Covid-19 – The Fight Continues…

COVID-19 continues to wreak havoc across the globe with a ferocity that shows no sign of abatement. Over 6 lakh cases of novel Coronavirus and over 27,000 deaths have been reported as on 28th March as per Worldometer.info. This is the worst pandemic since the 1968 influenza which lasted about six months and caused deaths of 1-4 million people as per WHO. From that perspective, we could still be some months away from the end of this pandemic even as the advancement of medical science has helped reduced the fatality rate.

Covid-19, suspected to have entered a human body through bats, was first reported to the World Health Organization (WHO) by China on 31st Dec’19. Even though the world has seen many pandemics, this one stands out for its rapidity of spread. While the first 100,000 cases were reported on 6th March’20, nearly three months after the first suspected case, second 100,000 cases occurred in just 12 days. The subsequent 100,000 cases are occurring in just about 3 days as per the above-mentioned source. The fatality figure is equally horrifying. From a figure of about 3,500 on March 6th, the day it crossed 100,000 cases, fatality doubled to 7,000 in the next 10 days. The figure has quadrupled to nearly 28,000 in next 12 days only.

The country-wise breakdown shows even greater intensity of the exponential spread. Italy, the worst affected outside China (now overtaken by USA), saw inflexion on 1st March with over 500 new cases reported that day. (Inflexion point refers to the date when the cases surged and remained at the high level but not based on any mathematical model). No of cases which was about 1,100 on 29th Feb, jumped to nearly 6,000 a week later and then, rose more sharply to 21,000 and 53,000 in the next two weeks. (Indeed, India is at nearly the same stage at this moment although the peak in our case is substantially lower. Whether the extraordinary pre-emptive measures taken by the government is able to disrupt the progression can’t be said with all certainty).

The case of USA is even more baffling and points to casual nature of response, more so as it had the benefit of lessons learnt from other countries. USA had less than 100 cases on 1st March, the day it spiked in Italy and other parts of Europe. The inflexion point for US came on 13th March, almost two weeks later indicating the ample amount of time it had to respond with reported new cases rising to over 550. Lack of adequate action and even greater linkage with Europe, the new hotbed, meant the virus spread even faster with total cases rising from less than 2,200 on 13th March to almost 20,000 just a week later and crossing 100,000 in the next one week. The response of USA, possibly, points to sheer arrogance even in the face of threat looking large. Western countries would have to take the blame for being casual and underestimating the potential of the pandemic despite warning by WHO.

While there was possibly a delay in China reporting the pandemic, its response has been coordinated and highly aggressive involving mobilization of large number of health workers. As per a WHO-China joint study, undertook during 10th–24th Feb, large no of teams of epidemiologists undertook extensive contact tracing to prevent the spread. This involved 1,800 teams with minimum five members in one region alone. The report states that China carried out tracing of over 35,000 contacts helping identify nearly 800 Covid-19 positive cases. Even the cases of fatality fell from over 17% in January to less than 1% in February. The report lauds the fact that on the first day of WHO mission, the country reported nearly 2,500 new cases. This declined sharply to only 478 cases in just two weeks, the last day of mission. The irony is that China is now screening people coming from other parts of the world.

Even as the virus spread to other regions, India managed to escape the first wave of infection coming from China during the month of Jan-Feb. Reported number of cases was only three on 1st March, the day it spiked across Europe. However, it was taken by surprise by the entry of virus from other infected nations leading to re-surfacing of cases starting 4th March. An entire batch of tourist from Italy were found Covid-19 positive taking the total to 29. March 27th is the possible inflexion point for the nation with new cases rising by sharp 160 as per Worldometer. Since the virus has a median incubation period of 5-6 days, the rise, possibly, corresponds to transmission occurred before the lockdown. Nationwide lockdown, enforced since 24th March, had a high likelihood of breaking the chain and arresting the spread. However, the unanticipated mass exodus from urban centres to rural area has not only increased the risk but has also added risk of pandemic entering rural India.

The nation waits with bated breath as to whether it survives this risk or not…

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