Modi did too much in India for too little – Get the ecology of novel corona first, prevent apocalypse

Has 21 day lock down worked to prevent the spread of corona in India, anyone who knows a little science would never dare to say yes and nor would say no, but instead would ask whether the outcome even if positive, is transient or sustainable? 

The result of the lock down is as same as how we prolong the survival of a patient with the help of ventilator or by suppressing the clinical manifestations of a disease with the help of heavy dose of steroid and once the ventilator is removed or steroid is withdraw, worst medical complications and death of the patient is imminent.

The virus corona follows a perfect MLM (Multi-Level Marketing) strategy. 

The business model of any rapidly spreading pathogens are quite interesting; it behaves like a parasite in some individual if the immune surveillance of the host is effective and in some, it may behave like a pathogen if the host is weak and congenial to the arrogance of the pathogen, the end result may be death. 

Every Corona positive individual may transmit the virus to others and that cannot be stopped by lock down and forced quarantine but at best we can only reduce the spread.

But the big question that begs an answer is about the positive cases.  When we test people for corona carriage rate, let us say out of 100 individual screened, 30 or 40 may turns positive.  The 100 people are chosen based on certain rationale such as history of foreign travel, contact with likely corona positive cases etc.  But corona virus doesn’t need big gap to pass through.  Virus would have already hopped to many in our population and such population need not fall under the rationale or history of foreign tour or contact based test norms. 

The recent study done at Mayo Clinic in Minnesota, USA suggests that if the virus has migrated to lower respiratory system, the nasal or throat swab from such people may not yield positive result for the virus. 

The horizontal transmission of the virus harboring at nasal and throat level might have been reduced due to the lock down but the virus might be still active in India. 

During lock down, the virus, instead of jumping from one individual to another, would have chosen to go deep inside the lower respiratory system of certain individuals who are already invaded by the virus to multiply or proliferate. 

Imagine, if such individuals show no or least clinical symptoms and suffers the least distress, they are likely to move freely in the society and even if they follow social distancing norms perfectly and wear high quality mask approved by the WHO, still we cannot prevent the virus jumping at least to one individual, considering our population density and other socio-economic reality including health and hygiene awareness. 

When the virus invade a new host, it is likely to navigate the lower respiratory system only through nasal and throat region.  If the viral residency in the nasal and throat region is more infective, the spread of the virus is going to be unstoppable if the residency period is long.  India needs such data and only then an effective preventive strategy can be evolved.

So far India has been focusing only on the spread of corona in community and how to stop it. 

The spread of corona within an individual needs to be understood because many individuals with corona burden may virtually show no clinical signs of COVID 19 or any medical distress due to the same and also may not show positive for corona if we test nasal or throat samples. 

Therefore India must know the ratio of positive cases for Corona at nasal and throat level, positive cases without any signs and symptoms and those who show complete clinical signs and distress of COVID 19. 

The job of ICMR should be to understand how corona behaves in each and every individual after its invasion, because Indian scenario is quite different from rest of the world. 

Without corona mapping in each and every individual who is tested positive for corona but shows no clinical manifestations of COVID 19, we cannot prevent novel corona pandemic in India. 

It looks like Modi has done too much for too little by rushing the lock down too early with too little data? 

Epidemiological understanding should have been the most important focus and all relevant data, India should have analysed before lock down. 

Another important question is about the rate of multiplication of corona in each and every host, India must study. 

At nasal or throat level harbouring, corona may spread fast to others but when it migrates down to lower region of respiratory system, the rate of multiplication of virus is expected to be quite high besides spread to others.  It means such patient may show high viral burden or viremia.  What would be the consequence of such patients turns infective and imagine, if they show no signs and symptoms of COVID 19? 

In the lower respiratory system, the virus is likely to face stiff challenge from our immune defence and such combat may bring certain mutations in the virus.  How dangerous or harmless is such mutant virus?

Can we apply the known norms of any viral infection to explain our above doubt?  If so, then how can call corona – novel corona, new to you, me and to everyone?

Many state governments in India are rushing to buy ventilators and many scientists in premier research centres are busy sequencing of the virus genome to speak more about the virus.  Where is the data on the ecology of noval corona?

The virus corona would be insignificant if it has not infectivity.  Therefore every micro or nano level of behaviour of corona in different population in India is necessary to evolve a strategy to contain the pandemic that sequence data.  Viral genome sequencing may be useful but core medical data is important for preventing the spread of the virus.  It is the treating physician’s voice the world must hear first and not the policy makers or ICMR. 

Clinical or medical understanding of corona in different population is the need of the hour, but such urgent need remains like Cinderella in India and we are rushing towards procuring more test kits and ventilators.

ICMR must be pressed to provide all such details to save India.  Coming months look dangerous to India because we have wasted lot of time and our resources by doing too much for too little benefit by locking down India for 21 days.

It should have been done after collecting and collating the data at least at base level.   Another 3 to 6 months are extremely critical for India.  S Ranganathan