Even as ICMR insists that there is no community transmission, the Health Ministry on its website says there is limited community transmission. And 11 SARI patients testing positive for novel coronavirus is a reflection of wider community spread.
Even as the Indian Council of Medical Research (ICMR) insists that there is no community transmission of novel coronavirus (SARS-CoV-2) in India, on March 29, the Health Ministry on its website mentions that there is “limited community transmission”. In the document on standard operating procedure for transporting a suspect/confirmed case of COVID-19, the Health Ministry website says that there is both local transmission and limited community transmission.
On March 29, Dr. Raman R. Gangakhedkar, Chief Epidemiologists at ICMR told ANI that 11 of 110 people with severe acute respiratory illness (SARI) had tested positive for coronavirus. Only a few days ago ICMR allowed testing pneumonia and SARI patients for novel coronavirus to know if there is community transmission.
SARI cases testing positive are a clear indication
Since, almost 85% of people infected with the virus do not require hospitalisation, 11 SARI patients testing positive for the virus is a reflection of a wider spread of the virus in the community. Since the virus is known to spread rapidly, wider testing in the community is required in the areas from where the SARI cases have been reported.
But Dr. Gangakhedkar insists that there is no community transmission yet in India. “Three of these patients, who belong to Chennai, Uttar Pradesh and Maharashtra do not have any travel history or any contact with an infected person. These few cropped up cases are not the base of solid evidence for community transmission,” Dr. Gangakhedkar told ANI. Dr. Gangakhedkar could not be reached.
“Community transmission is well defined in epidemiology as number of cases with no known contact with a confirmed case per 1,00,000 cases or in a particular geographical area. But its use in a given situation is an operational issue,” says Prof. Giridhara Babu, Head of the Lifecourse Epidemiology at the Public Health Foundation of India, Bengaluru.
According to Prof. Babu, once the government confirms community transmission, the testing strategy currently in use has to be changed and testing has to be expanded to confirm the extent of community transmission.
What the WHO says
The Situation Reports of the World Health Organization, including the latest one on March 29, lists all countries where even a single case of novel coronavirus has been reported as having either local transmission or imported cases only. The WHO has not listed community transmission for any country including the U.S., which with 1,43,527 cases is the highest in the world, and other countries such as Italy, China and Spain.
However, in the legend, WHO defines community transmission as the “inability to relate confirmed cases through chains of transmission for a large number of cases”.