ICMR's decision to conduct random sampling to gauge if there has been community transmission in India is much debated. What is your opinion on this strategy?

What, in your opinion, is the right approach?

What could be the downside of random sampling?

India is currently said to be in Phase II and measures are being taken to halt progression to the next stage. Will the measures be adequate?

What should the government have done?

Dr Jacob John , former chief of ICMR's Centre for Advanced Research in Virology , speaks to TOI on why the outcome of random sampling may not be a correct measure of the extent of the Covid-19 threat— I personally don't agree with it. At this time, I feel it could be a waste of time and resources, or even diverting resources from what they should be actually doing. It assumes that cases of Covid-19 are randomly distributed, which is not the case. A time will come when distribution of infection is widespread, when random sampling will tell us the likely magnitude of infection prevalence. When you know that infection has reached a region, then testing pneumonia cases there will help. Without knowing if infection is spreading in a place, random small-size sampling will give misleading data.— A "sampling approach" is for monitoring statistical probability. That is a research method to monitor statistical trend. What we need is diagnostic support service for all suspected cases. What we need is universal testing based on the criteria for suspecting Covid-19 infection. All hospitals should be instructed to ask patients with fever of recent origin if fatigue and cough are present. If all three symptoms are present, that is a suspect case. If you want to know if the infection has reached a particular town, clinical screening is first step. In random sampling, you could test 10 patients, but what if the 11th one has Covid-19?— For a rare infection, random sampling is almost always negative. It could lull people into confidence and complacency. For a common infection, random sampling will give a measure of magnitude. If you want to know if infection has reached some place, all suspect cases — not just a sample — must be tested. So, the crux is knowing prevalence frequency before one goes for a sampling approach.— Phasing this pandemic can be tricky. Cities or communities could be going through different phases at any given point in time. To say that a city — Pune or Patna , for instance — and the rest of the country are in the same Phase II is unscientific and could make people confident that things are under control.Think of fire sparks falling in different spots at different times. At each spot, the fire will go through various phases. These phases depend on when Phase I started. India had many places at stage zero, some in stage 1, others in stage 2. In the states ( Maharashtra and Kerala), careful analysis is needed to see if a shift from stage 2 to 3 is happening. If stage 1 occurs, 2,3 and 4 are inevitable. When in stage 2, interventions appropriate for 3 must be in place. Always ahead of the progression of the epidemic.— The government should have understood that this is a national emergency of unprecedented magnitude. A strategy for uniform application in all states should have been planned. Allowing each state to decide for itself is not good. There should have been a strategy planning group.