At a time when hotspot containment measures are among the focus areas for prevention and control of the coronavirus outbreak (COVID-19) , renowned virologist T. Jacob John has called for a shift in strategy — chasing the virus should be phased down and checking the virus in infected persons should be stepped up.
COVID-19 | Interactive map of confirmed coronavirus cases in India
“This is not a hotspot transmitting virus but it is a virus that transmits everywhere… Containment measures have to continue. But now, containment measures should have 30% priority, and healthcare testing 70% priority. Healthcare checking is another way of containment measure as we will be finding infected people who had no travel history,” said Dr. John, retired professor of virology, Christian Medical College, Vellore.
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That community-based transmission is happening in India is not accepted, he stated. “We do not see it because the majority of people are silently infected and only a few will show symptoms. We are not looking at symptomatic people. We are looking at test results, tests based on travel and contact with those who have travelled. That phase is more or less over. Continuing to chase people who had travelled and their contacts is alright if we have sufficient manpower and energy. But today, what we need to understand is that the virus has widely spread,” he stated.
COVID-19 is a pandemic, meaning that all countries are affected. It means it is a widely transmitting virus, he said, adding: “In every pandemic, within countries, the virus will spread to every nook and corner where human beings live. Even in tribal areas where the neighbouring house is one mile away, the virus will reach there as people will have contact with someone. If not this month, next month. So that kind of a spread should be anticipated now, a widespread community spread is going to happen.”
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What should be done now? He said now is the time to prepare the healthcare system to face huge numbers of sick people. “That preparation is what we need now, not chasing the virus. Chasing the virus must be phased down and checking the virus in sick people must be stepped up. The strategy from now onwards should be lesser and lesser on efforts paid for travel-related search and more emphasis on illness-related testing,” he said.
Dr. John added that it was high time that the strategy be shifted to testing people with fever and cough. “Anybody with fever and cough must be checked. Additional symptoms like fatigue, headache, nausea, vomiting, diarrhoea, body ache are common to both influenza and COVID-19. High fever is common in COVID-19 but not in common cold. So, influenza and COVID-19 should be in one category, and all other respiratory infections in another. If there is a loss of smell, if taste disappears for one day, if there is breathing difficulty, it is more like COVID-19. Those people should be tested for influenza and COVID-19,” he explained.
“The testing strategy must expand to illness testing as the virus is on the loose in the community. Whether the government accepts it or not, it is already in the community,” he said.