COVID-19: Has community transmission begun in India?

Govt denies India in Phase 3 but experts not sure about its claim

By Banjot Kaur
Published: Saturday 21 March 2020

The Union government has maintained that there has been no case of community transfer in the novel coronavirus outbreak (COVID-19) in India. But some experts doubt that.

Currently, there are at least two COVID-19 cases whose travel history has not be traced till date. Could these cases be an indication of the beginning of community transmission?

Community transmission is the third phase when a person who does not have an international travel history to one of the disease-affected countries or is not a contact of a confirmed case gets infected. 

One of the two cases in question is a 20-year-old male living in Tamil Nadu. He tested positive on March 21.

However, the Union government has not been able to say as to where he caught the infection from. The state’s health minister C Vijay Bhaskar has described it as a ‘domestic case with no travel history’.

The second case is of a 41-year-old Pune woman who is now critical. She was confirmed positive on March 20. There is no history in her case as in the Tamil Nadu male’s, the district’s district magistrate has said. 

However, the government still denies that these are community transmission cases, saying their contract tracing is still on.

“Tracing contacts is a very difficult and time-consuming job. We are still trying to trace contacts,” Lav Agarwal, joint secretary, Union Ministry of Health and Family Welfare (MoHFW) said in a press conference on March 21, 2020.

He did give a clear reply if there was a limit to the number of days of contract tracing after which it was declared that contact could not be traced.

Another official from MoHFW said that while the source of infection in the two cases was untraceable was a fact, it did not mean that these were cases of community transmission. Instead, they pointed to serious gaps in the contact tracing exercise, he said.

“I have also heard that contact could not be traced,” R Gangakhedkar, head of the Indian Council of Medical Research (ICMR)’s epidemiology division said on March 20. But he added in the same vein that this should not be construed as community transmission.

Could it be simply rejected as a failure in the contract tracing exercise? Former head of ICMR’s Centre for Advanced Research in virology T Jacob John says no.

“It is better to accept the reality and prepare than to run away. While one or two cases in actuality may not make a case for widespread community transmission but they are a pointer,” he said. 

Why was testing criteria changed?

Only two days ago, the ICMR made public, the results of 826 samples collected randomly from people suffering from serious respiratory illness but having no history of international travel and contact. All those samples were found to be negative for the novel coronavirus (SARS-CoV-2).

On this pretext, the ICMR claimed that there was no reason to expand the testing criteria. 

However, on the morning of March 21, it did and even allowed those people who had serious respiratory illness without a history of travel or contact to undergo a COVID-19 investigation. What explains the change?

While Agarwal said it was a result of the ‘changing situation’ without elaborating what change it was, a ministry official said there was no change as such. “The ministry just told ICMR that if there is no dearth of kits, then there is no harm in expanding the net,” the official said. 

On March 20, the government opened the criteria for private labs

The government has also fixed maximum prices of hand sanitisers and masks. “A 200 ml bottle of a sanitiser should not have an MRP of more than Rs 100, a 2-ply mask Rs 8 and a 3-ply mask, Rs 10,” Pawan Agrawal, secretary of the Union Ministry of Consumer Affairs, said.

However, an important rider is this would not be applicable to existing products in the market but the new ones to be manufactured from now on. To curb the shortage, ethanol distillers have been allowed to manufacture sanitisers without taking mandatory permission. 

Agarwal claimed that the Sunday's ‘janta curfew’ will help in breaking the ‘chain of transmission’ of the virus. When queried whether there was any scientific evidence to back the fact that a 14-hour lockdown could actually do so, he did not reply. 

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