In India most of the people who are being tested for coronavirus infection are those who have a travel history or who have been in contact with a coronavirus positive family member or others who have developed symptoms after being in contact with a suspected infected person. Hence the number of coronavirus positive cases are getting projected as low. To know whether infection has entered the community at large (stage 3 of the epidemic) random anonymous testing of cross section of the population needs to be done at an all India level. It is referred to as sentinel surveillance, which was undertaken during the AIDS epidemic in India by the very same Indian Council of Medical Research (ICMR) based in New Delhi. Why is the ICMR now turning a blind eye to the most basic principle in epidemiology? Why are the professors of community and social medicine of medical colleges all over the country maintaining a deathly silence on this? The Union Health Minister being himself a qualified doctor is expected to know the basic principles of epidemiology.

Besides testing for coronavirus infection is being done only in government laboratories and those in authority regulate on whom the test should be done. The risk of this is that spread in the community at large would be missed at an early stage.

In Italy – which has the largest number of cases outside China – the medical authorities missed the spread of coronavirus infection in the community at large and is hence paying the price by way of high morbidity and mortality. In fact doctors in Italy had detected large number of pneumonia cases not responding to treatment at an early stage but could not – at that point – diagnose that they were dealing with coronavirus infection. Other countries including India has a lesson to learn here.

[Dr. P. S. Sahni, member ABVA; Senior Research Fellow, ICMR:1981-82, posted at Safdarjung Hospital, New Delhi; Research Associate, ICMR 1982-83, posted at All India Institute of Medical Sciences, New Delhi. Email: aidsbhedbhavvirodhiandolan@gmail.com]


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