some of these will transmit before they are symptomatic. A large percentage of cases are mild, but for older individuals, the mortality rate is strikingly higher. Children are less likely to be infected and less likely to be hospitalized than adults are. Illness is less likely to be severe in children than in adults, and the infection rate is less likely in females than males.[3]

it is essential to test those who have symptoms such as coughs, cold, fever or respiratory distress even though they have no travel history or have not come in contact with an infected person. Testing is important otherwise we will not know what percentage of people with such symptoms are coronavirus-related as opposed to sufferers of ordinary seasonal colds, coughs and flu. India govt. had acted promptly to check entry into the country and while sensible steps like shutting schools, colleges, theatres and cinemas and imposing lock-down in timebut woefully the testing is inadequate for a country with a 1.3 billion population.

There is no need to rush for immediate testing but if you have a cold or cough or fever or respiratory distress and it persist after about four days then you should get yourself tested.If someone is quarantined at your house, then rest of the family members should take commonsensical precautions but this does not mean that they cannot enter the premises to serve eatables. They can actually hand the tray over rather than leave it two feet away. You can wash the utensils used by such a person or their clothes and there is no need to wear gloves but you must wash your hand. There is absolutely no scientific basis for believing drinking gaumutra and taking gobar baths could prevent the Coronavirus infection. There is also no scientific basis for any of the homeopathic remedies that are being suggested for the cure of Covid-19.[4]

[1] https://weather.com/en-IN/india/news/news/2020-03-23-covid-19-worst-case-scenario-30-crore-indian-infected-coronavirus. Visited on 2nd April, 2020

[2] https://www.worldometers.info/coronavirus/. Visited on 2nd April, 2020.

[3] https://www.ndtv.com/health/coronavirus-india-may-see-25-crore-covid-19-cases-in-next-3-months-report-2201489.

[4] https://thewire.in/health/india-coronavirus-ramanan-laxminarayan . Visited on 2nd April, 2020.

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