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‘STEP UP CHECKING IN PATIENTS’; COMMUNITY TRANSMISSION IN INDORE?; MIDDLE-AGE MORTALITY

Why in news?

  • 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.
  • As most COVID-19 patients in Indore, where 17 persons tested positive on 31st March 2020, have no contact or travel history, health workers are grappling to identify the source, indicating the most populous and largest city of Madhya Pradesh MAY already be witnessing the community transmission stage.
  • Middle-aged people, and not just the elderly, have a dramatically higher risk of dying or developing serious illness from coronavirus (COVID-19), says a study.

Prioritizing Containment and Testing for the virus: Virologist’s views

  • Healthcare checking is another way of containment measure as we will be finding infected people who had no travel history.
  • 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.
  • 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.

Suspected Community Transmission in Indore?

  • According to the World Health Organisation (WHO), community transmission is evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases, or by increasing positive tests through sentinel samples.
  • Indore bears the burden of 44 patients, most residents of congested localities, of the 66 cases in the State.
  • Coincidently almost all positive cases, including first ones, have come from congested areas, so probably they have done a lot of community transmission.

Middle-age COVID-19 mortality risk

  • It was found in a study that age was a key determining factor in serious infections, with nearly one in five over-80s requiring hospitalisation, compared to around 1% among people under 30.
  • Taking into account estimates of the number of cases that may not have been clinically confirmed — that is, mild or asymptomatic infections — the data showed the hospitalisation rate of patients in their fifties was 8.2%.
  • Analysis very clearly shows that at aged 50 and over, hospitalisation is much more likely than in those under 50, and a greater proportion of cases are likely to be fatal.
March 2024
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