Worrying indicators 

‘Super-Spreader Events and Super-Spreaders’ was the somewhat curious main topic of the Issue Number 15 of the ‘COVID-19 Weekly Bulletin’ issued by the Integrated Disease Surveillance Programme (IDSP), Department of Health and Family Welfare, Nagaland on October 17. 

A thorough perusal of the IDSP’s analysis of the case status till October 16, however, showed that its preoccupation with the issue was not mere conjectures. As a public health watchdog, the infection trajectory in recent times justifies its concerns and accordingly be construed timely intervention and an ardent call for renewed vigilance amid the creeping weariness in the fight against the pandemic. 

What are Super-spreader events and who is a Super-spreader then? As per the bulletin, Super-spreader events “used to describe persons and events where the spread of COVID-19 is much than under normal circumstances.” “Normally one COVID-19 case will infect only one or two more people but super spreader events are where more than 10, 15 cases or even hundreds are infected in a single event,” it elaborated. 

Such events are related to the 3 C’s (Crowded places, Closed/ enclosed spaces and Close contact settings), where distancing, crowding, ventilation and other safety measures are compromised, it added. 

Digging little deeper into the weekly infection data also gives a clue to the State IDSP’s concerns. According to the Bulletin, in the week ending October 16, a total of 716 cases reported–the second-highest number of cases in a single week after July 31-August 6 when 964 cases were reported. There has been a gradual increase in cases after the 3rd week of September.

Most importantly, the October 10-16 period saw the highest number of traced contacts till date with its percentage among confirmed cases increasing from 7% in July to 56 % by mid-October. 

“This indicates shift of cases towards the community,” the Bulletin highlighted.  As a result, the positivity rate for the past week was 16.2 %, the highest so far and for the first time sample positivity rate in Nagaland at 8.5 % was higher than the national average (7.9%).

The data also pointed to violation of safety measures by mobile groups in the 21-40-years age group with the highest positive cases among traced contacts (53%) from the cohort. 

Positivity rate among office goers (27%) and household contacts (26%) continue to increase while it is also high among students at 16%, the Bulletin noted, calling for urgent implementation of SOP in work places and schools.  It was also reiterated that infections in the old and high-risk groups immediately follow after infections in the young. A total of 22,859 quarantine violations were also received from the PHQ through digital monitoring.

According to State’s IDSP, there were uncontrolled spreads in closed settings like restaurants, bakery, religious community etc due to disregard of basic safety principles, thereby increasing the  risk of spread in the community and further apprehension of “more hospitalizations and severe cases in the coming days.” 

All these data affirmed to the various well-documented case studies that human behaviour plays a crucial role in either controlling or spreading the virus. The State’s IDSP’s instructions on the only proven preventive measures till date on COVID-19 are clear – strictly follow the 3 W’s (Wash Hands, Watch Distance and Wear Mask) and avoid the 3 C’s (Crowded places, Close Contact Setting and Confined settings. To mount an effective response and ensure behavioural change, while proactive implementation of guidelines are imperative, the public health authority and other public agencies should also ensure that they are engendering abiding faith from the public.