Has India studied the stages of COVID 19 in positive individual or we are doing ‘a shot in the dark’ approach, ICMR must explain

The 21 day lock down of India is coming to an end by April 14, 2020.  The possibility of the continuation of lock down looks certain because India is shivering over the increasing test positive cases of COVID 19 and the community transmission might have already taken place and hence the option left before the government is to continue the lock down to save life.

Our premier medical research organization and policy making body for medical science and research in India, Indian Council of Medical Research (ICMR) should explain about the science behind the 21 day lock down and why the lock down must continue, from the data available so far from increasing positive cases of COVID 19.

Any epidemic disease would go through different stages or phases within the infected population in the community.  Broadly 5 phases are recognized and they are  

1       Incubation

2     Prodromal

3    Illness

4     Decline

5    Convalescence  

In different populations, different age and gender group, the duration of incubation period, prodromal, illness, decline period etc., would vary greatly.  Even within the same age and gender group also great variation bound to occur due to the immunological and or genetic differences and the co-morbidity conditions of the individual. 

The fundamental question that seeks clarity from ICMR is about the average incubation period of Corona in Indian population in general and how it differs from regions to region? 

Because India is not comprised of one single population but is a combination of several populations that follow varied culture, different food habits, hygiene and health practices and the exposure and disease burden do vary between different states.  For example allergic diseases are high in urban areas with recorded high pollution and metal toxicity is high in remote villages in certain states like Bihar, Odisha etc., where mining activity is high. 

Therefore we should know, at least with reasonable accuracy, about the duration of incubation period of Corona in Indian population?

What would be the time period taken by an individual to move to prodromal phase after inoculation of the virus? How long the signs and symptoms of COVID 19 would last if the patient does not die and when on, the decline phase would start?  What is the duration of convalescence of an individual who just turned positive for the virus but has not shown any symptoms and the one who has shown all classic symptoms of COVID 19?

Do an individual turns positive for corona by PCR, infective to others in all the above 5 stages?

If we do not know the above details, how the 21 day lock down period has been arrived at to prevent the spread and how prolonging the lock down duration have been decided scientifically? 

Are we running after corona or corona is chasing us and at the end, are we not destroying Indian economy and livelihood of millions of Indians in the name of saving humanity?

If the incubation period is for example 14 days, prodromal period is, let us assume 5 days, illness may last for another 5 days, decline (complete removal of virus from our system may take another 5 days with standard deviation of ± 5 days, then what would be the lock down period required to prevent the spread? 

We can assume such lock down period may work only if all the people in the given population got infected on the same day.  Imagine, different individuals are infected on different time intervals, how we can solve the problem of virus transmission in country like India through lock down? 

If we really want to completely stop the viral spread, we may have to shut down India for 1 or more.  Is it possible, conceivable and imaginable in a country like India with dense population with clear social, cultural, economic and educational division?

Have we just followed the western model of lock down without any understanding about India? 

The political map of India is different from the health map of India and indeed the epidemiology of any disease we can fit into India only considering the diversity and not by trial and error or permutations and combinations with one formula and then celebrate the mission by calling we are one India, want one election, one ration card…… etc.

To save humanity from one disaster called Corona, have we pushed India into another disaster, from which India may not recover until we find ANOTHER DR SUBRAMANIAN SWAMY (finance Minister in Chandrasekhar Government), NARASIMHA RAO AND DR MANMOHAN SINGH. 

Every media house must ask questions to ICMR for all the micro details of corona that they are supposed to have collected and analysed and used for preparing the lock down strategy.

Corona curve will plateau only when the last virion of corona is eliminated from India or the corona has to infect every Indian and who get rid of corona due to own immunity.  Until then the graph will grow and if we want the graph to plateau, we must stop testing, and then graph will decline rapidly.   Otherwise it may take a year or more, for the curve to flatten. 

We eliminated Polio or Polio virus from terra firma?

Can ICMR tell us Polio virus in not there in India?  Thanks to immunization, no one is getting infected by Polio virus.  So shall Mycobacterium leprae, Filariasis etc. 

We have killed the livelihood of millions and millions of people in India, increased their anxiety and fear, lowered their immunity due to lack of anything to eat and now by prolonging the lock down, we are attempting to save them from corona.  What a wonderful strategy we have adopted to contain corona?

The purpose of the article is not to question the intent of the government but only to question the methodology adopted and to know the scientific/medical logic behind the lock down?

The question is not about taking stern measures to prevent the spread of the disease, but have we go sufficient understanding about the virus to extent the lock down or repel it? Can we eliminate corona virus from India totally and completely by lock down strategy?

Indian economy will definitely die due to corona and may not Indians.  S Ranganathan