Authorities in many states across India are trying to find out how people with no travel background or reported contact with a Covid-19 patient developed the infection in what many experts have called the deadly third stage of the disease.
Such cases have been registered from all over the country: a 29-year-old rail employee in Bihar, a young political leader in Kerala, a 60-year-old bank official in Odisha and a 57-year-old man in West Bengal are just a few examples. In none of these instances was it possible for officials to identify a confirmed source of the contagion.
This has sparked concerns that India has slipped into the disease’s population transmission process where the virus rapidly spreads to a Covid-19-hotspot within a group and a person with no travel history or established contact with a previous patient becomes infected.
Undiagnosed cases infect others during this period, making it difficult for physicians to locate, identify and treat patients. As a result, clusters of infections spiral off balance and transform into epidemics.
There are four stages of the disease according to the Indian Council of Medical Research (ICMR), the country’s top biomedical research agency. Step 1 is receiving imported cases, step 2 is local transmission where a person at a global hotspot is infecting a local citizen, stage 3 is group transmission, and stage 4 is an outbreak.
Given several cases of people with no documented contact with an infected person or travel background, the ICMR maintained that India is still in stage 2 as the infection is mainly limited to people with a travel history and close contacts.
“As of now, there is no communal transmission in India, because by definition community transmission implies when there are a large number of cases where the source can not be traced. A few cases in a large country like ours where communication/source is not established does not mean group transmission, it means the need for more effort to track communication. It’s not an easy procedure and it takes time at times, “said Lav Aggarwal, joint secretary, health and family welfare ministry.
Yet experts aren’t convinced. They point out that because testing requirements are strict in India, and the number of tests is small – the country has one of the lowest per capita test levels in the world – the number of reported cases of group transmission is unlikely to be high.
“If you’re not studying, you don’t know. There are very few cases in the initial phase of the disease, but once it starts its spreads like wildfire. So it holds the secret to studying more individuals. It will decide whether we are heading for Italy, or Korea, “a senior public health expert said, calling for anonymity.