Q: After almost two weeks of lockdown now, what is your assessment of its impact on Covid-19 transmission?
A: We must recognise that there is a lag period between infection and clinical symptoms. This is usually around 5 days but can extend to 14 days. So the impact of the lockdown, in terms of markedly slowing down the rate of transmission, will be mostly seen in its third week and beyond. Even at present, we are seeing an impact on the lengthening of doubling time of the infected cases. Google mapping data also show that social distancing in India has been more effective than in many other countries.
Q: What is the current growth trend in terms of new cases? What is road ahead for us?
A: We are still on the ascending limb of the infection curve, though we seem to have brought it to a lower slope by slowing down transmission. The doubling rate of detected cases has ranged between 3 and 5 days but now seems to be closer to the latter. We should expect to see some more new cases, even when the curve bends. We should try to bend it soon by combining the beneficial effect of lockdown with maintenance of social distancing and personal protection measures.
Q: How serious is the issue of Tablighi Jamaat? How difficult is it going to be to control the transmission after such incidents?
A: Even though the congregation took place before the lockdown, it was a very ill-advised breach of social distancing. Added to the danger posed by the large size of the gathering was the foreign origin of several persons who were part of it. The mingling of foreign visitors from many infected countries made transmission very easy. As the infected persons then dispersed across the country, the virus found many new persons to infect in multiple locations. Public health, intelligence and law enforcement agencies are making heroic efforts to quickly trace participants and identify cases as well as contacts for isolation.
Q: The government has maintained that if lockdown and social distancing measures are followed stringently, the chain of transmission can be disrupted.
A: It has been clearly demonstrated in multiple countries, even during previous respiratory virus epidemics, that social distancing prevents person to person spread. Lockdown is a stronger measure, which involves a society wide form of distancing ... that is effective in interrupting the transmission chain of a highly infectious virus.
Q: Are we likely to see an upswing of the epidemic?
A: More new cases are likely to appear for some more time but if containment measures are effective, it will slower rate of increase. Then the curve will come down.
Q: Is coronavirus disease here to stay? Will it become a seasonal infection, like H1N1, and the seasonal coronaviruses that cause symptoms of common cold?
A: Planet Earth is a good home for viruses as it is for humanity. Our task is to keep them confined to the wild and not invite them into our habitat and human bodies through acts of ecological vandalism, distorted development paradigms and fetish for exotic animal flesh. I believe this virus will stay as a long-time resident of this planet.
Q: Is the summer going to be a saviour?
A: I hope so. Though this coronavirus is new and its behaviour patterns are not fully known as yet, the limited evidence that is available suggests that it will wane in summer. We must remember, of course, that India is a large country with many climatic zones.
Q: How prepared is India's health system to tackle further surge in cases, especially if the virus spreads to remote areas?
A: We have seen the health systems of many high-income countries crumbling under the pressure of an advancing epidemic. The measures we have already taken should slow down the epidemic, giving more time to strengthen our health system response with more resources and operational coordination. The southern states are better prepared. We should not forego the advantage of having a large rural population, unlike more urban countries, which have been worst affected so far. We should prevent urban to rural transmission as effectively as possible. We should also speedily strengthen both rural and urban primary healthcare services and district hospitals.