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Physical Distancing, Hygiene New Normal as Indian Epidemiologist Predicts Longer Stay of COVID-19

© AP Photo / Dar YasinKashmiri doctors and health workers identify the area to be monitored on an aerial map during a contact-tracing drive after the first person in the region was tested positive for COVID-19 in Srinagar, Indian controlled Kashmir, Thursday, March 19, 2020
Kashmiri doctors and health workers identify the area to be monitored on an aerial map during a contact-tracing drive after the first person in the region was tested positive for COVID-19 in Srinagar, Indian controlled Kashmir, Thursday, March 19, 2020 - Sputnik International
New Delhi (Sputnik): India implemented a 40-day lockdown with nearly curfew-like situations across the country starting 25 March. Despite social distancing norms being implemented, the numbers of cases have been rising. A top Indian epidemiologist predicts that physical distancing will become the new normal as COVID-19 is here to stay.

The world has currently recorded over two million positive COVID-19 cases, while 127,590 have died and 500,717 have recovered across the globe, as per John Hopkins University. In spite of the rise in COVID-19 cases on a daily basis, the Indian government has decided to open up economic activities in a restricted manner beginning 20 April to mitigate the economic difficulties of people.

​Giridhar R Babu, Professor and Head Lifecourse Epidemiology, Public Health Foundation of India, while supporting the lockdown, claimed in an interview with Sputnik that the world should prepare itself for a long battle and that social distancing norms will stay in place to curb the spread of the virus.

Sputnik: Several reports pointed out that the number of COVID-19 cases will surge at an exponential rate in the coming days, taking cases to the thousands in India. What is your view about these estimates?

Giridhar R Babu: India has done well in taking lockdown measures much earlier than any other country, which itself is a highly influential measure. With this, we have curbed the transmission of the pandemic in the country. With an extended lockdown, India will have sufficient time to plan and mount a sound exit strategy from the current scenario.

Given the volatility in India’s daily data over the past few days, we cannot predict the future trajectory now. We need to wait until the end of April.  Also, cases will likely continue to mount over the coming days as testing expands, but India will have a much lower burden compared to Europe, the US, or UK due to the early measures taken.

Sputnik: US epidemiologist Larry Brilliant while quoting a research paper claimed that COVID-19 r0 is 5.7 not 2.2 (Parameter to find the level of herd immunity). “This upends our hope that merely vaccinating or infecting 55% of the population would stop the pandemic. If confirmed true, we need about 82% which means we are in for a very rough ride”. Some Indian epidemiologists are also expressing immense hope on herd immunity. What is your analysis?

Giridhar R Babu: Until we have a vaccine, physical distancing, using masks, good hygiene practices, (frequent hand-washing) and the use of personal protective equipment (PPE) are the only way to prevent contracting and spreading the virus.

Herd immunity via the spread of the new coronavirus is not something any country can afforda, it's especially damaging to lower-middle income countries. The vast majority of the vulnerable members of society, such as older adults and people with some chronic health conditions in many of these countries could simply succumb if such a strategy is adopted.

Sputnik: Since it is a novel virus and the global community is fighting with an unseen enemy that can infect the entire human race, few are expressing hope in the number of recoveries. Do you believe that if someone gets it and recovers, that person thereafter has immunity against this particular virus?

Giridhar R Babu: We don't know whether people who recover from COVID-19 are immune to future infections of the virus. Doctors are finding antibodies in ill and recovered patients, and that indicates the development of immunity. The question remains how long that immunity will last.

Other coronaviruses like SARS and MERS produce an immune response that will protect a person at least for a short time. The novel coronavirus has also been found to be mutating, with varying rates. This means, even if a recovered coronavirus patient develops immunity for one variety of SARS-CoV-2, it is too early to say if it can protect from a mutant version. Research finds re-infections are common in the cases of human coronaviruses. With what we know now, it takes a long time even years to achieve immunity to the coronavirus.

Sputnik: We are witnessing unprecedented things which many still are not able to imagine in their lifetime — stay in the house, stay one metre away from other people, don't go to religious places. Are we on the right path (advice) to tackle this pandemic considering we hardly know anything about the virus, or are we just spreading or postponing the number of infections?

Giridhar R Babu: The idea behind all these measures is to stop the spread of infectious diseases, and I feel that these are the measures that we should have taken to combat diseases like TB. Now that the virus is going to stay with us for some time, it is time to get used to the new normal. I am sure we are on the right path.

Sputnik: When will we be able to live freely even after lifting lockdown in a gradual manner? Will we ever live our life the same way we used to before this crisis struck?

Giridhar R Babu: Once you adapt to the new normal, this will be okay. We are free even now, it is just that it will take some time for routine things to be the way they were. I wouldn't think freedom is at stake; what we need is to be responsible members of society. I think both of these go hand in hand. As long as the virus exists somewhere, there is a need to continue the containment and mitigation measures.

Sputnik: In a country with a population of more than 1.3 billion we were not able to test even a million. Is it too late for testing to make a difference?

Giridhar R Babu: There is too much said about testing. The outcome of testing is isolation and quarantine. I don't think we should wait for testing to do these measures. We should immediately implement syndrome-based surveillance all over the world and use tests (based on availability) to confirm. Whether we confirm or not using tests, we should do home isolation of suspected cases and their contacts.

Sputnik: The Indian Health Ministry has been saying for days that everyone need not wear masks. But now the government has made it mandatory. Did we make a mistake in the early days by not covering our mouth, nose, considering that several cases have been revealed without symptoms? 

Giridhar R Babu: The available evidence from Asian countries suggests that masks are beneficial. They protect preventing the transmission of disease from one individual to another. Even homemade masks can help. If the masks are worn following the hygienic measures, then it will help in preventing the disease. However, masks alone would not be sufficient; they are effective only in combination with physical distancing, hand-washing, and cough etiquette, etc.

Sputnik: Could you suggest some options to the government other than a lockdown to curb the spread of the virus?

Giridhar R Babu: Currently, we have only two measures to curb the spread of the virus, and they are containment and mitigation. Both are necessary to control the spread of the virus. There are no shortcuts. The more we detect, the more cases will be isolated, and more contacts will be quarantined. During the lockdown, this is the only way to limit the spread.

Once the lockdown is lifted, it will spread to the most susceptible and vulnerable will be disproportionately affected with severity. Our health system cannot manage later if we don’t detect cases and isolate them now. 

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