Corona positive, tested negative, none, Is India under fire, are we going with Rasputin luck, ICMR must explain

The recent study done by Dr. Priya Sampathkumar, an infectious disease specialist at Mayo Clinic at Minnesota has suggested that three types of people may exist in our population with reference to Corona virus and if we fail to understand the distinctions between them, we may end but celebrating the success of 21 day lock down with the luck and charlatan wisdom of Rasputin.  It is already known that many of our medical scientists and clinicians run their life merrily with Rasputin luck.

We have little substance to discuss about those who tuned positive for corona RNA by PCR test, where the sample was collected from either nasal or throat swab. 

They are positive for corona.  We also must recognize the sensitivity of PCR based assay which is reported to be only 60-70%.   The sampling collection method can also influence the result greatly.

 

For the time being, let us forget such possibility and leave it to the destiny and god; those who are pushed inside the quarantine chamber because shown positive for corona virus may or may not be really positive for the virus and those who are left free because the test result came negative needs not be truly negative at all based on the sensitivity data of PCR and possible error in sample collection.  

India is no way far advanced than US and UK in performing PCR test, and especially in medical colleges or by the medically trained staff.   Modi may not like us to admit the above truth because such expressions may be described by the present government as un-patriotic and only if we promote cow urine therapy for various diseases, we will be showing true patriotism.

The PCR positive cases form the first category. 

The second category is comprised of those who are totally free of corona in their body.  This group are psychologically vulnerable than medically because of fear. 

The third group are the one who have definite history of contact with corona positive cases but have turned negative for corona by PCR.   

The US report have clearly shows that those who turned negative for corona need not be so, because Corona virus doesn’t stay in the nasal or throat region alone and the virus would move down to nasopharynx and then the virus would migrate down to the lower respiratory system. 

Under such circumstances, the nasal and throat swab may not show the presence of virus and hence the likelihood such people getting designated as negative are quite high. 

The question before the nation is, whether ICMR and our health care policy makers are aware of the above fact? 

Where is epidemiological data and detailed analysis of Corona within the infected individual than in the population, ICMR has collected and analysed? 

To establish whether one is really positive or negative for corona, sample from bronchalveolar lavage must be collected.  Such sample collection warrants the patient to be sedated.   Through such sample collection only we can really exclude corona negativity conclusively?

Government can celebrate how the lock down has reduced the spread of corona.  But the big question India has to answer is not about reducing the spread, but the total elimination of the virus, otherwise we have only given holiday for corona for the time being and it is going to come back. 

The population density, illiteracy, superstition, medication health fraud, relaying too much on grandma’s traditional kitchen recipe (although such practice enjoys the privilege of a separate Ministry), all collectively and individually exist in India and hence, will the lock down really going to help?

We need complete epidemiological data and what the ICMR has done to enhance our knowledge about corona within a positive individual than how it spreads in the population. 

Everybody knows that viral infections would spread fast and we do not need ICMR scientists with hefty salary to tell us that.  

ICMR must tell the life cycle of corona in Indians; whether the clinical signs of COVID 19 would be more during its nasal and throat inhabitation stage or during its downward migration into lower respiratory system? 

How long the virus may take to reach the lower respiratory system and how long the virus can survive there without any clinical symptom, ICMR must explain?    

The role of ICMR is not just to tell how to stop the spread through simple lock down but how the virus behaves within different population groups (age, sex, with co-morbidities) and what is the maximum time period for the above process and how such data ICMR is going to use to evolve a strategy to deal corona pandemic? 

If we remain ignorant about how the life of virus in each and every hosts system and or those who turned COVID 19 patient, we cannot prevent the spread or reasonable elimination of corona. 

Our political establishment may not know all such final details but ICMR and the scientific fraternity in various government agencies must know and must answer. 

Indian cannot remain as a mere consumer or beggar country for scientific knowledge that emerges from western world and with such wisdom, we can shape our strategy?  

We must get to the root of the problem while we run after corona like how we are running after procuring ventilators and other medical equipment’s to save the life. 

Just by saving the COVID 19 cases, we cannot save all Indians who are not yet infected.  Only through concrete learning and prudent data analysis about various stages of corona in each and every positive case, we can have an effective road map.

Let us be pessimistically optimistic that we are going to have corona for another one or more years and the best part is that if corona has to win its war in India, corona has to fight Salmonella, Shigella, Malaria and many other primary pathogens that live in India either as our family member or as our neighbour.    

Government of India must ask ICMR to provide all micro details and we should not allow ICMR to have its best of time and luck like that of Rasputin. S Ranganathan