Table of Contents:

Part XXX. Post Publication Independent Review of “The invisible pandemic”

Published at:

https://www.ijbst.org/covid-19-post-publication-reviews/part-30

Twitter Communication Link:

https://twitter.com/PrabhuBritto/status/1259057829140262912

Publons Review Link:

https://publons.com/review/7954860/

Post Publication Independent Review of

The invisible pandemic

Johan Giesecke

Published: May 05, 2020 DOI: https://doi.org/10.1016/S0140-6736(20)31035-7

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31035-7/fulltext

Review Comments:

1. Quote “Many countries (and members of their press media) have marvelled at Sweden's relaxed strategy in the face of the coronavirus disease 2019 (COVID-19) pandemic: schools and most workplaces have remained open, and police officers were not checking one's errands in the street. Severe critics have described it as Sweden sacrificing its (elderly) citizens to quickly reach herd immunity.¹ The death toll has surpassed our three closest neighbours, Denmark, Norway, and Finland, but the mortality remains lower than in the UK, Spain, and Belgium.²” End of Quote

The author is attempting to highlight a new perspective.

2. Quote “It has become clear that a hard lockdown does not protect old and frail people living in care homes—a population the lockdown was designed to protect.³ Neither does it decrease mortality from COVID-19, which is evident when comparing the UK's experience with that of other European countries. PCR testing and some straightforward assumptions indicate that, as of April 29, 2020, more than half a million people in Stockholm county, Sweden, which is about 20–25% of the population, have been infected (Hansson D, Swedish Public Health Agency, personal communication). 98–99% of these people are probably unaware or uncertain of having had the infection; they either had symptoms that were severe, but not severe enough for them to go to a hospital and get tested, or no symptoms at all. Serology testing is now supporting these assumptions.⁴These facts have led me to the following conclusions” End of Quote.

The author has made some interesting observations and seems to be banking on them for some conclusions drawn using those observations.

3. Quote “Everyone will be exposed to severe acute respiratory syndrome coronavirus 2, and most people will become infected. COVID-19 is spreading like wildfire in all countries, but we do not see it—it almost always spreads from younger people with no or weak symptoms to other people who will also have mild symptoms. This is the real pandemic, but it goes on beneath the surface, and is probably at its peak now in many European countries. There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear. I expect that when we count the number of deaths from COVID-19 in each country in 1 year from now, the figures will be similar, regardless of measures taken.” End of Quote.

· These insights seem unique and different and so do the preceding observations.

· Let us try to fit the Indian COVID-19 response, with specific consideration to the huge population, population density, and challenges in providing simultaneous healthcare solutions to such a large population.

· India went into complete Nationwide lockdown on March 24, 2020 for three weeks.

· Details and progressive changes can be seen at https://www.mohfw.gov.in/

· This was followed by an extension to May 3^rd and then further to May 17, with progressive relaxation.

· The recorded incidence was low and the curves were starting to grow.

· Health infrastructure enhancement along with supplies procurement and replenishment was done in a timely manner, so that health service insufficiency may not be rampant when COVID-19 spikes in INDIA.

· It was noticed that the COVID-19 containment and treatment protocols were adaptive and evolutionary, with modifications done as per requirement, with continuous monitoring in place.

· Recently, some relaxation measures for the industry to resume work partially have been done.

· Transport Services are gearing up to operate at reduced transport load with physical distancing and preventive measures incorporated.

· Education Systems have already switched to online teaching learning processes, with more adaptive evolutions coming in periodically.

· At the same time, the priority task of treating COVID-19 patients and containment/prevention of outbreak is also underway in full swing, with the Authorities & Officials of the Service, Allied & Related Ministries & Departments exhibiting their service levels at very good appreciable levels.

· Glitches if any, are overcome in a timely manner, and the work of the COVID-19 containment and treatment processes continue without break.

· When the authors observations and insights are going to be felt acutely in INDIA, INDIA would have already undertaken the COVID-19 containment and treatment processes in a systematic way, and it would be in a better position to possibly overcome the unique pattern of the COVID-19 outbreak as indicated by the authors.

· It may take some time for everyone to understand and appreciate that India is fulfilling the COVID-19 containment and treatment processes in a good & appreciable manner, but as the author pointed out, it will take one year for the results to speak out & in this case, it will be one year more for the results to favourably speak about the INDIAN COVID-19 containment and treatment processes.

· This post publication review records appreciation for the INDIAN COVID-19 containment and treatment processes (ahead of the one year time duration for the results to speak) and at the same time, suggests that glitches be continuously cleared on war-footing so that the results (one year from now) may be better than actual.

· Reference is hereby sought to https://www.ijbst.org/covid-19-post-publication-reviews

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