As stated in a recent report by the World Health Organisation (WHO), India remains one of the countries with no Community Transmission (CT) since the onset of the Covid-19 pandemic. Unlike other countries such as the United States, Brazil, United Kingdom, France that have categorized themselves as being in the ‘community transmission’ phase, India and nations like Italy and Russia haven’t labeled themselves as being in ‘community transmission’.
Understanding Community Transmission (CT)
Community Transmission (CT) is a particular stage of a pandemic. It is broadly characterized by instances whereby new cases recorded within 14 days can’t be traced back to individuals with a history of international travel or linked to specific clusters. The CT classification has been organized into four levels, ranging from low incidence, known as CT1, to very high incidence, or CT4.
The Four Stages of a Pandemic
A pandemic typically progresses through four stages. Stage 1, or Imported Transmission, occurs when the disease is reported among travelers entering the country via borders and airports. It can usually be monitored and controlled through thermal screening and quarantine. Stage 2 is Local Transmission; here, the disease transmits through direct contact with an infected person within the country.
Stage 3 is when Community Transmission begins. This stage indicates that the virus is present in the community and can affect people who don’t have a history of travel to affected areas or any contact with an infected person. Finally, Stage 4 is Epidemic. During this stage, the disease becomes an epidemic in a country, leading to a vast number of infections and increasing deaths with no end in sight. At this point, the condition is considered endemic or prevalent in the region.
India’s Current Classification
Currently, India classifies its Covid-19 situation under a less severe category referred to as ‘cluster of cases’. This classification means that ‘Cases detected in the past 14 days are mostly limited to well-defined clusters, which are not directly linked to imported cases’. It implies a low risk of infection to others in the wider community, provided exposure to these clusters is minimized. It is assumed that there might be several unidentified cases in the area.
Implications of India’s Classification Decision
India’s decision not to classify itself as being in community transmission signifies an “ostrich in the sand” approach. Accepting the state of community transmission is not stigmatic or indicative of failure; instead, it shows how authorities handle a pandemic. If cases are still considered as cluster-based, the government should focus on testing, contact tracing, and isolating to prevent further spread of infection.
On the other hand, if India were to admit to community transmission, the priority would shift to treatment and implementation of advisories to ensure protection. Community transmission signifies that the health system has lost control over tracking the virus trajectory, and infections are occurring without knowledge of the source. Once the government accepts community transmission, the pandemic control strategy will transition to the next phase, the mitigation phase, focussing primarily on ensuring that only people needing medical care reach hospitals. This process will help save lives, and the primary strategy will no longer be to track or contain infections.
