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No community transmission in India yet: WHO Regional Head

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Poonam Khetrapal Singh WHO

New Delhi, April 8 : Given that many parts of India are witnessing large number of cases of Covid-19, experts have expressed their views on community transmission, but speaking exclusively to IANS, Poonam Khetrapal Singh, Regional Director of the World Health Organization’s South-East Asia region, said that currently cases in India have been traceable so there is no community transmission.

Dr Khetrapal Singh spoke on variety of topics related to the novel coronavirus, India’s response of containing the disease, testing strategy and lockdown. Here are the excerpts of her interview with IANS:

Question 1: What has WHO discovered about this new virus behaviour and character? What kind of trends or data are coming about this novel virus? Any findings or conclusion about its aetiology so far?

Answer: Based on currently available data, the main driver of COVID-19 transmission is people who have symptoms. Preliminary data suggests that people may be more contagious around the time of symptom onset as compared to later on in the disease. Detailed exposure histories are being taken to better understand the pre-symptomatic phase of infection and how transmission may have occurred in these few instances. While there are some reports of laboratory-confirmed cases who are truly asymptomatic, to date there has been no documented asymptomatic transmission. This does not exclude the possibility that it may occur. Transmission from an asymptomatic person is very rare with other coronaviruses, such as Middle East Respiratory Syndrome coronavirus (MERS-CoV). Persons who are symptomatic spread viruses more readily through coughing or exhaling. WHO is regularly monitoring all emerging evidence about this critical topic. About the source, increasing evidence demonstrates the link between the COVID-19 and other similar known coronaviruses circulating in bats, and more specifically those of the Rhinolophus bat sub-species. At this stage, it is not possible to determine precisely how humans in China were initially infected with SARS-CoV-2. The route of transmission to humans at the start of this event remains unclear. The current most likely hypothesis is that an intermediary host animal has played a role in the transmission – this could be a domestic animal, a wild animal, or a domesticated wild animal and, as of yet, has not been identified. WHO continues to collaborate with experts, countries and other partners to identify gaps and research priorities for the control of COVID-19, caused by the SARS-CoV-2, including the identification of the source of SARS-CoV-2. Current information suggests that the virus can cause mild, flu-like symptoms as well as more severe disease. Patients have a range of symptoms: fever (83-98 per cent), cough (68 per cent) and shortness of breath (19-35 per cent). About 40 per cent of cases seem to have mild disease, 40 per cent of cases have moderate disease (defined as radiology-confirmed pneumonia), about 14 per cent appear to progress to severe disease, and some 5 per cent are critical. Risk factors for severe disease are older age and comorbidities. This is a new disease and our understanding is changing rapidly. WHO continues to analyze information on both current and any new cases, as this is critical to enhancing our understanding of severity.

Question 2: A post is doing rounds on social media, defining the time frame of survival of the virus on different kind of surfaces (like aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel) How true it is?

Answer: The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or speaks. These droplets are too heavy to hang in the air. They quickly fall on floors or surfaces. You can be infected by breathing in the virus if you are within 1 meter of a person who has COVID-19, or by touching a contaminated surface and then touching your eyes, nose or mouth before washing your hands. Surfaces can be contaminated with the virus. Studies conducted on SARS-CoV and MERS-CoV indicate that coronaviruses can persist on different surfaces for up to a few days depending on a combination of parameters such as temperature, humidity and light. Thus, frequent hand washing and cleaning of surfaces has been always recommended by WHO.

Question 3: Has WHO done any finding on this SARS-CoV-2 relation, response or reaction with (High and Low) temperature?

Answer: There is no robust evidence yet to such hypotheses. It is important that people practice hand hygiene regularly with soap and water; clean surfaces regularly with disinfectant – for example kitchen benches and work desks; cover their cough and sneeze; take extra precautions to avoid crowded areas if you are over 60, or if you have an underlying condition such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer; if you are sick, stay at home, and eat and sleep separately from your family, use different utensils and cutlery to eat; and if you develop shortness of breath, call your doctor and seek care immediately.

Question 4: How far is the world still from finding therapeutic cure for COVID-19?

Answer: No pharmaceutical products have yet been shown to be safe and effective for the treatment of COVID-19. However, a number of medicines have been suggested as potential investigational therapies, many of which are now being studied in clinical trials, including the Solidarity trial co-sponsored by WHO and participating countries. So far, 74 countries have either joined the Solidarity trial or are in the process of joining and more than 200 patients had been randomly assigned to one of the study arms. Each new patient who joins the trial gets us one step closer to knowing which drugs work. There are multiple randomized clinical trials investigating the safety and efficacy of anti-virals and steroids ongoing worldwide.

