If done well, contact tracing and case isolation is enough to control a #COVID19 in India over 3 months. Delays in identifying cases and incomplete contact tracing results in decreased probability of interrupting the transmission. thelancet.com/journals/langl… 1ofn #Covid19India 
Under best-case assumptions, screening will miss more than half of infected people. Most cases missed by screening are undetectable because they have not yet developed symptoms, are unaware they were exposed or have taken paracetamol to mask fever. ncbi.nlm.nih.gov/pmc/articles/P… 2ofn
#India has done exceptionally well in changing the course of what could have been a potentially devastating outbreak. Thanks to @ProfBhargava @ICMRDELHI @icmr_nie @Director_NCDC for the extraordinary measures and leadership in tackling the evolving situation. #Covid19India 3ofn
However, the course of action in next week will determine if we can avert the surge in cases.
1. Random testing of people with no symptoms, but travel history to countries with a high burden.
2. Tracing and random testing of travellers with no symptoms in the past 1 month 4ofn
1. Random testing of people with no symptoms, but travel history to countries with a high burden.
2. Tracing and random testing of travellers with no symptoms in the past 1 month 4ofn
Failure to detect Community transmission should not be confused with its absence. Our surveillance teams are good to detect if you tell them where to look. If we want to find transmission, look where it can be present; mostly around diagnosed and missed cases #covidinindia 5ofn
#India definitely has missed detecting local transmission in some of the large states. Let us remind, we need to identify all the cases, not few of them to interrupt the transmission. States with no and low cases should be reviewed personally by @ProfBhargava @narendramodi 6ofn
As per @WHO, serological surveys can aid investigation of an ongoing outbreak and assessment of the attack rate and find the extent of an outbreak. We should attempt to do that to be certain of the absence of community transmission. 7ofn #covid19inindia
Rapid tests by #NIV should be conducted on priority in the areas surrounding the inhabitations of those with travel history to the affected countries; not just around the confirmed cases. This is important to prevent the spread of transmission. 8ofn #covid19inindia
The samples from the Influenza-Like Illness network should be tested for #nCoV19. A simple examination of areas exceeding the expected rates in different areas of the country can direct where this testing can be done. #covid19inindia 9ofn
There is no shame in asking for help in such situations. It is time @MSF @IndianRedCross are involved in planning for transient arrangements for any possible surge in cases. We should have to get makeshift ICUs and #PPEs on priority for efficient management of adversities. 10ofn
While clapping can lift the morale of healthcare workers, what they really need are #PPEs. How much do we require for this country? What is the shortfall? Do we need help here? Also, what precautions should #ANMs and #ASHAs will have to take? 11of n #Covid19India
A virus can bring the globe to its knees; need strong #healthintelligence. Strengthening #surveillance system in India & having an autonomous #NCDC is of paramount importance with funding equivalent to @CDCgov. Otherwise, all this reactive brouhaha is nothing #nofn #Covid19India
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