The pandemic has changed the world as we see it. With cases on the rise and recovered patients also getting discharged various questions on the virus are asked everyday. , Deeksha Mittal Clinical Scientist at Department of Nephrology at All India Institute Of Medical Sciences (AIIMS), who is at the forefront of the pandemic along with all doctors speaks to Nikita Jain of Millennium Post about asymptomatic cases, what it means and what is the next step now.
Q. Who is mostly at risk in this pandemic and how does different age group react to it?
A. Everybody is at risk. Although extremes of the age are at more risk, which includes less than 12-year-old or elderly people which is more than 60-year-old. Apart from the age other problem is co-morbidity. If a patient has a history of some disease then it becomes an issue. If someone has lung related issues or have lung cancer or if there is a patient of hyper-tension or TB. If someone has kidney transplant or has had some sort of surgery due to which their immune system goes low are at risk.
Q. When should one go and get themselves checked?
A. Covid has two variants type – 1 and type – 2 both have same presentation but vary, meaning which has early mortality rate. The presentation is the same - there is cough, but it's dry, there will be cold but at a minor version. But after one has nausea symptoms, blood in stool and breathlessness, which is severe – it means that one is symptomatic to Covid and one should get investigated. And in investigation it doesn't mean one would be found positive in just one day.
Q. Many doctors are getting effected despite wearing protective gear raising a lot of issues?
A. The thing is that the virulence of the virus can give early and heavy infection to others. Meaning if you and I are standing at a distance of 1 metre - due to social distancing - the virulence is so strong that everyone will be affected. Ideally the distance should be 2 to 3 meters but due to India's population that is not possible - and the virulence is so strong that within that 1 metre we will be exchanging the same gases. Since, we are exchanging the same gases, and if you are affected in any way then it becomes asymptomatic, which means you don't have any symptom but you are Covid positive.
That stage has come to us but it's still not community spread. So, if you are asymptomatic and we are exchanging the same gas then the other person will get affected. Even though doctors are taking all precautions, I am for example taking all precautions, but by default due to a small ignorance something happens the virus might pass through. If the upper layer is totally infected and the doctor even touches a finger, then they will get affected.
Q. Has the virus become air borne yet? And what is asymptomatic carrier?
A. If we speak about community spread, then we haven't reached that stage but we are walking towards that stage. We are, at the moment, we have dealt or are dealing with serious and low morbidity patients. Now, we are at a stage where asymptomatic are in numbers. If you are a positive carrier, you are spreading it through the community.
In this situation you are just creating herd immunity, which means that if there are about 100 people and I am an asymptomatic carrier but as I don't have any symptoms or side effects, I haven't got any treatment. This means that immunity was made in my body against the coronavirus.
So, herd immunity is then I am spreading the infection to 100 people, but in this case their immunity is developed as they showed to symptom. And the rest who showed the symptoms they have adverse effects are will be hospitalized or will die.
But we don't know the results of the herd immunity in our country yet. Meaning, we won't know who is positive and who is not and the number of such cases will be high and no country in the world is prepared to tackle that.
Q. In such a situation lockdown becomes more necessary then?
A. We were advised that we do a 49 day lockdown at a stretch looking at the population of our country. In the first 21 days we got all serious cases, travel history cases that we cleared. The final outcome will come which is discharge, death or recovery.
The next 24 days, all cases of asymptomatic carriers will community will stay at home. Either they will develop immunity and recover by staying at quarantine. the chain reaction would be stopped due to this. Most cases are of mild symptoms and would require medicines. Either it will be serious or mild. Majority of the cases are getting recovered. Like out of 100 60 are getting recovered and the rest 40 are having adverse effects.