Even as evidence grows that a very large share of those infected with COVID-19 could be asymptomatic and this, in turn, suggests India needs a dramatic increase in its testing, Public Health Foundation of India (PHFI) president Srinath Reddy feels this is not the solution; Reddy is also a member of the executive group of the International Steering Committee of WHO’s COVID-19 Solidarity trial. In an interview to this newspaper, Reddy says social distancing will need to be in force for a year if we are to meaningfully combat the virus.
Reddy spoke of how it is very difficult to catch asymptomatics, unless individuals get themselves tested on demand, or the public health authorities organise testing in a cluster. He cited Boston 25 (a digital video news outlet) reporting that, of 397 people in a homeless shelter in Boston, 146 people tested positive and all of them exhibited no symptoms.
A population-wide testing, Reddy says, or even large-scale testing, is neither advisable nor feasible given the requirement for testing kits, reagents, lab personnel, protective gear, sample collection paraphernalia, etc. Indeed, he adds, you need continued testing to see if an infected person is truly cured or if an uninfected person remains so, given the reports of asymptomatic infection, in the long run. It doesn’t help that no test is fully perfect and you have the presence of false positives and negatives.
In the event, Reddy recommends India carry on testing as it is now, with ICMR reviewing and updating the strategy as and when necessary. Apart from that, continue with social distancing for whatever duration it is deemed necessary. People will also need to adopt the advised hygiene practices to keep the virus at bay. Most important, to protect our elderly and other high-vulnerability groups – those with diabetes, COPD, hypertension and coronary diseases – we must have some household and individual risk-profiling from data on underlying diseases. To protect the rural areas from transmission from the urban areas, minimise transport linkages (other than those for emergency purposes) between urban areas, where COVID-19 in India is at present concentrated, and the rural areas which are unexposed to the virus from foreign travellers or their contacts.
