COVID-19 Stage 3: Dreaded community spread

Buses getting disinfected

Buses getting disinfected 

Masks are now common in transit hubs

Coronavirus spread

Awareness campaign

Markets and customers stocking up

Body temperature checks at a supermarket

Battling the COVID-19 pandemic with a limited testing but maximum caution approach, is Bengaluru’s healthcare infrastructure ready for a potentially catastrophic community transmission? Is the city’s stretched yet untested system ready to take the big hit?

The skeletal system has endured so far. Thousands of international arrivals have been screened at the Kempegowda International Airport (KIA). Symptomatic travelers have been quarantined at specially created new facilities, their travel histories tracked and advisories activated.

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Yet, disturbing questions remain. Reports have emerged that many arriving passengers advised self-quarantine at their homes did not do so. Since the virus often manifests itself only after five days or more, the free movement of asymptomatic travelers within the community might trigger transmission.

Is the Indian Council of Medical Research (ICMR)’s statement that there is no community transmission yet reassuring enough for Bengaluru? ICMR had tested 826 random samples of influenza-like and severe acute respiratory-like illnesses for community transmission. These had returned negative.

Enhanced testing

Detection of community spread would mean the country’s edgy entry to Stage 3 of the Covid-19 outbreak. This, health experts say, would imply enhanced, more accessible testing. But is the city’s health infrastructure ready for an exponential rise in detection of cases and testing?

Of the five laboratories tasked with testing, two are in Bengaluru: The National Institute of Virology (NIV) field centre and the Bangalore Medical College and Research Institute’s Virus Research and Dignostic Laboratory (BMRCL VRDL).

Also Read: Coronavirus India update: State-wise total number of confirmed cases

The 35-member team at VRDL has managed the daily testing load of 20 to 25 samples so far. But any escalation to Stage 3 is expected to put immense pressure.

“Our advisories to the IT companies, hotels, bars and restaurants, schools and colleges issued earlier remain relevant. We are not issuing any rules, but precautions. This has to be a collective effort. We are all together, the BBMP, the Health Department, the State Government,” says Dr B K Vijendra, the Palike’s Chief Health Officer (Public Health).

By Friday evening, the Palike Commissioner extended the closure of places of mass gatherings, cinema houses, malls, marriage halls and clubs included, to the month-end. While schools, colleges, coaching classes and swimming pools would remain closed, the ban on conferences, workshops, summer camps and other events stays.

Stage by stage

Stage 1 of the pandemic has had individual cases from Corona-affected countries landing up at the city airport. The initial screenings had left out thousands from the hitherto unaffected countries. But the rule was applied to every international arrival once an IT professional with a travel history to the United States and Dubai turned positive for the virus.

At Stage 2, the virus is transmitted from a cluster of positive cases to family and friends. A few cases of this transmission has already been reported in parts of the city. But the State Health officials are confident that the transition to Stage 3, where the virus spreads to a small geographic area, will not happen.

To justify their optimism, they cite the scheduled halt of all international flight arrivals from Sunday. Over the last 10 days, much effort has gone into tracking symptomatic passengers, where they went, who they were in contact with and more.

Threat perception

But not many share this optimism. The threat of community transmission is alive, they say, drawing attention to crowded supermarkets and retail spaces across the city. Although crowds have thinned in BMTC buses and the Metro, it is almost business as usual in many congested revenue pockets, particularly on the city’s outer areas.

On the narrow Annasandrapalya Main Road and New Thippasandra Road, for instance, the buzz has not dampened at all. Traffic is often high and the mood is almost festive. It would appear that the entire Corona craze is a distant drum.

“The enemy is not visible, so people are not realising the seriousness of the situation. People are having gettogethers, parties, hangouts. These have to be avoided, and they have stay at home, locked down. We don’t have much time,” warns Dr Manohar K, a Consultant Physician with Manipal Hospital.

Get serious

The situation, he says, is ‘very, very bad.’ Social distancing and self-quarantine should be taken very
seriously. “People think quarantine is like a jail. It is only a way to pick up symptoms and treat them early before it gets worse,” he explains.

It is critical that the virus is controlled right now at Stage 2. Letting it get to Stage 3 would be disastrous.

“It is a new virus, there is no immunity. Overnight, we just cannot produce enough doctors well-versed with ICU care management. During Dengue season itself, the beds get full. Imagine when community transmission spreads!”

Quarantine, Dr Manohar says, delays the virus peak and could make it manageable. But changing weather that triggers cold, cough and fever, could complicate matters. Panic could set in, and this too has to be smartly managed.

Avoiding panic

Dr Prakash Kamath, who runs a nursing home in Indiranagar, advises patients to first call the doctor to understand what their symptoms mean.

“When even common flu symptoms make them panic, patients often rush to the doctor. These visits can get problematic. I have also restricted my consultation time and advise patients on phone,” he says.