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What are four stages of Covid-19 transmission and stage of India?

The four stages of Covid-19 transmission and comparing India with different countries based on these stages.

4-Stages-of-Covid-19
4 Stages of Covid-19 transmission

The prime minister of India Narendra Modi addressed the nation on 14th April’2020 for the 4th time in last 20 days and announced the lockdown till 3rd May’2020. The address is followed 48 hours after PM held meeting with CMs’ of all the states on Saturday to understand the situation in details and to check if the country can afford the further lockdown amid Covid-19 situation. Through the economy of the country does not give much leverage to extend the lockdown further but at same time objective of the Government is to delay stage 3 transmission or community spread of Covid-19 disease.

The Government along with the help of all the state Governments are trying there best to delay the stage 3 of Covid-19 transmission by providing frequent updates, by launching applications like Aarogya Setu, awareness campaigns & by setting-up 24/7 helplines. The local authorities along with the help of Government have made sure the the essentials items and groceries reaches to people.

Although we all have been hearing about the different stages of Covid-19 transmission in news and media, but most of us are still wondering what are the stages of Covid-19 transmission? Has India reached at a stage of community transmission? Has lockdown proved successful in controlling the community spread of coronavirus pandemic?

As the joint secretary (Health Department) Luv Agarwal has been assuring people through his press conferences that India has still not reached at the stage of community transmission of Covid-19 i.e. 3rd stage of Covid-19 transmission. Lets understand the four stages of Covid-19 transmission

  • Stage 1 – Imported cases: This is the stage when the cases starts emerging and cases reported have travel history to infected areas or countries. In this stage the cases can be traced with their source of origin based based on recent travel history. India was in this stage from January to mid march where the number of Covid-19 positive cases were low. Ideally in this stage the situation is under control as the number of cases reported are very low.

  • Stage 2 – Local Transmission: In this stage the the disease starts transmitting locally through an individual who either has a travel history, or have come in direct contact with the infected person. At this stage the disease gets spread through the affected person to his family, friends or neighbors directly. It is easy to trace the direct contacts in this case and can be asked to quarantine. According to Indian Council of Medical Research (ICMR), India is currently at this stage with around 10,000 total confirmed Covid-19 cases as of 13th April’2020 and have been able to do so by imposing the 21 days nation wide lockdown which is further extended.

Once we reach the community transmission stage, spread is extremely contagious and difficult to control, hence is a matter of concern for India, a country of 1.3 billion people.

MPMC expert: Source NDTV
  • Stage 3 – Community Transmission: This is the stage where the where community transmission starts and infections happen in public. At this stage the people who do not have any travel history to affected places or who have had no known contact with foreign source-person also starts getting affected. Once the community transmission starts, it becomes extremely difficult to trace the source of spread and controlling the chain of transmission. The only possible way to control the community spread is through geographical lockdown. The lockdown in India was imposed in stage 2 itself to delay the community transmission. The countries like Italy, USA, Germany have already passed this stage.
  • Stage 4 – Widespread Outbreak or Pandemic: This is the most dangerous stage of all when the virus goes out of control. At this stage the number of cases and deaths starts multiplying with no end in sight. In this stage the cases and deaths starts rising steeply in the exponential chart and the disease becomes epidemic i.e. native to the population. Countries like Italy, USA Spain and Germany are currently in this stage where as China passed this stage of transmission in February.

Regional Director of WHOs’ South-East Asia region Poonam Khetrapal Singh in one of her interview with IANS said

Community transmission in any country is confirmed when the source of infection is unclear. In other words, when transmission in a given area is extensive, in multiple locations, without reported travel history to areas reporting community transmission and without epidemiological links to known cases. Currently, cases in India have been traceable.” She also added that

Whatever the stage, the key action points are – engage with people; find, isolate, test and treat and trace every contact; ready your hospitals; and protect and train health workers. That’s the only way to combat COVID-19

Poonam Khetrapal Singh: Source IANS

Furthermore to understand the four stages for Covid-19 transmission, we ranked the countries based on the total Covid-19 confirmed cases and marked the stages of the countries. (Check world Covid-19 Tracker)

Current RankCountryTransmission Stage**Total Cases*Total Deaths*
1USAStage 45,73,82722,950
2SpainStage 41,69,49617,489
3ItalyStage 41,59,51620,465
4FranceStage 41,36,77914,967
5GermanyStage 31,28,0923,038
7ChinaBack in Stage 282,1603,341
8IranStage 373,3034,585
9TurkeyStage 361,0491,296
9BelgiumStage 330,5893,903
22IndiaStage 210,453358
48SingaporeStage 22,9189
62New ZealandStage 11,3495

*Source of Total Cases & Total Deaths is Worldmeters.info
**Base for stage marking is Coronavirus Situation Report by Who.int

As we see that Covid-19 confirmed cases and deaths in countries like USA, Spain, Italy & France are multiplying on a daily basis these countries have reached at stage 4 of transmission. Among these countries Italy has started showing some recovery with less number of case being reported on daily basis. On the other-side USA is epicenter of the outbreak with most number of confirmed cases of coronavirus in the world.

Also countries at stage 3 as per above chart are at very initial stage of outbreak as the number of deaths reported are less compared to other countries and the spread is being controlled by major locksdown. Also Germany is the 5th country based on number of confirmed cases but has one of lowest date rate compared to others.(Source)

Finally, the countries where the cases are still emerging and are traceable based on local transmission or travel history are at stage 2 or 1. China is an exception for being at stage 2 again because they have already passed stage 4 and number of new cases being reported are extremely low. India being at the stage of local transmission has been able to control the situation by taking proactive and strong decision of imposing the 21 days lockdown which may further get extended till 30th April’2020.

At the end, we leave it up our audience to decide “what stage of Covid-19 transmission does India stand?” Where many media houses are reporting that India has reached at stage 3, few media houses claims that India is still between stage 2 and stage 3. While you decide on this, do share your views with us at on WhatsApp (Click here) & we will publish the same in 2nd part of this article which is on Community Spread and where does different Indian states stand at stages of Covid-19 transmission.

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