India coronavirus dispatch: New insights on managing Covid-19

Most states are abandoning contact tracing, what to do under home isolation, and how does coronavirus spread?-a roundup of articles in Indian news publications on how India is dealing with the endemic

Expertspeak

New insights on Covid, key learnings from managing it: As the Covid-19 pandemic enters its sixth month in India, read this interview with Dr Randeep Guleria, Director of AIIMS, about key learnings from managing it, and new aspects that have emerged about the disease. He explains the systemic effects, and how it causes inflammation of the inner lining of blood vessels and its implications, among other observations. 

Managing Covid-19 

As cases surge in India, most states abandon contact tracing: India’s Covid-19 containment protocol requires states “to identify contacts as early as possible for preventing spread of further transmission”. The idea is to isolate people as they could be infected too and possible carriers of the disease. The protocol states that attempt should be made to identify all household members, social contacts, contacts at work place and contacts in health care settings who have had contact with a confirmed case between two days prior to onset of symptoms and the date of isolation. However, anecdotal reports indicate that many states seem to have stopped tracing contacts beyond the immediate household members of the patient. Read more here.

I am under home isolation with Covid-19 – what must I know? Stating that a large number of people who have tested positive for Covid-19 showed no symptoms, the Union Health Ministry revised home isolation guidelines to include asymptomatic patients, along with mild and pre-symptomatic cases. The revised norms have also reduced the number of days by which the coronavirus patients can end their home isolation and can be considered discharged. Read more here.

When millions rushed home, a school programme gave Kerala’s migrants reason to stay: Kerala trialled online classes -- First Bell -- for two weeks from June 1 for all classes except class 11, and made these available on a channel run by the general education department and online. Classes are scheduled for two hours for class 12, 90 minutes for class 10, and 30 minutes for lower and upper primary students. The videos are edited down to small capsules and shared with students and parents and are followed with instructions for educational activities. Read more here. 

Opinion 

Hardly smart about urban health care: The novel coronavirus pandemic has largely been an urban crisis so far, with megacities accounting for most of the positive cases. Indian cities are not only facing a public health crisis but also a larger emergency of economic issues and livelihoods. Despite the renewed policy focus on cities, India’s urban local bodies continue to be financially and administratively weak and heavily understaffed. There is also high level of vacancy of ASHA workers, the frontline public health workers carrying out contact tracing, in urban areas, especially in COVID-19 hotspot cities such as Mumbai. Read more here. 
 

Understanding Covid-19

How does coronavirus spread? The principles of fluid mechanics hold the answer: Understanding how fluids move can help understanding the way the virus is transmitted, which in turn can inform public health interventions to minimise the risk. Recent work has shown that a cough or sneeze consists of a multiphase chaotic gas cloud. This gas cloud transports viral pathogens much further than predicted. The mounting evidence has led the WHO to acknowledge that the coronavirus can be spread by tiny particles suspended in the air. Read more here. 
 

Fatigue and shortness of breath persist in recovered Covid patients, study finds: Recent evidence on the multiple organs and systems the novel coronavirus affects raises lingering questions about how long does it takes for a person to heal after the infection — not just test negative. This also has implications on how a death is categorised as a ‘Covid’ death — is it only till the virus lasts in the body or is it till the symptoms last? In one of the first such studies, researchers in Italy studied patients who had ‘recovered’ from the infection over two months ago to find out what were the long-term effects of the infection. Read more here.

Will Covid-19 be evidence-based medicine’s nemesis? In the current fast-moving pandemic, where the cost of inaction is counted in the grim mortality figures announced daily, implementing new policy interventions in the absence of randomised trial evidence has become both a scientific and moral imperative. Whilst it is hard to predict anything in real time, history will one day tell us whether adherence to “evidence-based practice” helped or hindered the public health response to Covid-19 – or whether an apparent slackening of standards to accommodate “practice-based evidence” was ultimately a more effective strategy. Read more here.

The four known ways in which the coronavirus affects your brain: Six months into the Covid-19 pandemic, we’re still learning what the disease can do. There are now detailed reports of brain illness emerging in people with relatively mild lung illness, in those who are critically ill and also in those in recovery. One key thing we’re seeing is that severity of lung illness doesn’t always correlate with severity of neurological illness. Having only minor lung illness doesn’t protect against potentially severe complications. Read more here.
 

How different vaccines work, including Covaxin and ZyCoV-D: The world is waiting with bated breath for a functional Covid-19 vaccine. In the past century, vaccines have rescued humankind from many infectious diseases. What makes designing a potential vaccine for COVID-19 challenging? To answer this question, it is important to understand how a vaccine elicits an appropriate immune response in the body. Read more here.

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