COVID-19: Experts rubbish Centre's denial of community spread in India

A poor understanding of the epidemiology of COVID-19 is probably what prevents the Union government from declaring the community transmission of the coronavirus in big Indian cities like Mumbai, Delhi and Chennai, say veteran virologists tracking the pandemic.

While doctors, managing the epidemic in the field and medical researchers studying various facets of the disease, are of the opinion that such transmissions are happening since March, the Centre has so far steadfastly refused to admit that the disease has progressed to stage-3 level.

In fact, the topic was a bone of contention at a meeting on Tuesday involving the Delhi government.

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“Lack of epidemiological understanding may be one reason for the government to remain silent on community transmission,” T Jacob John, one of India’s leading virologists and a retired professor of virology at the Christian Medical College, Vellore, told DH.

Preliminary reports from an Indian Council of Medical Research (ICMR) sero-surveillance also confirm the trend though the report has not been made public. The survey finds 100-200 times more infections than the reported numbers at some sites in Delhi, Mumbai and Kolkata. This implied that the infection was much more widespread and containment strategies had not worked well. In some of the areas with high exposure, 15-30% of the population has been exposed to the infection, which is high in big cities but very low in rural areas.

The survey was carried out in 60 districts and 10 hardest-hit cities.

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Asked why the government was silent on community transmission, John argued that the officials probably have a mindset that they knew “all sources of infection”, which was an “obviously untenable claim”.

“This may have made them deny community transmission defined as ‘unknown person(s) transmitting infection’. Such claim also shows lack of deep understanding of the dynamics of introduced epidemics.”

Medical scientists also observed that one of the reasons for the government’s denial could be a line of thinking that the acceptance of community transmissions is tantamount to acceptance of the government’s failure to stem the outbreak.

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“The government should not feel embarrassed about it. It is fully expected. This is how an epidemic grows. It cannot be considered as a failure on the part of the government because of the nature of the disease. They (officials) are worried that this may be called as their failure, but nobody in the world can do anything about it,” said Jayaprakash Muliyil, former principal, CMC Vellore, and chairperson of the scientific advisory committee of the National Institute of Epidemiology, Chennai — one of the ICMR institutes.

Two ICMR studies published in the last two months gave a clear indication of the COVID-19 outbreak moving from the local transmission stage to community transmission.