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Friday, June 12, 2020

India Fights COVID-19: Serological Survey and Government’s Reassurances!


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For the last almost ten days India’s rise of new COVID-19 cases per day hovered around just below the 10000 mark, and finally the mark was breached as India reported over 10500 new cases in the latest twenty-hour period with number of deaths per day crossing the 300 mark for last three days. Meanwhile to get valuable insights into the spread of the Coronavirus pandemic in India a serological survey was conducted by the Indian Council of Medical Research (ICMR) in May, 2020 in collaboration with state health departments, National Centre for Disease Control (NCDC) and World Health Organization (WHO), India. The study was conducted in 83 districts covering 28,595 households and 26,400 individuals. The study found a few good-news results and a few mixed ones. Before going into the findings let us know what exactly is a Serological or a Sero survey.

Serology is the scientific study of serum and other body fluids which in practice means the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection, like here the COVID-19 pandemic, or against other foreign proteins. Experts say that Serological tests may be performed to diagnose infections and autoimmune illnesses to check if a person has immunity to certain diseases, and in many cases the person’s susceptibility as per his/her blood group. Serological tests may also be used in forensic serology in crime scenario investigations. Serological surveys provide the most direct measurement to define the immunity landscape for many infectious diseases, yet this methodology remains under-exploited, experts comment. In this context India has done a tremendous job in conducting a serosurvey. If a person is positive for antibody test under serology this means that the person may have had symptomatic or asymptomatic infection in the past, in this case COVID-19, and need still to protect himself/herself in future, because there is no proof that the person may or may not have the infection again. For a negative antibody result the person might not have had any COVID-19 infection in the past, and would need protective measures in the future.

The Director General of ICMR narrated the results of the serosurvey in a press briefing on 11th June, 2020. He first dwelt on the good-news part: in India the percentage of infected persons per hundred thousand is the lowest in the world and so is the fatality rate (0.08%). The study also clearly points out that the measures taken during the lockdown have been successful in keeping the transmission low and in preventing rapid spread of COVID-19, he added. However, he revealed that compared to rural areas, risks of spread are 1.09 times higher in urban areas and 1.89 times higher in urban slums. Therefore, he stated that still large parts of the Indian population are susceptible to getting the infection and the states/union territories of the country must not let their guard down at any cost. He concluded with the warning that although at the moment the spread of the virus is not a matter of grave concern for India the virus may come back stronger.

In a further reassurance gesture the Indian Health Ministry official also said that the numbers in India should not be compared with that of various other countries because of India’s vast population and a very high population density. In the context of the relentless media ‘investigations’ into hospital lapses based largely on stray cases and in selected states only, the official parried a question by saying that a suspected case of COVID infection should first report to the health helpline of that particular area and follow the instructions given regarding tests to be done, when and where, instead of directly approaching the hospital of his/her choice.

As experts all across the world have been repeatedly saying that the killer virus is in no hurry to leave humankind alone the people, the governments, the medical fraternity, the police and law enforcement authorities and the media in India too must learn to adapt to the new challenge of living with the virus and take all precautions as notified instead of panicking, beating around the bush and create an atmosphere of mistrust and doubts. During this time of the worst crisis ever faced by humanity a united fight should be the motto all over, particularly for India where politics, conflicts and avoidable dissents occur at the slightest pretext. 

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