Social distancing and isolation mandatory to contain coronavirus: Dr Ramakanta Panda
   Date :30-Mar-2020

Dr Ramakanta Panda_1 
 
Principal Correspondent :
“The COVID-19, though highly contagious is not as fatal as SARS and MERS”, says Dr Ramakanta Panda, Chairman of India’s Asian Heart Institute. Dr Panda is known for performing procedures on the celebrities like Dr Manmohan Singh, former Prime Minister of India.
 
Dr Panda while talking to ‘The Hitavada’ pointed out, “Everyone needs to be vigilant during viral outbreaks like with the new coronavirus, and follow the precautions set out by the public health authorities. But the big difference with coronavirus is that in 80% of the cases the symptoms are mild. 15% cases are severe and some of these need hospitalisation and management and it is only critical in 4-5% cases needing intensive care and possible ventilator.” The reason it is spreading so fast because 80% are mild and many are not detected and isolated. They are spreading the disease. This is unlike SARS & MERS where majority had severe illness leading to easy identification and isolation.
Dr Panda adds that measures taken by the Government such as social distancing and isolation are very important to contain the spread.
 
A summary of control measures and key takeaways is as follows
1. Children below 15 don’t seem to be affected or have very mild disease.
2. The efficiency of transmission for any respiratory virus has important implications for containment and mitigation strategies. The current NEJM (New England Journal of Medicine) study indicates an estimated basic reproduction number (R0) of 2.2, which means that, on average, each infected person spreads the infection to an additional two persons. This reproduction ratio has to fall below 1% for the disease spread to be contained.
3. COVID-19 is far more contagious than common cold or flu. Because it is highly contagious social distancing is a must. Hence, measures taken by Government are good, especially because many patients who get coronavirus are not easily identifiable. Citizens must realise that cooperation is in their own long term interest.
4. Social isolation should become a way of life as the virus will continue to infect and will be in circulation for at least 3-6 months with periodic spikes in the number of cases. It will take some time before the vaccine is developed. So, it is very important to follow the guidelines set forth by Health Ministry and WHO.
5. A very high concentration of virus at an early stage - in the throat - make steam inhalation and warm saline gargles necessary in adult population. (to reduce intensity of virus infection).
Commenting on the literature that heart patients are more at risk, Dr Panda concurs; but with caution.
“A recent bulletin released by the American College of Cardiology (ACC) says that the
mortality rate of coronavirus jumps to 10.5 per cent for people who have cardiovascular
disease; but in any given heart disease population 50% are diabetic, 30% have some
hypertension related issue and about 5-10%
are smokers. Prevalence of CHD in India is
5684 for 1 lac population- 5.6%- as per the journal of ACC.”
The bulletin by the ACC adds that people who have an underlying chronic respiratory disease will experience a 6.3 per cent death rate.
Dr Panda cautioned, “Lifestyles have to change. There will be spikes in number of cases in between when vigilance goes down. Being a super-speciality hospital, we are screening anyone with a cough and cold. We also have temperature sensors at the entry point limiting number of visitors.”