Remember “three Cs” scenarios –1^st Case, 1^st Cluster and 1^st Community spread whenever a new Case comes 

India, 28 cases: 3 Kerala, 1 Telangana, 1 + 6 Delhi, 1 + 1+ 15 Jaipur

1. Cases in Delhi and Telangana: Red alarm
2. Cluster in Jaipur: Red alarm
3. Community spread not yet
4. People who have been in contact with the positive cases in last 14 days must be isolated: Yellow alarm
5. All others (standard precautions): Green

Red: Infected cases; Yellow: Close contacts of infected cases; Green: Others

In the last 24 hours, almost 9 times more cases have been reported outside China than inside China. Epidemics in the Republic of Korea, Italy, Iran and Japan are of significant concern. The cases in the Republic of Korea are most likely to emerge from suspected cases from the 5 known clusters, rather than the community. It is important as it indicates that surveillance measures are working and Korea’s epidemic can still be contained.

This virus is not influenza. This respiratory pathogen has the potential of community transmission, however, it can be contained, if right measures are taken.

• Of the 88,913 cases reported across the globe, 90% are from China, mostly 1 province.
• Of the 8,739 cases reported outside China, 81% are from 4 countries.
• Of the other 57 countries affected, £ 10 cases have been reported from 38 countries, 1 case from 19 countries, and none from many countries as they have already contained the virus in the last 2 weeks.

No one-size fits all approach

Different countries are in different scenarios:

• Over 130 countries have not detected any case yet
• Some have just mentioned their first cases on March 1
• Some countries have clusters of cases, with transmission between family members and other close contacts
• Some are experiencing rapidly expanding epidemics while some have declining epidemics, and have not reported a case for more than 2 weeks.

Some countries are experiencing more than one of the above mentioned scenarios at the same time. For instance, China had community transmission in Wuhan, however, relatively small numbers of cases have been reported in other provinces. Other countries also have a similar pattern.

The basic actions in all scenarios remain the same, however, the emphasis may change according to the country affected.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA