60 Tamil Nadu infected have no source, experts flag community spread – Times of India

CHENNAI: The curious case of some 60 people, mostly in Chennai, having tested positive with no trace of the source of infection has led public health experts to point to community transmission of Covid-19, though the TN government denies this.
Out of the 1,596 cases so far, state officials could not trace the source of infection of more than 60 people. Most of them were from Chennai, including a patient who tested positive more than a month after the suspected primary source was found infected.
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As state health officials continue to say that the spike in the number of cases was due to increased screening and rise of secondary infections, medical experts say these cases could be a sign of community transmission.
Dr Jayaprakash Muliyil, chairman of the scientific advisory committee of the National Institute of Epidemiology, said the Chennai patient testing positive a month after contact with an infected person was a clear indicator of community transmission. He said the Chennai patient would have got the disease from some other infected person, as the virus has so far exhibited an incubation period of a maximum of only 14 days. “This particular virus is not that catching. Only a certain proportion of the people who come in contact with a case get infected. This person must have got it from somebody else. It is a very good example of what a community transmission looks like,” he said.
Chennai has recorded the highest positive count in the state, with 358 cases as on Tuesday. “Most of the cases are related to that single cluster (Tablighi Jamaat). Without that, Tamil Nadu would have been in a better position. I am sure Chennai is also affected due to the same reason,” said Dr Abdul Ghafur, infectious diseases expert.
Earlier this week, health minister C Vijayabaskar said there was no community transmission in the state and that the high numbers were due to the increased screening among asymptomatic close contacts and those with influenza-like illnesses. But experts blame it on a weak testing strategy.
T Sundararaman, public health expert and former dean of school of health systems studies, TISS, said the rising number of hotspots and locking down of neighbouring areas is itself an indication of community transmission and that the government is only uncovering the cases that had already existed as it has extended testing outside the cluster. He blamed the rising number of cases both in the state and the country to a weak testing strategy.
“In Chennai, they are doing more tests because it has hotspots. They are testing influenza like illness and all symptomatic cases whereas it is not done in other places. There is a sense that if there is community transmission, Tamil Nadu will be in great danger. But the reality is, it was always there and once you cross 100 cases, it is more or less likely to be there. It is a phase in the way an epidemic spread,” he said.
“The whole idea of community transmission has been tweaked into ridiculous levels. The government should admit to the existence of the problem and manage. We won’t blame them for that, but denial is very dangerous,” he added.
He said it is time for the government to start managing the disease through proper public health approach instead of extending lockdown measures. Adopting a strategy to test all people with respiratory infections, isolation, good disease surveillance system, home quarantine of contacts and good ICU centre for treatment are ways to combat the disease after the lockdown is lifted.
“Perhaps, lockdown is simpler for government because they do not have the confidence to do complex things that they need to do. Lockdown is not going to eliminate the disease. They should lift the lockdown because the disease will anyway come back,” he added.

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