L J Ravi Covid-19 Pandemic Poses Fundamental Challenges to all Societies Prabir Purkayastha IT is now clear that Europe, particularly the core European Union countries – Italy, Spain, France, and Germany – is the new epicentre of the Covid-19 epidemic. China, followed by South Korea, managed to contain their outbreaks; the European countries did not. The US and UK numbers are creeping up, poised to take off at any moment. In the US, only the Trump administration’s lack of testing – either intentional or due to incompetence – is hiding the real numbers. As its testing scope increases, a sharp increase in numbers is already visible. India’s numbers are still small, though here again the real numbers could be higher, as testing is confined to only a small section of the population. According to ICMR guidelines, only those coming from high risk, Covid-19 affected countries (12 as of now), or those in direct contact with somebody who has tested positive, can be tested. Instead of the widespread testing done by China or South Korea, India will do random testing to see if there is any community spread before changing the testing guidelines. The ICMR’s argument is that we are not yet in the community spread phase, and also there is a scarcity of resources. The ICMR has only 100,000 test kits, though it has ordered another million. At the stage India is in, the WHO recommends testing contacts of confirmed cases only if they show symptoms of Covid-19. Addressing a press conference on March 16, WHO director-general Tedros Adhanom Ghebreyesus said, “We have a simple message to all countries – test, test, test… All countries should be able to test all suspected cases. They cannot fight this pandemic blindfolded.” For countries that are in the community spread phase, extensive testing is the only way to slow down further infections. The problem is to identify the tipping point when a country moves from containment phase to community spread. ICMR’s idea of random testing of other patients suffering from severe respiratory infections could be a worthwhile approach. WHO recommends isolating the infected as early as possible to contain the epidemic. In the containment phase, people should impose social distancing: reduce the number of person to person contacts, maintain a certain distance from each other, and take other precautions such as hand washing. In this phase, we test for those coming from high risk regions and people in contact with those who have been confirmed as infected.
