‘Social distancing best to arrest virus spread’
POONAM KHETRAPAL SINGH, WHO South East Asia region director
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India is demonstrating the highest political commitment to tackle the disease. The country has a containment strategy and is taking several initiatives.
World Health Organization (WHO)’s South East Asia Region director Poonam Khetrapal Singh has called for urgent and aggressive action to prevent the spread of coronavirus disease (Covid-19). She spoke to Sanchita Sharma about the pandemic and how social distancing measures such as shutting schools, restricting travel and cancelling gatherings were among the best ways of tackling the disease. Edited excerpts: India has reported two Covid-19 deaths. How worried should India be?
Based on the current data, older people and those with underlying health conditions are at risk of developing the severe disease. Most deaths due to Covid-19 globally have been among such people. With Covid-19 cases increasing 13-fold outside China [where the outbreak originated] and the number of affected countries increasing three times in the last two weeks, Covid-19 has been characterised as a pandemic, which means all countries must take urgent and aggressive action to prevent the disease from spreading. India has restricted travel and suspended public events for social isolation, which is good. Can new cases decline with such proactive steps?
Social distancing is one of the best-known measures to reduce virus transmission. The virus is transmitted through respiratory droplets -meaning droplets from cough or sneeze or contact with surfaces where these droplets land. By maintaining a distance, we can reduce the virus transmission. Cough etiquette, covering cough and cleaning surfaces regularly, also helps in preventing the spread of the virus from one person to another. To contain the disease, WHO’s recommendation to countries is to enhance active case finding, contact tracing, monitoring, quarantining contacts and isolating cases. Suspension of mass gathering would prevent transmission. What is India doing right and what more does it need to do?
India is demonstrating the highest political commitment to tackle the disease. The country has a containment strategy and has been taking several initiatives. Passengers are being screened at airports, seaports, and border check posts. Surveillance has been strengthened. Isolation wards and quarantine facilities have been set up.
About 52 laboratories across the country are operational and an additional 57 have been strengthened for sample collection. A buffer stock of personal protective equipment and N95 masks for use by health workers are being maintained by states as well as the Union government. Community engagement initiatives and awareness campaigns are being rolled out.
Last week, the ministry of health and family welfare and the WHO trained over 1,000 officials from across the country to further train the health workforce in key activities such as surveillance, infection prevention, and control, community engagement etc. All countries, including India, would need a whole of the society approach, and preparedness to rapidly scale up response if needed. What is the WHO-recommended diagnostic test and how accurate is it?
The WHO recommends nucleic acid amplification tests for routine confirmation of Covid-19 cases. The accuracy of this test is 100% provided if it is done correctly. Does the WHO recommend rapid diagnostics tests (RDTs) being used in China and the US? What are the chances of false positives and false negatives?
There are no rapid diagnostic tests currently validated or approved, but many are under development by various manufactures. The challenge for RDTs is the sensitivity, like for any other viruses such as influenza. How many countries have reversed Covid-19 in the region? What were the best practices used?
Countries in the WHO SouthEast Asia Region are at various stages. Three have not yet confirmed any case; three had sporadic cases of importation while five have reported cluster transmission following importation. The region continues to benefit from whatever knowledge is available from countries that have dealt with the virus. How important is data-sharing between countries and with communities to contain the pandemic? How does it help people protect themselves?
Epidemiologic information and science are the best tools to combat Covid-19. WHO has set up platforms for countries to share information on surveillance, details of cases and their clinical profile. This will help us better understand the disease, and take evidence-based measures to save lives.