IASbhai Daily Editorial Hunt | 29th Sep 2020
The only person you are destined to become is the person you decide to be.– Ralph Waldo Emerson
EDITORIAL HUNT #162 :“Understanding the Peak of COVID-19 | UPSC“
T. Jacob John | M.S. Seshadri
Understanding the Peak of COVID-19 | UPSC
T. Jacob John is former Professor and HOD, Clinical Virology Department, CMC Hospita. M.S. Seshadri is former Professor and HOD, Clinical Endocrinology Department, CMC Hospital, Vellore,Tamil Nadu
Imperatives after India’s September virus peak
After having peaked in the middle of this month, COVID-19 infections could continue till March before turning endemic
SYLLABUS COVERED: GS 3: Health : Disease
How can we calculate the peak of COVID-19 Pandemic .Discuss measures to adopt vaccination programme in India -(GS 3)
- This article starts with numbers and data input . Ignore the numbers and understand how we can calculate the Peak of COVID-19 .
- Post Peak Scenario.
- Leadership roles.
- It has been followed by a downtrend since then — if we work backwards for four weeks from September 26, 2020.
WHAT THE DATA REVEALS
- MIDDLE OF SEPTEMBER : From September 5 to 11 and September 12 to 18, were 6,37,136 and 6,48,096 cases, respectively.
- A WEEK BEFORE SEPTEMBER : The week before the peak (August 29 to September 4), the total was 5,58,999.
- A WEEK AFTER SEPTEMBER : And the week after the peak (September 19 to 25), the number was 5,96,096 cases.
- TWO PEAK WEEKS : During the two peak weeks, the weekly average was 642,616 cases, and in the two flanking weeks, the average was 577,547 cases.
DRAWING A MEDIAN
- MEAN AVERAGE PRE-WEEK : The mean daily numbers in the pre-peak week were 79,857; on no day did the number reach 90,000.
- MEAN AVERAGE : During the two peak weeks, the mean daily number was 91,801; on 12 days, the number had exceeded 90,000.
- MEAN AVERAGE POST-WEEK : In the post-peak week, the mean daily number was 85,156;
- NEED FOR DOCUMENTATION : As the numbers of documented infections are determined partly by the daily volume of tests, there cannot be too much reliance on these numbers alone.
- CONFIRMED DATA : We need additional supportive evidence.
LAB TESTS, HERD IMMUNITY
- UNDETECTED CASES : The number of infections detected by RT-PCR testing was a small fraction of the total burden in the community that remained undetected.
- UNAUTHENTIC : For every laboratory-diagnosed infection, there were 80 to 100 undocumented infections in the country.
- CORRECTION FACTOR : Using the correction factor of 80-100 proposed by the ICMR, India’s total burden of infection was between 480 million and 600 million.
- HERD IMMUNITY : In India’s population of 1,380 million, the proportion infected — in other words the herd immunity — was in the range of 35% and 43%.
- PEAK OF THE CURVE : About 30% herd immunity is sufficient to reach the peak of the epidemic curve, we can be confident that India indeed has reached the peak of the COVID-19 epidemic.
- BELL SHAPED CURVE : In an epidemic of a directly human-to-human transmitted microbe, graphically represented by the more or less symmetric bell-shaped epidemic curve.
- ENDEMIC PHASE : For the pandemic influenza of 2009 which had about the same degree of infectiousness, a proportion of individuals remained uninfected, constituting the pool of susceptible people who sustained its endemic phase.
- ASSUMPTIONS : If 35% of the population was infected pre-peak, another 35% will be infected post-peak, for a total of 70% during the epidemic.
- RESULTANTS : The residuum of 30% is sufficient to sustain the microbe in the human population.
- MORTALITY : As more people are infected, new cohorts of children replace them to make the numbers up.
- STEADY STATE SYSTEM : The logic is that input and output have to be balanced in any steady state system, endemic prevalence included.
- PER THOUSAND : We must anticipate 15-18 infections per 1,000 population every year — more in some years and less in others.
- END OF PANDEMIC : So it is reasonable to assume that the epidemic will continue for a further six months, until mid-March 2021, before it turns endemic.
VACCINATION AND ANTIBODY TEST
- VACCINES ARE MUST : Unless interfered with using vaccination, we can expect low seasons and high seasons; low years and high years.
- DECREASING MORTALITY RATES : Vaccination is the ready answer to prevent death in these vulnerable subjects.
- DISTRIBUTION : Protection is important for those who are susceptible to severe disease and death, namely senior citizens and those with comorbidity.
- TESTING ANTIBODIES : Known infected and antibody positive persons need not be vaccinated.
- TESTING REAGENTS : The state should create facilities for large-scale antibody testing with indigenous production of test reagents.
USING INDIA’S STRENGTH AT WHO
- STRATEGIC USE : We also have a unique opportunity to eradicate COVID-19 altogether if we prepare now for the strategic use of vaccines globally.
- EXPECTED DATE : Judging by the speed with which Phase 3 trials are progressing, we can expect a few vaccines emerging before March 2021.
- ERADICATION IS A GLOBAL NEED : India can provide leadership, with Indian officials of influence in the World Health Organization.
More than a vaccine, it is about vaccination ! A vaccination programme is necessary to protect life and reduce the disease burden.
SOURCES: THE HINDU EDITORIAL HUNT | Understanding the Peak of COVID-19 | UPSC