It’s like a public corona health emergency in Rajasthan and Delhi

“28 cases positive India”

Remember “three Cs” scenarios – first case, first cluster, first evidence of community transmission.

India, 28 cases: 3 Kerala, 1 Telangana, 1 + 6 Delhi, 1 + 1+ 15 Jaipur

Cases in Delhi and Telangana, RED alarm
Cluster in Jaipur red alarm
Community spread not yet
Yellow alarm, all have been in contact with the positive cases in last 14 days: must be isolated
Green all others (standard precautions)

RED = infected cases; Yellow close contacts of infected cases, GREEN others

In the last 24 hours there were almost 9 times more cases reported outside China than inside China.

Epidemics in the Republic of Korea, Italy, Iran and Japan are greatest concern.

The cases in the Republic of Korea appear to be coming mostly from suspected cases from the 5 known clusters, rather than the community. That’s important because it indicates that surveillance measures are working and Korea’s epidemic can still be contained.

This virus is not influenza. We have never before seen a respiratory pathogen that is capable of community transmission, but which can also be contained with the right measures. He said if this was an influenza epidemic, we have expected to see widespread community transmission across the globe by now and efforts to slow it down or contain it would not be feasible.

Of the 88,913 cases reported globally so far, 90% are in China, mostly in one province.
Of the 8739 cases reported outside China, 81% are from four countries.
Of the other 57 affected countries, 38 have reported 10 cases or less, 19 have reported only one case, and a good number of countries have already contained the virus and have not reported in the last two weeks.

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There is no one-size fits all approach. Different countries are in different scenarios

more than 130 countries have not detected any cases yet
some just received their first cases on March 1
some have clusters of cases, with transmission between family members and other close contacts
some have rapidly expanding epidemics, with signs of community transmission, and
some have declining epidemics, and have not reported a case for more than two weeks.

Some countries have more than one of these scenarios at the same time. For example, China had community transmission in Wuhan, but relatively small numbers of cases in other provinces. Other countries have a similar pattern.

Dr KK Aggarwal

President CMAAO, HCFI AND Past National President IMA

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