Positive cases raise questions about quarantine

At least four asymptomatic people who had traveled to Kashmir three weeks ago have tested positive recently. The cases raise concern of asymptomatic carriers of COVID19 endangering lives of high risk groups with their complacence.

While the quarantine for COVID19 is meant to monitor suspected cases for symptoms for two weeks, new cases from district Shopian has given rise to many questions regarding the manner and mechanism of the preventive locking process.

Four people from Shopian who had travelled from Saudi Arabia to Delhi and from Delhi to Srinagar in the flight AI443 on March 16 have tested positive for COVID19 in the past three days. They were co-passengers of the first COVID19 positive patient of Kashmir – a Srinagar woman. Following this first case, all passengers who had travelled by that flight had been traced and put under quarantine in many areas of Kashmir.

The four people, that have now tested positive, had also been quarantined along with seven others from district Shopian at a PHC. Two weeks later, in absence of any symptoms, the passengers were discharged and sent home.

However, soon after, the passengers were again taken to hospital as one of their co-passengers had been found positive for COVID19. Surprisingly, four from this group also tested positive, three weeks after their arrival from Saudi Arabia.

Prof Parvaiz A Koul, head department of internal and pulmonary medicine at SKIMS, and an influenza expert says the “late positivity” could be due to two reasons. “Either the incubation period in these patients has been very long, which is quite rare,” he said, adding, “or they have got infected at the quarantine itself.” He said there was a possibility that one of the passengers was already positive for COVID19 when the group was put under quarantine and that person resulted in others getting infected due to cohabitation in a facility.

The second case scenario, he said, was “quite scary”. “If, under quarantine, people are not safeguarded against possible infection from each other, we are putting their lives at risk,” he said. He advocated home quarantine for asymptomatic contacts in order to avoid risk of cross infection. “Being asymptomatic in itself is a good and a bad thing,” he said. Prof Koul said asymptomatic carriers, although safe themselves, could put life of those at risk into danger. “The elderly and those with co-morbidities could get infected and it can prove life threatening for them,” he said.

Dr Naveed Nazir Shah, in-charge COVID19 at Chest Diseases Hospital said it was quite possible that the people in quarantine were exposed to the virus in the facility they were sharing. “One of the persons was possibly infected abroad or somewhere he visited, and that resulted in infecting others,” he said. He added that quarantine guidelines be implemented and respected by everyone. “People cannot be living too close to each other and huddling together,” he said.

Dr Shah said most of the COVID19 positive cases admitted with CD Hospital are asymptomatic. The hospital has 21 positive patients currently. He acknowledged that people who have no symptoms and are infected with COVID19 could be putting other people at risk. “In current scenario, it is important to maintain physical distance from everyone, symptoms or no symptoms,” he said.

Bhupinder Singh, nodal officer for COVID19, said the fact that most COVID19 positive people having no symptoms accentuated the need for lockdown. “Otherwise, we could be having a dangerous chain as people who have no symptoms go on infecting others,” he said.

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