On some experts suggesting that there is alreadycommunity transmission (stage 3) of the virus in the country,President of Public Health Foundation of India, Prof. KSrinath Reddy maintained that it is a matter of definition.
Because, if one looks at the spread to people withouthistory of travel or history of contact, certainly there areseveral such cases, he said.
"But most of them are concentrated around the originalpoints of entry of the foreign travellers or the travel routesof their contacts. So, these people who are describing it asstage 2 still are saying this is traceable local transmission,it is not unpredictable community transmission, he told .
Therefore, we are avoiding the term communitytransmission. It is a matter of definitions and language; weneed not debate that really, Reddy, who formerly headed theDepartment of Cardiology at All India Institute of MedicalSciences (AIIMS), said.
But he said it should be recognised that communitytransmission has occurred in virtually every country whichexperienced this pandemic in a major form and India shouldalso be prepared for it and act as though it is happening andtake all precautionary containment measures.
There is not only risk and but actually threat ofcommunity transmission, said Reddy, who presently serves asan Adjunct Professor of Epidemiology at Harvard.
According to him, nations in South East Asia, includingMalaysia, and India in particular, have kept the COVID-19death rates per million of the population low compared tocountries where the pandemic broke out around the same time.
He said the low death rate in India could be the benefitof multiple factors such as younger age group, more ruralpopulation, temperature and climatic conditions as well as thebenefits the containment measures which preceded lockdown, andthen got much more consolidated with the lockdown. "Its quite possible that all of these factors have beenhelpful and we have seen that benefit, Reddy said. But we need to continue to consolidate that. There aresome risk factors, when the lockdown opens there will be muchgreater mobility of people, there could be more widespreadtransmission of the virus, so we have to maintain as much aspossible physical distancing, continue practices like wearingmasks 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 aspossible, particularly for elderly people and to people withco-morbidities, whether they can be provided temporaryshelters elsewhere with good social cares.
Fortunately, he said, most of the infections arerestricted to large cities and areas radiating around them.
Referring to return of migrant workers, he said caremust be taken to see that they themselves will not be victimsof the epidemic, and at the same they dont infect others.
"But most important thing is to protect the ruralareas (from COVID-19) because two-thirds of India is in ruralareas, and the transmission of the virus is low there becausemobility is low, Reddy said.
Several precautionary measures have to be taken in orderto contain the virus because the risk of transmission willcertainly increase with the lifting of the lockdown.
We must recognise that this virus is going to stay onfor some time and we have to make sure that at least for thenext one year, we try and keep the virus as slowly moving aspossible by physical distancing and other protective measureslike masks and handwashing."
Evolutionary biology of the virus says that when themovement is greatly restricted and its chances of transmissionare greatly reduced, the virus actually can turn into a mildervirus, said Reddy, who is also an Adjunct Professor of theRollins School of Public Health, Emory University and HonoraryProfessor of Medicine at the University of Sydney.
So, we will have to do everything to reduce thetransmission, speed and number, at the same time try andmoving it towards milder form to our own defensive measures.So, while there are threats, there are also opportunities forus to protect ourselves and even control not only the spreadof the virus but also the virulence of the virus, he added. RSVS VS