Very large population having freedom to move, poor governance,
added with poor health management and future vision as well as limited
health resources & infrastructure are important factors related to
increase in number of cases and deaths in India.
There may be different modes of transmission for SARS-CoV-2,
including contact, droplet, airborne, fomite, fecal-oral, blood borne,
mother-to-child, and animal-to-human transmission. Infection with
SARS-CoV-2 primarily causes respiratory illness ranging from mild
disease to severe disease and death, and some people infected with the
virus never develop symptoms11https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions. Looking
at huge number of cases and lack of well established meritorious
scientific research it’s very difficult for India to control the
pandemic. Like previous year if the pandemic subsides on itself then
India should develop a proper strategy with future vision.
Environmental factors - The environmental factors of key
importance are modifications and sanitary measures required to halt the
progress of pandemic. Water, sanitation, food and air quality are vital
elements in the transmission of communicable diseases and in the spread
of diseases prone to cause epidemics.
A number of environmental factors influencing the spread of SARS-CoV-2
diseases are prone to cause epidemics. The most important of these are:
- water supply
- sanitation facilities
- food
- Climate.
Climate can affect disease transmission in a variety of ways. The
distribution and population size of disease vectors can be heavily
affected by local climate. Flooding after heavy rains can result in
sewage overflow and widespread water contamination. In addition, there
is some evidence to suggest that pathogens can be spread from one
region to another along air streams or by wind22https://www.who.int/teams/environment-climate-change-and-health/emergencies/disease-outbreaks/.In India there is improper living condition in reference to
above mentioned conditions resulting in surge of cases and deaths.
Conclusion – In the epidemiological triad we have
agent/host/environment. For controlling this pandemic of covid-19 we
have to apply clinical & public health approach. Our mind should be
clear to have a keen and deep view of epidemiological triad. The
epidemiological triad (concept of causation) consist of agent (causative
factor), host (those who get infected from agent) and the surroundings
(ecology, environment etc.).
What we can do regarding agent; - We have to assess
following and act accordingly
- Various Strains & mutations
- Virulence of strains
- Infectivity of strains
- Pathogenecity of strains
- attack rate of strains
- secondary attack rate of strains
- reproduction number of strains
- Prevalence & Incidence rates of strains
- TCID-50 assay & cycle threshold of strains infecting
- Monitoring & evaluation of strains