Corona Diaries 46: The Test Conundrum. Should We Or Shouldn’t We?

Six lakh plus cases so far and more than 18,000 deaths. And it’s still not clear whether we have touched the peak, at the mid-point or only a few notches up the bottom. We are close to overtaking Russia to be the third worst-hit country in the world. Given the size of our population it won’t come as a surprise if we top the table a couple of months later. Should we be worried? The obvious answer to this question should be yes. But if you go by the shift in the perception of the disease among people, the question gets a bit complicated.

Something about the contagion beggars deeper understanding. If the attitude of people has transformed from fear to casual acceptance in three months, the reason has to be more than economic compulsion or tiredness of inactivity or devil-may-care mentality. Anecdotal evidence suggests that people are getting infected with the novel coronavirus but they prefer not to go for tests. Once they develop corona-like symptoms, they consult family doctors, follow their advice and stay in isolation at home. The medication in the period includes liquid food, warm water gargle and vitamins. If there’s cough and fever, they are advised routine medication. In a few days they are up and about. It’s just like normal flu.

One is not sure whether it should be a reason for relief or concern. There are some points to ponder about the scenario. One, contrary to the opinion of several experts, has the community spread of the disease already happened? Two, given the way infected people are responding to the disease medically, do we see herd immunity developing? Three, do such people pose a health threat to others around by not reporting the disease? A corollary to this is if everyone reported infection, or suspected infection, would the healthcare system be able to carry the load? Four, since we seem to have a milder strain of the disease and recovery rate is high, do we relax a bit and rethink our strategy?

We should leave it to the judgement of experts minding the nation’s health. The easing of the sense of panic among the public, however, is likely to torment them no end. It might lead to carelessness and undoing of all the gains from the lengthy lockdown. In the US, there has been a rebound in number of positive cases after a period of lull since the process of unlocking began. The World Health Organisation has been warning repeatedly that the pandemic is nowhere close to the worst yet. The situation may get really nasty in the monsoon months and the winter, the peak flu season in many countries. Making the matter more worrisome is the absence of a vaccine or a cure as yet.

Governments, of course, cannot mimic the public mood and let the guard down. They have to continue with the efforts to prevent the spread of the disease. The galloping number of the infected, and the gradual growth in the fatality rate should keep them on their toes. It’s going to be a long fight. They must have the stamina for it.

NO COMPLACENCY PLEASE

‘We have it once, we won’t have it again’. The glum assertion is perhaps more scary than the disease itself. Some of those getting cured at home believe they have nothing to fear now. It reflects in the sense of abandon they conduct themselves at home and in public. This could be dangerous as they might end up as spreaders, and thus enemies of public health.

There’s no proof yet that the disease won’t strike the same person again. According to a news report from China, about ten per cent of patients released from health facilities in Wuhan after being treated for COVID-19 were reinfected within a few weeks. Reinfection is not uncommon in the case of regular coronavirus strains which remain around us. There is no reason, say experts, why it should be different in the case of the novel coronavirus. Moreover, with no tests done it is not easy to conclude that a person had and been cured of COVID-19. The symptoms overlap with common flu. It is possible they never had COVID-19 in the first place. That’s one reason why tests are critical.

THE LONG WAIT FOR THE PEAK

How long will this last? Those predicting peaks and plateaus appear less enthusiastic about the exercise now. The more optimistic ones who drew up mathematical models to predict the peak in April or May or June obviously have been proven wrong. The mid-July peak is also not likely to happen. Their intention may not have been dubious, but surely they overlooked critical variables. The most important of these being the number of infected persons who entered India undetected between February and early-March. Going by aviation passenger traffic, the number could be in several lakhs. We had phasewise flight bans and thermal screenings, but perhaps all these measures were either a bit delayed or inadequate.

Once these people spread out and passed on the infection to all those they came in contact with, the explosion was just a matter of when not whether. A few statistical models must have failed to map the whole range of contacts. Also, the correlation between the number of tests and the spread of the disease didn’t have due weightage.

Those who have been more circumspect with the data available predict a peak in October. It’s not comforting at all, but one hopes the ordeal ends there.

NO LESSON LEARNT

The whole experience of the pandemic so far should ideally make people value their freedom more. We take it for granted the same way we take free air and water for granted. Once jolted by the scarcity of both we become aware of its value. The same should happen with our liberty to move around after the lockdown experience. We don’t seem to be living in the ideal world though. The old recklessness is back at crowded places after the unlocking began. The mask is in place but people don’t seem to care much about physical contact, particularly in market zones. Experts warn there maybe a price to pay for this callousness.

Also Read: 100th Day Of Lockdown: India’s COVID-19 Tally Breaches 6 Lakh-Mark; Recovery Rate 59.43%