Editorial

Speak softly and maintain a social distance from people who talk face to face, sing, shout or do breathing exercises

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Latest studies and a large coronavirus outbreak in Massachusetts question the spread of novel coronavirus.

As of now, it is known that the virus spreads primarily by people who have symptoms, such as fever, cough or difficulty in breathing. However, it appears that a Massachusetts coronavirus cluster with at least 82 cases was initiated by people who were not showing symptoms at that moment. Concordant to this report, over half a dozen studies have shown that people without symptoms are responsible for substantial infection.

In context to this, the World Health Organization (WHO) has mentioned that asymptomatic transmission is possible, though it is not a major factor that causes the spread.

How can the infection happen?

It is well known that a naked virus cannot travel on its own unless it is hitching a ride with a droplet of mucus or saliva. These mucus and saliva droplets are ejected from the nose or mouth as we cough, sneeze, breathe, laugh, sing and talk. If they don’t hit something along the way, they land on the floor or ground. To get access to the cells again, the viral droplets must enter through the nose, mouth or eyes. The most likely forms of transmission are sneezing and coughing. Talking face-to-face with someone could also enhance the risk. Sitting in front of someone who is singing, laughing, shouting or taking a forced large breath can shed the virus in the atmosphere. According to the reports by South Korea, patient No. 31, discovered on February 18 was a member of a quasi-Christian cult called Shincheonji. Shincheonji teaches to attend services. In this process, people sit closely together, breathing in spittle as they repeatedly amen in unison loudly. This patient was found to be responsible for infecting a huge population.

What can be your part?

Maintain a distance of 6 feet from someone who is singing. Do sympathetic breathing yoga only in parks in the sun (Bhastrika and Kapalbhati). They are otherwise good to build respiratory capacity. The distance between patient and doctors talking to each other should be 3 feet. Face to face meetings should have a distance of 3 feet. Speak softly and not loudly. Do not shout. Avoid joining laughter clubs in the morning during this period or maintain a distance of 6 feet with the other person. Ban balloon been blown on the roads with the mouth. Ban all toys in which the air has to be blown in. Maintain social distancing in all religious chanting.

References that suggest that asymptomatic people can transmit the infection

According to the CDC: "Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads". Coronavirus response coordinator, Dr. Deborah Birx’s, note on asymptomatic transmission: “Theyre trying to understand people under the age of 20 who dont have "significant symptoms" -- "Are they a group that are potentially asymptomatic and spreading the virus?" Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota reported that "We now know that asymptomatic transmission likely [plays] an important role in spreading this virus". Concern about the spread of the disease by people who havent yet developed symptoms, or who are only a bit sick was expressed in an article 2 weeks ago in the New England Journal of Medicine.

"There is also strong evidence that it can be transmitted by people who are just mildly ill or even pre-symptomatic. That means COVID-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people."

"Asymptomatic and mildly symptomatic transmission are a major factor in transmission for Covid-19," said Dr. William Schaffner, a professor at Vanderbilt University School of Medicine and long-time adviser to the CDC.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA