Staying calm and informed
As India’s fight against COVID-19 intensifies, Dr Shiv Kumar Sarin gives us an idea of what we can expect in the coming weeks and why we should still be hopeful regarding government efforts to combat the contagion
After the Tablighi Jamaat incident, the number of the Coronavirus positive cases is doubling and it could spiral up in the coming week but there is no need to panic, says Dr SK Sarin, an eminent Delhi-based Gastroenterologist at the Institute of Liver and Biliary Sciences (ILBS). Dr Sarin also heads the five-member committee constituted by the Delhi government to tackle the COVID-19 crisis, insisting on reduced mobility of people after the lockdown is recommended to contain the outbreak. Here's the interview:
Is a 21-day period of lockdown enough to contain the outbreak of Coronavirus, or it should be increased?
The way we are doubling up (on the Coronavirus positive cases in the country), we may spiral up in the coming week. After the end of this lockdown period, I suggest we should go for modest lockdown. Mobility should be reduced for at least four weeks after the 21-day period ends. People should wear masks while going out for whatever reasons.
What is your take on the Tablighi Jamaat incident which has become a source for over 30 per cent of the Coronavirus positive cases that are now coming forth?
There is no doubt that it was Delhi's misfortune that this congregation took place. It was a hotspot of Coronavirus infection. People from this congregation travelled all over the country. We need to rigorous contact screening, including those people who have come in contact with those who participated in this congregation. Track their GPS, CCTV images or bank accounts, whatever is possible.
What is your reaction on news going around that the TB vaccination administered early in childhood could become a silver bullet in fighting COVID-19? Additionally, would the increase in temperature during the summer have an impact on the virus?
There is nothing scientific to establish the TB vaccination claim. As it was administered in childhood, and there is no proof of the effectiveness of such a vaccine if presently administered, there is nothing to show for such tall claims. Moreover, the impact of high temperature on the virus is also not known. There are no good studies on the temperature affecting the virus.
Have you observed any changes in the virus incubation period and if the Coronavirus can travel up to 8 meters from the point of exhalation, what would you suggest?
Initially, the incubation period was 4 to 14 days, but now we could see the incubation period has changed from 4 to 24 days. Viral shedding could be low in the initial few days of illness but it could rise significantly after a few days. Also, the virus can go up to 8 meters. Therefore, it is extremely important to wear a mask when you step out of the house. India is among the late spreaders but there is no need to worry or panic. At ILBS, we are conducting 150-200 tests every day, which is a good number for a virology lab.
We are already half-way through the lockdown period and Indian Council of Medical Research is less than 30 per cent of its testing capacity. Should ICMR not increase its testing capacity or roll out widespread testing?
Blood testing has brought a significant change as it has superseded testing done through nasal and throat swab, which has only 60 per cent accuracy. Initially, it was a nasal and throat swab test but now we are doing more blood tests. The blood test can be done through easily available kits – and within three days results are available. A person can know if he/she has an acute exposure, whereas, in the nasal and throat swab tests, positive cases could come out negative.
The age profile of the Coronavirus positive cases suggest nearly 84 per cent are below 60 years; and 75 per cent between 21 to 60 years. Do you think it is worrying that more youth and middle age are susceptible to catching the viral infection?
Majority of our population is young and while the virus is less fatal for younger people, this does not mean we venture out and not follow the guidelines on the lockdown and steps to contain the viral infection. Death and infection do not look at age though people above 60 years are certainly more vulnerable and the mortality rate is high as they have lower resistances and other diseases. The outcome of the viral infection is worse for the elderly. Delhi in its place is well prepared to handle the COVID-19 situation if the citizens continue to comply with the government directive.