Question 5: Although health authorities have not said that it is a ‘community transmission’ stage in India. Do you think the same?

Answer: Community transmission in any country is confirmed when the source of infection is unclear. In other words, when transmission in a given area – is extensive, in multiple locations, without reported travel history to areas reporting community transmission and without epidemiological links to known cases. Currently cases in India have been traceable. However, whatever the stage, the key action points are – engage with people; find, isolate, test and treat and trace every contact; ready your hospitals; and protect and train health workers. That’s the only way to combat COVID19.

Question 6: Do you think India is conducting less tests even as WHO Director General said “testing testing and testing?

Answer: On testing, India’s response has been proportionate to the need and the transmission scenario of COVID-19. The country has, on an ongoing basis, been ramping up its capacities with currently 152 public sector laboratories and 49 accredited private lab chains testing all symptomatic individuals who have undertaken international travel in the last 14 days; all symptomatic contacts of laboratory confirmed cases; all symptomatic health care workers; all hospitalized patients with Severe Acute Respiratory Illness and asymptomatic direct and high-risk contacts of a confirmed case. Besides all influenza like cases in hotspot areas are being tested. India has been calibrating its testing strategy as per the changing situation, taking into account scope, need and capacity.

Question 7: Looking at the number of cases, do you think India is amid an outbreak? Or do see that the disease is still contained very well here? Do you think India has taken the decision of lockdown very late, despite early warning from WHO?

Answer: India has so far managed to keep cases relatively low by rolling out quick and aggressive response. India has an advantage as the country-initiated response early and had an opportunity to learn from other countries that are ahead in terms of cases and applying different strategies in responding to the ongoing pandemic. The most effective way to control an outbreak is to detect disease early, isolate, treat, trace contacts, and promote social distancing measures. A lockdown helps in conducting these well but is not the solution by itself in curbing the epidemic.

Question 8: Is India getting any help in procuring PPE from WHO funds? Or do you think it’s doing very well on its own?

Answer: India’s response is nationally funded. WHO has provided some PPEs and primers and probes from its stockpile, and is also facilitating supplies through the global pandemic supply chain. WHO’s work with the Ministry of Health and Family Welfare and state governments on various preparedness and response measures include strengthening surveillance and contact tracing; laboratory and research protocols; risk communications; hospital preparedness; training on infection prevention and control and cluster containment plan.

Question 9: How do you think India is responding to the evolving situation as compared to other countries in the South Asian region?

Answer: WHO has been recommending all countries to scale up emergency response mechanism to A1) engage with people, 2) Find, isolate, test and treat every case and trace every contact; 3) ready hospitals; and 4) protect and train health workers.India’s response to COVID-19 has been pre-emptive, pro-active and graded with high-level political commitment. India’s efforts, that are led by the highest political leadership, is very much in line with WHO recommended actions such as coordination, planning, and monitoring; community engagement; surveillance, rapid response teams and case investigation, points of entry, national laboratories; infection prevention and control; case management; and operational support and logistics. This needs to continue/be ensured at all levels.

(Sfoorti Mishra can be contacted at [email protected])

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Covid-19 corollaries on the dairy sector: CRISIL

Overall, demand for milk and dairy products would be lukewarm in the near term, so prices are unlikely to boil over, according to the report.

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dairy industry

New Delhi, May 26 : Supply chain disruptions in the early weeks of the nationwide lockdown, and bread-and-butter issues for hotels, restaurants and cafes, have materially reduced demand for dairy products.

This is despite supply of most dairy products continuing during the lockdown, since they are categorised as essentials.

The shuttering of hotels and dine-ins has also dried up off-take of skimmed milk powder and khoya.

According to report by CRISIL Research on the state of dairy industry and supply chains, products that can’t be made at home easily – such as cheese, flavoured milk and also khoya – haven’t found their way back to the dining table in the same quantities as before the lockdown.

Demand for ice creams, which usually peaks in summer (accounting for 40 per cent of annual sales) has just melted away. Rural areas, which are feeling the income pinch more, seem to be staying off butter and ghee, the report by global analytics firm has said.

To be sure, since the third week of April, supply chains have turned smoother, so demand for staples such as milk, curd, paneer and yogurt are expected to see a quick rebound, leading to on-year expansion in sales, CRISIL said.

The pandemic, however, may sour the business for unorganised dairies because of pervasive contamination fears.

