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As the number of people infected by the novel strain of the coronavirus continues to rise, with the number of infected people shooting above a million in the world as of April 2020, countries are ramping up their efforts to stop the disease from spreading any further, which has already claimed nearly 28,000 lives worldwide.

Despite China - where COVID-19 first broke out - managing to contain the number of positive cases, there has been an alarming rise in the number of persons infected and eventual deaths elsewhere. The United States of America and the continent of Europe have been the worst hit, with Italy and Spain reporting the highest number of deaths.

There have been concerns over India, which with a population of 1.3 billion people, has been forced to take extreme measures by announcing a 21-day nationwide lockdown on March 25 to curb the spread of the disease. According to the World Health Organization’s (WHO) stages of transmission of a global pandemic, India is currently in stage 2 of the transmission, with cases having reached a local transmission level, but the source or the carrier of the infection can still be tracked.

But with the country also reporting a sharp rise in cases over the last week, taking the number of infected people to over 4,000 with over a 100 deaths, it is also bracing for an eventual upgrade to stage 3 of the transmission. Stage 3 of the pandemic is also called community transmission, where human-to-human transmission has begun, which means a person doesn’t need to have travelled to a country already affected by the virus, nor has one come in contact with someone who has.

Read more: COVID-19: 10 safe ways to engage socially while maintaining healthy distance

  1. Preparing for Stage 3 of COVID-19
  2. Why number of positive cases in India remains low
  3. Studies point towards rise in COVID-19 cases in India
  4. Steps to curb the spread of coronavirus infection in India

While the Indian Council of Medical Research (ICMR) as well as the Government of India maintains that the disease is still restricted to Stage 2 of the pandemic, many states individually are taking measures to prepare for the scaling up of testing and treatment of patients. For instance, Delhi Chief Minister Arvind Kejriwal announced on Twitter that the city is prepared for the eventuality, preparing to handle at least "1000 daily positive cases, for testing, treatment and isolation".

Even before the country had announced a nationwide lockdown, many states in the country had announced curfews to restrict the movement of people. Researchers have warned of an outbreak worse than the ones reported in Italy and Spain due to the sheer population size, along with the lack of access to quality healthcare in the country.

With the scientific community hard at work towards creating an effective line of treatment for COVID-19 patients globally, practising hand hygiene, covering the nose and mouth with masks as well as enforcing people to stay indoors and limit human contact are being promoted as safety measures to flatten the curve.

India had also mandated those who had returned from international travel over the last month to be placed under a 14-day quarantine in their own homes to limit their contact in an effort to stop the infection from spreading.

Read more: How to take care of a COVID-19 patient at home

Since the first positive case was discovered in late January, the number of patients testing positive for the novel strain of coronavirus remained low up until the beginning of March. Experts believe that was due to the limited number of tests that had been carried out until then, as India didn't have enough testing facilities or kits made available to cater to its large population. 

Until the end of March 2020, India was conducting only about 90 tests on a daily basis, nowhere near the numbers that would satisfy the global health community. However, with the number of testing centres and test kits being ramped up around the country, the figures are projected to rise.

Various studies, conducted by Indian as well as international agencies, have estimated staggering numbers of positive cases in the coming months in the world’s second most populous country. According to the ICMR, strict social distancing measures for those presenting symptoms of the disease can help in reducing the number of COVID-19 cases by a value of 62%. 

Another research group called COV-IND-19 Study Group comprising a team of researchers from all over the world, also pointed out that while the initial numbers of positive cases in the country were a good sign, it wasn't a true reflection of the parameters with the vital component of large-scale testing not applied as yet. According to them, going by the early phases of testing data, India is still looking at about 1-13 lakh positive cases in the next two months.

"So far, the number of people tested in India has been relatively small. In the absence of widespread testing, it is impossible to quantify the magnitude of community transmission," according to the researchers in the report. "Thus, our current estimates are at best underestimates for India based on early phase data."

Read more: COVID-19: Why mass gatherings are dangerous

The researchers further go on to add that India would have to take draconian measures to curtail the figures and limit them to a minimum until the scientific community is ready with suitable treatments and vaccines. According to World Bank data, India doesn't have adequate healthcare facilities to cater to its significant population, which adds to the problems.

The 21-day lockdown has come as an unprecedented-yet-welcome step towards limiting the spread of the infection in the country, with economic relief packages being readied for the worst-hit industries due to the global pandemic. But with the number of testing centres and treatment facilities rising across the country, the lockdown gives the healthcare community vital time to prepare to handle several cases at a time.

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  2. Mathur R. Ethics preparedness for infectious disease outbreaks research in India: A case for novel coronavirus disease 2019. Indian Journal of Medical Research. 2020 Mar 4. (epub) PMID: 32202255.
  3. Agarwal A et al. Guidance for building a dedicated health facility to contain the spread of the 2019 novel coronavirus outbreak. Indian Journal of Medical Research. 2020 Mar 16. (epub) PMID: 32202258.
  4. Bhatnagar T et al. Lopinavir/ritonavir combination therapy amongst symptomatic coronavirus disease 2019 patients in India: Protocol for restricted public health emergency use. Indian Journal of Medical Research. 2020 Mar 11. (epub) PMID: 32202256.
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