The winter of Corona crisis is far from being over. No green shoots seem to be appearing anywhere across the globe as yet. The Director-General of World Health Organisation, Tedros Adhanom Ghebreyesus has already pressed the panic button saying that the “worst” of the novel Corona virus has yet to come. The WHO further asserted “it’s a virus that many people still don’t understand” He compared the present situation with the outbreak of Spanish Flu that occurred a century back and killed 100 million people. True the statement of Ghebreyesus needs to be given a serious thought.

No one knows the nature of the virus, how to detect it and the cure. Doctors say that when certain symptoms develop in an individual like coughing, sneezing, fever and respiratory problem one can conclude that the person is suffering from corona virus infection. But these symptoms can be attributed to disease caused by other viruses as well. What is most mysterious and appalling is that according to global estimate about 80 per cent of the cases were asymptomatic and have some mild symptoms, while 15 per cent were symptomatic and five per cent were critical cases. The rise of asymptomatic cases is really a concern. Many of asymptomatic cases have led to death. This shows that the exact symptoms of the infection by the unknown enemy, corona virus (SARS-CoV-2 or COVID-19) is yet to be determined.

In India, the research body, Indian Council of Medical Research (ICMR) and its affiliate bodies that have analysed the samples say that 69 per cent of the cases were asymptomatic while 31 per cent of the cases were symptomatic, out of which 15 per cent were critical. Till the early morning of April 24, the ICMR have tested a total of 541789 samples from 525667 individuals, out of which 23502sampleshave been confirmed positive.

Bowing to the mounting pressures, particularly from the Opposition political parties, the Government distributed rapid antibody testing kits to different states. Most of the kits were imported, particularly from China. But the Chinese kits have come under ICMR scanner as states reported its malfunctioning. According to ICMR rapid antibody testing kits are not for detecting corona virus infection, but for testing immunity power of an individual. Rapid antibody testing is for surveillance, particularly in containment and hotspot areas. ICMR has developed protocols for such tests.

For effectively detecting corona virus infection, ICMR suggested real time polymerase chain reaction (RT-PCR) test and point-of-care molecular diagnostic assays. But it has limited it to certain categories like all symptomatic individuals who have undertaken international travel in last 14 days, all symptomatic contacts of laboratory confirmed cased, all symptomatic healthcare workers, all patients with severe acute respiratory illness. It also suggested such tests for asymptomatic persons who had direct and high risk contacts of a confirmed case. They should be tested once between day 5 and day 14 after coming in contact. In addition ICMR has recommended RT-PCR tests in hotspots and has developed a protocol and an updated containment plan for large outbreak,

ICMR has also suggested Cartridge Based Nucleic Acid Amplification Test (CBNAAT) using Cepheid Xpert Xpress SARS-CoV2 and TrueNat testing for COVID-19. At present a total 265 government labs are reporting to ICMR for all such tests – for RT-PCR tests 220 labs, for TrueNat test 40 labs and for CBNAAT test five labs. Also 87 private testing labs are reporting to ICMR. The number is increasing day by day.

As for the cure of the disease globally 17 vaccines are being developed, out of which four are at the stage of clinical trials. COVID-19 virus has mutated in different strains. There three main types of strains found in India – Chinese, European and American. These are mainly from people coming from these countries. In absence of perfect drug or vaccine for treatment, several therapies for treatment of malaria, cholera, HIV AIDS, Hepatitis B and C and other viral diseases are being tried on patients. ICMR has prohibited indiscriminate use of hydroxychoroquine (HCQ). It has cautioned that it is harmful to consume HCQ without prescription by a doctor as it may have harmful effects. ICMR has recently permitted plasma therapy which is proving to be effective in some cases.

India, with not so advanced healthcare system, is grappling to fight against this unknown enemy. The corona crisis has given a chance to improve its healthcare infrastructure. Keeping in view that India is the second populous country the situation is, however, more contained than in many advanced countries of the world. There are more than 700 COVID dedicated hospitals in the country with more than 100,000 isolation beds. Besides there are dedicated COVID centres for patients with moderate clinical symptoms and dedicated COVID centres for patients with mild or very mild symptoms. However, till April 24, there were 17,610 active cases, out of which 4,748 were cured and 718 succumbed to death. In March 23 the doubling of cases was taking place fast within a span of three days. Today it takes 10 days. The recovery rate has increased to 25.5 per cent. In 78 districts no case of further COVID infection have been reported since last 14 days.

The corona crisis has given an opportunity to boost Make-in-India programme. Personal protection equipment for doctors, masks, gloves and testing kits are now being produced in the country.

Out of 736 districts there are 326 districts where there has been no prevalence COVID infection so far. One state in the country, Sikkim has remained free from corona virus infection. There were expectations that these 326 districts and Sikkim will be free from lockdown restrictions. But in the second phase of lockdown that was imposed on April 14, the government gave relaxations only for agricultural and related activities, all health services, plantation, animal husbandry and fishery activities, financial and social sector, some rural activities, public utilities, select industrial, commercial and construction activities and inter-state and intra-state supply of essential goods, movement of cargo and select government offices.

Government believes that lockdown imposed till May 3 will further improve the situation as the practice of staying at home, wearing masks and gloves, practice of maintaining social distance between individuals which have already helped in containing the spread of corona virus will further help in the war against the yet unknown enemy. Let us hope we succeed !

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