Trend is suggestive of pandemic expanding in India, experts point out

The Asian Age.  | Swati Sharma

With more than 10,000 diagnosed cases every day in India and more than 500 daily in Telangana, the healthcare system will rupture soon

With the testing strategy multiplied many folds today — with an average of more than one lakh tests performed daily — as on 21 June 2020, a cumulative total of 6,950,493 samples have been tested

Coronavirus cases have risen rapidly in the past week. While a month ago, 7 out of every 100 samples turned positive, today, the numbers have risen to 31 out of every 100 samples. Experts say that the trend is suggestive of an expanding outbreak, and doctors say it is only a matter of time before COVID-19 sweeps India.

Start to spike

Dr Hari Kishan Gonuguntla, MD, DM, Senior Interventional Pulmonologist, Yashoda Hospitals, takes us back to the first few days of the pandemic in the country.

“The first case of COVID-19 in India was reported on 30th January 2020 in Kerala, from a student returning from Wuhan. Shortly, the number rose to three after two more students who returned from Wuhan tested positive on 3rd February,” he states.

“The initial rise in cases was slow, where most cases were imported and every measure was taken to contain them, trace their contacts and isolate them.”

For instance, Dr Hari points out, the first COVID-19-confirmed death was reported on 12th March 2020, nearly 45 days after the first case was identified.

The United Nations (UN) and World Health Organization (WHO) had then praised India’s response to pandemic as ‘comprehensive and robust’, and the Oxford COVID-19 Government Response Tracker (OxCGRT) gave India’s measures to control the pandemic a score of 100.

However, with the testing strategy multiplied many folds today — with an average of more than one lakh tests performed daily — as on 21 June 2020, a cumulative total of 6,950,493 samples have been tested.

“Today, as per the Centre for Disease Dynamics and Economic Policy (CCDEP), we have the highest number (425,282) of confirmed positive cases, top-most in Asia and fourth in the world,” states Dr Hari.

“Worse, the pace at which our numbers are accelerating, we would lead the world soon. All this just means that India’s measures to control the pandemic have failed.”

Reason for the spread

Dr Sunitha Lingareddy, founder and MD, Lucid Medical Diagnostics also agrees that that the number of COVID-19 cases in India is increasing at an alarming rate. She points out not only a lackadaisical public attitude but also lack of government support as some of the reasons.

“The public’s apparent careless attitude towards this issue — their not following simple measures such as wearing a mask, maintaining social distance and avoiding organising parties with many people in it are all causes,” says Dr Sunitha who shares that she also feels disheartened with their attitude towards healthcare professionals in the frontlines, diagnosing and treating patients.

However, Dr Swapna Yendru, Consultant Obstetrician and Gynaecologist, Swapna Health Centre, points out that the main reason one sees a sudden rise in the number of COVID-19 cases is also because there’s an increase in the testing frequency.  

“More than 10% of patients get infected by somebody asymptomatic, with about a week between case transmissions.”

“The increased numbers are of those already infected about ten days ago. Kerala’s success in controlling the number is because they strictly followed contact tracing, as most people are asymptomatic — when they get symptoms or feel sick, the virus has already spread to others.”

The nightmares of hospitals

With more than 10,000 diagnosed cases every day in India and more than 500 cases on average daily in Telangana, the healthcare system will rupture soon.

“India has a mixed healthcare system with both public and private health sectors playing important roles. However, if the current capacity or hospital admission policies for routine patient care are not increased at an exponential rate to accommodate the influx of COVID-19 patients needing hospital admission, getting a bed in a hospital will become a nightmare,” points out Dr Hari.

The doctor also tells us as per estimates, India has 19 lakh hospital beds, 95,000 ICU beds and 48,000 ventilators, with existing bed capacity mostly saturated in the government sector.

The hype around new medicines

Many researchers are studying various medicines for the treatment of COVID-19, including Hydroxychloroquine and Favipiravir for the mild form of the disease and Methylprednisolone, Remdesivir and convalescent plasma therapy for critically ill patients.

However, Dr Hari cautions the use of these drugs, especially Favipiravir. “A lot of false propaganda is being made around the new drug called Favipiravir, which is an anti-viral drug tested in a few trials from Japan, Russia and China,” warns Dr Hari.

For instance, since DCGI announced to approve Favipiravir for ‘restricted emergency use’ in moderate cases, social media is flooded with misinformation calling this drug a cure for COVID-19.

“This is false medical information. The drug has shown to have a faster viral clearance in mild to moderate cases in a few observational studies, while randomized control studies are yet to show benefit. The only medicine that is proven effective in a controlled study (recovery trial) from the UK is a drug called dexamethasone (steroid), which reduces the chances of death in critically ill patients,” the doctor reiterates.

Containing the pandemic

“As COVID-19 is mainly a droplet infection, transmission chances from asymptomatic individuals remain exceptionally low, but they still need to be identified by community-level testing for better isolation and quarantine methods,” Dr Hari points out.

“No matter how often lockdown protocols change, social distancing, use of mask and proper hand and respiratory hygiene are vital strategies for citizen in containing the pandemic. After you’re back home from outside, clean your clothes, masks, keys, purse, watch, bangles, etc.”

Dr Swapna also adds that another important instruction to keep in mind: visit a physician online even if you feel a little sick. “Doctors
know better how to handle medical cases and don’t ignore even minute symptoms,” she says.