No community transmission of COVID-19 yet. Here's what stage 3 would mean for India

The 21-day lockdown in India was implemented in the hopes of controlling and reducing the spread of the novel coronavirus. We know that the infection spreads from human-to-human. India was said to be in Stage 2 of transmission at the time - meaning that the only ones who have the virus were either imported cases (Stage 1) or the ones who were exposed to people who were confirmed cases. The source of the transmission in all cases in Stage 2 could be tracked.   [caption id=“attachment_8152071” align=“alignleft” width=“380”]  Representational image. PTI[/caption] Limiting movement, maintaining hand hygiene and keeping a social distance at all times was the best way to protect yourself from contracting the virus, according to the World Health Organization as well as the Ministry of Health and Family Welfare. Another thing the WHO said to do was expand testing exponentially - and while India has opened up more testing facilities and updated its criteria for testing, it is currently testing only 2,000-3,000 per day for the last few days. Before that, as per ICMR, the average was 1338 samples per day.    

List of government laboratories approved by ICMR to test #Covid19India.#IndiaFightsCorona #coronavirusindia pic.twitter.com/1D508gKjM8

— All India Radio News (@airnewsalerts) March 24, 2020

But yesterday, Arwind Kejriwal, Chief Minister of Delhi, posted a tweet that said preparations were being made for a possible Stage 3 outbreak of COVID-19 in the Capital and that this preparation had been recommended by a panel of doctors headed by Dr SK Sareen. This means they’re preparing for a situation in which 1000 patients start getting reported per day in Delhi - while remaining optimistic that it won’t come to that.  

I have recd the report from the panel of doctors headed by Dr Sareen recommending measures to prepare for a potential Stage 3 outbreak of Covid-19 in Delhi

We are ramping up our capacity for an eventuality of 1,000 daily positive cases, for testing, treatment and isolation.

— Arvind Kejriwal (@ArvindKejriwal) March 27, 2020

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What does Stage 3 mean?   The four stages of transmission are being defined by medical experts as the following:   Stage 1: Imported cases   When all the confirmed cases have a travel history of going to an affected country.   Stage 2: Local transmission   When the virus is transmitted from cases of Stage 1 to people they came in contact with. Stage 3: Community transmission When the source of transmission cannot be traced for a majority of cases. The confirmed cases in this stage neither have travel history to affected countries nor have they come in contact with any confirmed patients.   Stage 4: Epidemic When the disease takes the form of an epidemic, the transmission gets completely out of control and the disease has no clear end. Entering the stage of community transmission would mean that a large number of patients (going by Kejriwal’s tweet, 1,000 per day) will need to be tested, isolated and treated. The healthcare infrastructure is under a lot of pressure already - India’s planning body Niti Aayog put out a call for doctors who are fit and able to volunteer in the fight against COVID-19. This would include doctors who are retired or those who may work in the private or military sector. Additionally, many healthcare workers have already tested positive for the novel coronavirus in India since personal protective equipment (PPE), which is essential for them at this point, is in short supply. Unless it is made more easily available, we may see more cases in healthcare providers in Stage 3 - just like Spain did.

Unprecedented times call for unprecedented measures!

In the fight against the #COVID19, the Govt requests volunteer #doctors who are fit and willing to be available, to come forward & provide their services during this global pandemic.

Register: https://t.co/EbQDwiELbR pic.twitter.com/0bXl89nWmv

— NITI Aayog (@NITIAayog) March 25, 2020

No community transmission - yet As of now, the Health Ministry still maintains that there are no signs of community transmission. The question has been raised multiple times during press briefings and each time the answer is the same: if we all practise social distancing, India will not enter Stage 3.   Avoiding Stage 3 is an ideal case scenario. More developed and less populated countries than ours haven’t been able to manage it. Maybe it’s best that our leaders are taking all the precautions they can at this point so we’re ready to fight the disease at a greater scale if we do enter the stage of community transmission. For more tips, read our article on   How does COVID-19 spread? Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.