With 1.3 billion people jostling for space, India has always been a hospitable environment for infectious diseases of every kind. And the coronavirus has proved to be no exception: The country now has more than 6 million cases, second only to the United States.
And the report confirmed, as other studies have, that a small number of people are responsible for seeding a vast majority of new infections. India “is a place where you would expect a disease like this to roar through, at least in the older populations,” said Dr. Krutika Kuppalli, an infectious disease expert at the Medical University of South Carolina. “They haven’t seen that as much as you would expect.”
“I think what they were able to do is actually really remarkable, to be quite honest,” said Kuppalli, who has spent time in Tamil Nadu doing public health work. Contact tracing has proved difficult enough to do in the United States, she said. “I can’t imagine what it would be in a place like India, where it’s such a more crowded, crowded area.”
For example, more than 5,300 school-age children in the study had infected 2,508 contacts but were more likely to spread the virus to other children of a similar age. Because the researchers were not able to get information for all of the contacts, they could not assess the children’s ability to transmit relative to adults. But the finding has relevance in the school debate, as some people have argued that children spread the virus to a negligible degree, if at all.
The researchers noticed a key difference in those who did become sick and were hospitalized: They died on average within five days of being hospitalized, compared with two to eight weeks in other countries. The patients in India may deteriorate faster because of other underlying conditions like diabetes and high blood pressure or poor overall health, Lewnard said.
Conditions may be similarly dire in other resource-poor nations. The amount of time patients may spend in the hospital is a “key planning parameter” for governments preparing for outbreaks, Lewnard said, and longer hospital stays can create bottlenecks during a surge.
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