One undiagnosed COVID-19 case can infect up to 16,000 cases in 14 days if not quarantined: Prasun Chatterjee

Those above 80 who are not vaccinated against flu or pneumonia and living in old-age homes are at high risk, says the Associate Professor, Department of Geriatric Medicine, AIIMS

Updated - April 06, 2020 02:24 pm IST

Published - April 06, 2020 01:57 pm IST

Two old women wears protective mask fight against the coronavirus as they wait for public transport at a bus stop in Bhubaneswar.

Two old women wears protective mask fight against the coronavirus as they wait for public transport at a bus stop in Bhubaneswar.

One undiagnosed COVID-19 case can chain-infect up to 16,000 cases in 14 days if not quarantined and the elderly are most vulnerable, says Dr. Prasun Chatterjee, Associate Professor, Department of Geriatric Medicine, AIIMS, and Consultant WHO SEARO, in an interview with The Hindu.

Q) As the number of COVID-19 cases are increasing in the country, the elderly are surely at risk. What are the symptoms that one should look for? What are the atypical symptoms?

The older people, especially who are 80+, not vaccinated against flu or pneumonia, who are residing in old-age homes or long-term care facilities are at high risk of developing severe diseases due to COVID-19.

Cardinal symptoms for COVID-19 are fever, cough (dry and persistent) and shortness of breath, not due to a known chronic disease like COPD, Bronchial asthma or heart failure.

The other atypical symptoms could be headache, sore throat, nausea, diarrhoea, etc. Approximately 90% of patients are present with more than one symptom, and 15% of patients are present with fever, cough, and laboured breathing.

However, the most important consideration is detailed contact history with someone who has travelled to the countries where COVID-19 is widespread. Anyone above 65 with disproportionate respiratory symptoms should contact a doctor.

Why is COVID-19 more dangerous than other group of corona viruses?

It is similar to viruses like Flu or SARS and MERS, but this is much more contagious than usual flu.

Someone who is diseased or carrying COVID-19 can infect 2 to 3 persons and those 2 to 3 persons can transmit to another 2 to 3 persons and the chain will increase exponentially without interruption if most of them are asymptomatic and, as per calculation, one undiagnosed COVID-19 case can infect up to 16,000 cases in 14 days if not quarantined.

However, mortality is not that high (2-3% ) as per various data from various countries which have already suffered havoc from this virus infection. 10-15% may suffer from severe symptoms and may require ICU care.

Why should we quarantine/ self-impose lockdown for 10-14 days?

As per previous data, 97-98% persons who develop symptoms of COVID-19 do so within 12 days of getting infected from the virus. The incubation period varies, from various studies, from 2 to 14 days, that means someone who has contact with a case may develop the florid or mild symptoms up to 14 days of the infection. Similarly, he or she is the case to spread the virus to others.

So, the present government’s policy to lock down for the next 10 days everything in most of the States and ceasing public transport, especially railway services, would be definitely helpful to cut the chain.

Who needs to take extra precautions?

Long-term care centres or old-age homes should not allow visitors as only visitors would carry the infection inside. As most of the older people at old-age homes are frail and cognitively impaired with multiple disease, they are at high risk of the fatal disease. Old-age homes should be well-ventilated and physical distance of more than 1 metre should be maintained for older adults. Anyone who has cough with fever should use a three-layered mask and should be isolated within home.

This is also a flu season, what should one with fever, cold and cough do? Should the person go for testing?

Initially, if an elderly person is suffering from any of these symptoms like fever, dry cough, throat congestion without any contact history, they should only take rest, stay at home, maintain cough etiquette (coughing and sneezing into a tissue), sanitise their hand frequently by 60% alcohol containing sanitiser, they should call the helpline provided by Central or State govt. No need to panic.

However, if they have any alarm sign related to organ failure like shortness of breath, decreased urine, chest discomfort, diarrhoea with fever they should immediately visit a hospital.

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