80% Covid-19 patients asymptomatic, silent spread concern looms in Rajasthan

As doctors grapple with Covid-19 cases, an added concern is that about 80% of people infected by the coronavirus in Rajasthan are asymptomatic, posing a risk to vulnerable groups and increasing the possibility of a silent spread.

Doctors in the state said as the Sars-Cov2 virus infects more and more people, a majority are not showing symptoms of the disease but are becoming carriers who can potentially spread the virus among more sections of society.

“Approximately 80% of the cases being reported in the state are asymptomatic,” KK Sharma, director, public health, said.

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Asymptomatic persons are those who probably have a mild form of the disease but don’t show any symptoms. These people become carriers and pose a risk to vulnerable groups such as those who are above 60 years of age and whose immunity is low, those who have cancer or heart, lung, kidney and liver disease, or immune deficiency or those on steroids.

As the nationwide lockdown eases and the movement of people resumes, these spreaders will make it tough to contain the virus.

The Indian Council of Medical Research (ICMR) said last week that 69% of Covid-19 patients in India who were tested did not show symptoms of the infection, even as the Union health ministry said that the trend of cases worldwide showed about 80% of the patients had mild or very mild symptoms.

Doctors said the only strategy is aggressive mass testing and following preventive guidelines.

S Banerjee, head of the medicine department at SMS Hospital in Jaipur, said asymptomatic cases present a threat to vulnerable sections and the only workable strategy is aggressive testing. “If we don’t test and contain the spread of the virus, then it can lead to the third stage of community transmission,” he said.

Community transmission occurs when the source of the disease is untraceable and the virus is spread through a large number of people.

Virendra Singh, pulmonologist and a member of the Rajasthan chief minister’s advisory committee on Covid-19, said while asymptomatic cases can become carriers, the positive aspect is that it shows a milder form of the disease is emerging from which people are recovering without need for treatment.

In Rajasthan, six districts which have more than 100 cases each are a cause of concern for authorities. Several areas in these districts have become hot spots from where the disease has spread among a larger population, most of whom are now asymptomatic.

The six districts are Jaipur (799 cases), Jodhpur (341 cases), Tonk (115 cases), Kota (152 cases), Bharatpur (109 cases) and Ajmer (123 cases).

In Jaipur, doctors said around 80% of cases are asymptomatic. The disease initially spread from a person who returned from Oman to the congested Ramganj neighbourhood in the city, and some Tablighi Jamaat members who came back from a religious congregation in New Delhi. Social distancing was not followed and the disease spread rapidly.

The state health department has adopted a strategy of aggressive sampling in these hot spots to identify cases and contain the spread of the Coronavirus. However, doctors said it is impossible to test everyone given the limited manpower and resources.

Tonk’s chief medical health officer (CMHO) Ashok Yadav said of the 115 cases in the district, 114 are asymptomatic. He said initially some Tablighi Jamaat members hid their travel history and didn’t come forward for tests, which led to a chain of infections.

He said authorities are doing mass sampling in hot spot clusters to identify positive cases and to stop the spread of the virus.

Similarly, Bharatpur’s CMHO Kaptan Singh said of the 109 cases, all but two are asymptomatic. He said initially some of those who found positive didn’t cooperate with authorities and hid in their homes, which led to others getting infected.

Kota’s CMHO BS Tanwar said of the 152 cases, around 150 are asymptomatic. He too said people had initially hidden their travel history and offered prayers in congregations, spreading the infection to others.

However, he said people are now aware and are informing authorities if any person comes from outside the area or locality.

Jodhpur’s CMHO Balwant Manda said around 80% of cases being reported are asymptomatic. He said there is fear of community spread through the super-spreaders. “We are testing aggressively in hot spots to identify such super-spreaders and we urge people to cooperate and get themselves tested,” he said.