India Resists Community Transmission

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    India continues to label itself as a country with no community transmission (CT) according to the latest weekly report by the World Health Organisation (WHO). 

    Community Transmission (CT)

    • Community transmission means that the health system has now lost track of the trajectory of the virus and infections are happening without the source of the infection being known.
    • CT is when new cases in the last 14 days can’t be traced to those who have an international travel history when cases can’t be linked to specific clusters. 
    • The WHO guidelines further suggest four subcategories within the broader definition of CT. 
      • CT-1 implying “Low incidence of locally acquired, widely dispersed cases and low risk of infection for the general population”.
      •  a CT-4 suggesting “Very high incidence of locally acquired, widely dispersed cases in the past 14 days.

    Status Of Other Countries 

    • Countries such as the United States, Brazil, United Kingdom, France have all labelled themselves as being in ‘community transmission’. 
    • Among the 10 countries with the most number of confirmed cases, only Italy and Russia do not label themselves as being in ‘community transmission’.
      •  Both countries have been on a declining trajectory for at least a month and together contribute less than 20,000 cases a day .
    • India, since the beginning of the pandemic, has never marked itself as being in community transition.

    India’s Current Classification:

    • States and countries are expected to classify themselves appropriately and point to the kind of public health measures in place.
    • India opted  instead for the lower, less serious classification called ‘cluster of cases’,
      • India chooses to describe itself because 
        • Cases detected in the past 14 days are predominantly limited to well-defined clusters that are not directly linked to imported cases.
        •  It is assumed that there are a number of unidentified cases in the area.
          • This implies a low risk of infection to others in the wider community if exposure to these clusters is avoided”.

    Implications On India For Not Classifying Itself As Being In CT

    • India’s refusal to describe itself as being in community transmission was an “ostrich in the sand” approach since being in CT — far from being stigmatic or an indicator of failure — had a bearing on how authorities addressed a pandemic.
    • If cases were still a cluster, it would mean that the government ought to be prioritising testing, contact tracing and isolating to prevent further infection spread. 
      • CT, on the other hand, meant prioritising treatment and observing advisories to stay protected.

    Four Stages of a Pandemic

    • Stage 1:  It is when cases of infection are imported into a country that was not the source of the infection. 
    • Stage 2:The second stage of an outbreak is when there are cases of local transmission in the country.
      • This means that the person from whom the infection spread to another person is from the country itself. In this stage, the trajectory of the virus can be identified from the source to all the infected individuals.
    • Stage 3: Community transmission is the third stage of an outbreak. In this stage,  it becomes hard to track the chain of transmission of the virus in a large number of cases. 
      • This means that the virus has started circulating within the community and can also infect those individuals who have neither travelled to a country affected by the outbreak nor have come into contact with a person infected by the virus. 
      • In this case, a lockdown becomes highly important as any person can spread the virus, regardless of their travel history or the people they have come in contact with.
    • Stage 4: The fourth stage of an outbreak is when an infection becomes endemic in some countries and keeps resurfacing round the year, like malaria and dengue in India. These stages of an outbreak remain uniform across the world to make coordination and understanding simpler, so that countries can be prepared accordingly. 
      • Such a categorisation makes it easier for other countries to impose measures that they think will benefit, like India imposing travel restrictions on China quite early in the outbreak.  

    Source :TH

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