Conversely, as consumers shift, revenues of organised dairies and packaged products should fatten.

Overall, demand for milk and dairy products would be lukewarm in the near term, so prices are unlikely to boil over, according to the report.

Large brands such as Amul and Mother Dairy had already hiked retail milk prices by 4-5 per cent last fiscal. They may not serve an encore.

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445 people died from Australia bushfires smoke: Experts

Melbourne, Sydney and Canberra all had periods where they had the worst air quality in the world as a result of the smoke.

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Arogya Setu App

Canberra, May 26 : Smoke from Australia’s devastating 2019-20 bushfires killed at least 445 people, health experts revealed on Tuesday.

Fay Johnston, a public health expert from the Menzies Institute for Medical Research at the University of Tasmania, told the bushfire royal commission on Tuesday that her team estimated that 445 people died as a result of the smoke that blanketed much of the nation’s east coast, reports Xinhua news agency.

It takes the total death toll from the 2019-2020 bushfire season, which has been dubbed the “Black Summer”, to nearly 480 after 34 people lost their lives directly.

According to modelling produced by Johnston and her colleagues, 80 per cent of Australians were affected by the smoke at some point, including 3,340 people who were hospitalized with heart and lung problems.

“We were able to work out a yearly cost of bushfire smoke for each summer season and… our estimates for the last season were A$2 billion in health costs,” Johnston said.

“There’s fluctuation year to year, of course, but that was a major departure from anything we had seen in the previous 20 years.”

Melbourne, Sydney and Canberra all had periods where they had the worst air quality in the world as a result of the smoke.

Commissioners also heard on Tuesday that the increasing frequency of significant bushfire events in Australia meant that survivors no longer feel safe during the recovery phase.

“Disasters are no longer perceived as rare events, they are often seen as climate change, and they’re part of our new reality,” Lisa Gibbs, a child welfare expert from the University of Melbourne, said.

“We don’t know how that is going to affect recovery because the seeds of hope are a really important part of people’s ability to deal with what has happened and to get back on track.”

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Rising urbanization likely cause of heavy rainfall in South: Research

Their findings were reported in the ‘Quarterly Journal of Royal Meteorological Society’ on May 18, 2020.

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IMD heavy rains predict

Hyderabad, May 26 : A team of researchers at the University of Hyderabad (UoH) have discovered a link between heavy rainfall in several parts of south India and a growing urbanisation in the region.

A team led by Prof. Karumuri Ashok from the Centre for Earth, Ocean and Atmospheric Sciences of the University of Hyderabad, examined whether a common factor, the changing ‘land use land cover’ (LULC) in these states, has any implications for the heavy rainfall events.

Over the past few years, many heavy rainfall events have been reported in cities of south India. Prominent among them are the extreme rainfall that created havoc in Chennai and nearby areas of Tamil Nadu in December 2015, the heavy rainfall over Hyderabad and adjoining regions in Telangana in September 2016, and the extreme rainfall event in Kerala in August 2018.

Notably, these three states differ in their geographical locations, and also the season in which they receive rainfall. Kerala, located on the southwest Indian coast off the Arabian Sea receives heavy rainfall during the summer monsoon from June-September.

Tamil Nadu, off the Bay of Bengal, receives rainfall mainly during the northeast monsoon (October-December). The land-locked state Telangana receives the bulk of its annual rainfall during the summer monsoon season.

A UoH statement stated that their study showed the precipitation during heavy rainfall events in these states has significantly increased from 2000 to 2017. Using the LULC data from ISRO, and by conducting 2 km resolution simulation experiments of twelve heavy rainfall events over the states, the researchers found distinct LULC changes in these three states, which led to higher surface temperatures and a deeper and moist boundary layer. These in turn caused a relatively higher convective available potential energy and, consequently, heavier rainfall.

The study also suggests that increasing urbanization in Telangana and Tamil Nadu is likely to enhance the rainfall during the heavy rainfall events by 20%-25%. Prof. Ashok feels that improving the density of observational rainfall and other weather parameters may help in forecasting extreme rainfalls at city level.

Their findings were reported in the ‘Quarterly Journal of Royal Meteorological Society’ on May 18, 2020.

Prof. K. Ashok and his Ph.D. student Mr. A. Boyaj who is the first author, are both from the Centre for Earth, Ocean and Atmospheric Sciences of the University of Hyderabad. The work was done in collaboration with Prof. Ibrahim Hoteit and Dr Hari Prasad Dasari of King Abdullah University of Science and Technology (KAUST), Saudi Arabia.

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