Italian connect in India’s corona cases

Of 44 cases in India, 35 have links with the European nation which is reporting the highest new infections

NEW DELHI: Italy has emerged as the superspreader of coronavirus disease (Covid-19) in India, with 35 of the 44 confirmed cases in the country being diagnosed in Italian tourists and Indians who have recently travelled to the western European nation, or their close contacts.

With at least 7,375 cases and 366 deaths, Italy has recorded the highest number of deaths outside China and is inching towards replacing South Korea as the country with the second-highest number of cases. Italy has locked down 16 million people in Lombardy and other parts of the north, and the Vatican has suspended mass until April 3 because of the emergency.

“The main spread of coronavirus in India is by Italians or by people who have come from Italy, where the virus is virulent. The biggest problem for us is people hiding their travel history to Italy to avoid quarantine and testing. They are hurting themselves and their families. It is a very irresponsible behaviour,” said Dr Naresh Trehan, chairman, Medanta —The Medicity, where 14 Italian tourists with Covid-19 have been kept in an isolation ward since March 3.

Some people are reluctant to report symptoms or travel history, with some even running away from isolation facilities. A couple and their 24-year-old son who were diagnosed with Covid-19 in Kerala on Sunday suppressed symptoms and didn’t disclose their recent travel to Italy, which led to the infection spreading to two other family members.

“People must be upfront about where they have travelled from, who they were in contact with, and if they know of anyone who recently travelled to an affected country...,” said Dr Trehan.

TESTED CURE

With some travellers back from affected countries like Italy developing symptoms several days after landing or having no symptoms at all, a self-imposed home lockdown for two weeks is a must.

“Limiting social contact is the only way to stop the spread of the virus and everyone returning from Italy or another affected country, including those without symptoms, must stay home quarantined for two weeks with minimal contact with their family and friends to contain the spread of the virus. And they must get tested if they have symptoms to protect their family,” said Dr RR Gangakhedkar, head, division of epidemiology and communicable disease, Indian Council of Medical Research, which is the country’s apex network of laboratories for testing Covid-19.

Italian tourists account for 16 of the 44 Covid-19 cases; the driver of the group is also infected. Two from the group are undergoing treatment in Rajasthan. “The 14 Italian tourists (in Medanta) are stable...and they did not need ICU admission or oxygen support. Their swab samples were sent for testing on Monday and the results are expected by Wednesday to know whether they are negative. They will be discharged once they test negative for the second time,” said Dr Trehan.

VIRAL TRACKING

How the infection spreads depends on frequency of travel, particularly international travel, and the age and immunity status of population. “Italy has a very high number of tourists and the initial mass exposure happened during mass at churches, when people did not know they had Covid-19. The country also has an ageing population, who tend to have chronic diseases and lower immunity than healthy people, which has led to the fatality rate being higher than the global average,” said Dr Gangakhedkar.

The Covid-19 death rate in Italy is around 5%, compared to the 3.4% global average, according to the World Health Organisation. India has reported no deaths.

“India has a young demographic, which tends to have a more robust immunity. Covid-19, like other viruses, causes more severe disease among older population, with most children and young adults showing mild symptoms,” said a health ministry official, requesting anonymity.

The second-highest imported cases in India are from Iran, from where four travellers have come back infected.

“The people who got infected in Iran are mostly pilgrims, who tend to be older and have limited mobility and social exposure as compared to young adults. This has helped stop the infection from spreading to the community,” Dr Gangakhedkar.

At this stage of the disease in India, it is still possible to contain Covid-19 at the borders. “A tighter control of aviation, shipping and land borders will help...I have never seen such concerted action on part of the government against any other disease,” said Dr Gangakhedkar.