80% asymptomatic patients pose new challenge for Rajasthan
Asymptomatic people are those who have Covid-19, probably in a mild form, but have no outward manifestations of the virus such as shortness of breath, cold or fever.
As if an increasing number of Covid-19 cases isn’t enough of a worry, Rajasthan’s healthcare department has another reason to fret -- 80% of people who have tested positive for the coronavirus disease in the state are asymptomatic, posing a greater risk of carriers of the virus unwittingly spreading the disease and preparing the ground for community transmission.
Asymptomatic people are those who have Covid-19, probably in a mild form, but have no outward manifestations of the virus such as shortness of breath, cold or fever. Vulnerable groups whose immunity is low such as the elderly or those suffering co-morbidities like cancer, heart, lung, kidney or liver disease are especially susceptible to catching the infection from them.
As of Sunday night, Rajasthan had 2,185 Covid-19 cases and reported a total of 41 fatalities.The state has so far tested 82,942 people.
“Approximately 80% of the cases being reported in the state are asymptomatic,” KK Sharma, director of public health in Rajasthan, said.
As the extended lockdown eases after May 3 and movement of people resumes, these unwitting spreaders will make it tough to contain the spread of the virus, according to doctors, who say the only way out is aggressive mass testing and following preventive guidelines.
“If we don’t test and contain the spread of the virus then it can lead to the third stage of {the disease of} community transmission,” Dr S Banerjee, head of the medicine department at SMS Hospital
A viral disease is said to be in the community transmission stage when a person who has no recent history of travel or exposure to a known patient develops the disease, and the source of infection cannot be traced.
While asymptomatic people can become carriers, the silver lining is that it shows that the emergence of a milder form of the disease from which people are recovering without the need for treatment, said Dr Virendra Singh, pulmonologist and a member of the CM’s advisory committee on Covid-19.
Ajitabh Sharma, the nodal officer for Covid-19 prevention in Jaipur district, said the administration had identified some potential asymptomatic superspreaders such as provision store owners, dairy booth managers, milk suppliers, vegetable vendors and health workers and was testing them. The government had initially planned to conduct rapid tests on such superspreaders, but after the rapid test kits turned out to be faulty, that plan has been put on hold.
In Rajasthan, six districts with over 100 cases each are a particular cause of concern for health authorities. Several areas in these districts have become hotspots from where the viral disease has spread among a larger population, most of whom are now deemed to be asymptomatic.
The six districts are Jaipur with 799 cases, Jodhpur with 341 cases, Tonk with 115 cases, Kota with 152 cases, Bharatpur with 109 cases and Ajmer with 123 cases.
In Jaipur, the disease has been traced to a person who returned from Oman to the congested Ramganj neighbourhood in the city, as well as some Tablighi Jamaat members who returned from a religious congregation at the Islamic missionary group’s headquarters in Delhi’s Nizamuddin Basti, which had gone on to become the biggest coronavirus hotspot in India. Social distancing was not followed and the disease spread rapidly.
The health department has adopted a strategy of aggressive sampling in these hotspot areas to identify cases and contain the spread of Covid-19. To be sure, doctors say, it is impossible to test everyone given the limited staffing and resources.
Tonk’s chief medical and health officer (CMHO) Dr Ashok Yadav said that of the 115 positive cases in the district, 114 were asymptomatic. He said that some Tablighi Jamaat members hid their travel history and did not come forward for tests, which led to a chain of infections.
Bharatpur’s CMHO Dr Kaptan Singh said that of the 109 cases in the district, 107 were asymptomatic. His Kota counterpart Dr BS Tanwar too said that of 152 cases, around 150 were asymptomatic. Both Singh and Tanwar said people had initially hidden their travel history, offered prayers in congregations and spread the infection to others.
Jodhpur CMHO Dr Balwant Manda said there were fears of community spread of the disease through asymptomatic superspreaders. “We are testing aggressively in hotspots to identify such superspreaders and we urge people to cooperate and get themselves tested,” he said.
