In-Situ and Ex-Situ Transmissions of COVID-19

Paojakhup Guite *

Of late, rumours roared buzzingly across the State that COVID-19 had reached its climax of transmission: Community Transmission. In epidemiology, community spread happens to be the third stage. At this stage, sources of the disease are not known.

The World Health Organisation (WHO) defines Community Transmission as one which is “evidenced by the inability to relate confirmed cases through chains of transmission for a large number of cases, or by increasing positive tests through sentinel samples (routine systematic testing of respiratory samples from established laboratories)”.

In the US, a Community Transmission of the disease (COVID-19) has three specific source countries. Therefore, community spread in the US means those cases which are occurring in people who did not have any known contact with others from China, South Korea or Italy.

Similarly, in Manipur, the third stage of transmission of COVID-19 may be evidenced by inability to relate confirmed cases through chains of transmission for a large number of cases to those who have a “staying history” in quarantine centres i.e., occurring in people who did not have known contact with someone from Community Quarantine Centres (CQC) or Institutional QCs or Home Quarantines. Community Transmission as such is yet to take place in the state (if not prevented in the right direction).

As of I write this piece, Manipur has contracted 4-digit cases of COVID-19. These thousand cases have been clinically confirmed through sentinel samples thanks to the Government of Manipur. However, none of these cases can be traced or related to a community spread. Most of them had their transmissions happened among the inmates themselves inside the Quarantine centres.

I call this mode of transmission as In-Situ transmission. Apart from this transmission, we also have some confirmed cases on who had initially tested negative while in a quarantine centre, but later confirmed positive after a requisite 14-day or more quarantining. Still in this case, s/he is believed to have contracted from fellow inmates i.e., both having a staying history in Quarantine centres.

I call this mode as Ex-Situ transmission. Both the in-situ and ex-situ transmissions are non-local, non-community. They can be collectively called Managed Transmissions. The managed transmissions, namely in-situ and ex-situ transmissions are said to be the spill-over effects of mismanagement of transportation and quarantine facilities of returnees.

Air Transmission

One of the fastest modes of transport is airways. Ministry of Civil Aviation was quite prompt to consider the home sickness of its people living outside their home states. The Union Ministry works with State Governments of the country in unison to repatriate the expatriates.

As a result, while a stringent lockdown was strictly enforced on ground, traffic began to jam in the air from 25th May, 2020 after a brief ban on airways.

The passengers reached quarantine centres in 4 to five hours time. Asymptomatic persons carried with them the disease. Hence, the disease travelled in such a breakneck speed to reach the jewelled land (Manipur) through air. Thus, air is being polluted.

At the initial stage, due to lack of testing technology and of Personal Protective Equipments (PPE) kits, quarantining alone was not robust enough to contain the disease within its four walls. Worse, Quarantine centres were not able to provide basic amenities to the inmates. This raised questions of security concerns.

Lack of basic amenities poses an existential threat (basic necessities like toilet, washroom, diet, etc.) to humankind. This existential threat to the inmates was a viable route for the virus to spread easily to as many as people in a very short span of time.

In a nutshell, COVID-19 is a passenger-borne and not air-borne. Let’s give time to the World Health Organisation to refute its own earlier finding that the virus is not air-borne. Kudos to those experts who have, after a series of rigorous research, lettered the world health body to review its earlier guidelines on transmission of the Coronavirus.

If the air-borne transmission is proved, Lockdown 6.0 is likely to be imposed all the more harshly. Alas, our atmospheric aerosols have been adulterated by the airways!

Real Transmission

Maximum contractions in minimum time of the disease happened through railways. Numbers of passengers are comparatively larger and the time taken to reach a destination is over 19 times more than that of airways.

Defying Standard Operating Procedures (SOP), passengers turned the Shramik special trains as an Opera centre- enjoyed the whole journey with music, songs and instruments on the train. Not maintained social distancing guidelines. They thronged in groups . Therefore, Rails apparently have become the real breeding ground of COVID-19.

Behavioural Transmission

Only pointing at the infrastructural loopholes in the Quarantine centres might not do us good. Expecting a VIP treatment will be counterproductive- since late last year, we have had an unstable government in the state. In fact, hitherto, finance might not have been an issue.

Rather, the issue at hand is the moral failures of the inmates who could not bear the brunt of existential challenges. The Government, therefore, under the garb of Civil Society Organisations (CSOs) have invested most of their times in lecturing.

Flouting the guidelines on the train continued till the Quarantine centres. Some inmates were seen in their worst discipline. They even felt like meeting in their rendezvous. Some were exposed to their erotic dancing moves by themselves. The news of this undesirable behaviour went viral and national.

While even religious gatherings were prohibited, some inmates were found in group in some Quarantine centres without maintaining social distance and performed their religious worships therein. For such zealot persons, humanity appears to be contradictory with religion.

Rather, the two are complimentary and go hand in hand. As long as humanity exists, so will also religion. Religion is something which is ingrained in us, and humanity needs to be inculcated. For atheists, humanity is their religion.

Prison Bluff

Government should not always play a face-saving tactic. Declaring that a violator of Quarantine SOPs be put into a prison is a gimmick. Nevertheless, the government calling for the bluff was the immediate and viable solution against the clamours of half-fed disgruntled inmates.

Battle against COVID-19 is not to be fought by government alone. It is a people’s war. From government to returnees to quarantinees to common people, we have to stand together on a war footing to emerge victorious against this disease. Doing this would reduce the burden of doctors, Para-medics and other frontline health workers.

Eventually, human beings will develop such a technology and immune system to edge the dreaded SARS-CoV-2 out of humanity not to come back forever.

(The write-up tones satirical, and yet the writer puts up his best to walk the tightrope).

* Paojakhup Guite wrote this article for Imphal Times
The writer can be reached at guitepaojakhup9(AT)gmail(DOT)com
This article was posted on July 11, 2020.

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