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'We may have 5 lakh-10 lakh infections per day and around 5,000 deaths a day by mid-May'

Last updated on: May 06, 2021 08:00 IST

'Even with 3 lakh cases a day, we have saturated our resources.'
'It is scary to even think what will happen when the number doubles.'

IMAGE: A woman waits to receive oxygen support at a gurdwara in Ghaziabad, April 27, 2021. Photograph: Adnan Abidi/Reuters

More than 3 lakh covid cases every day.

Thousands of people dying, gasping for breath.

That is the situation India is in right now.

Will there be a pause in the way the coronavirus is spreading?

Is the graph of the infection going to come down?

Unlikely, says Dr Anoop Thekkuveettil, senior scientist in the division of molecular medicine at the Sree Chitra Thirunal Institute of Medical Sciences and Technology in Thiruvanathapuram, whose team has been studying the virus from the time it made its appearance in India.

In an interview with Shobha Warrier/, Dr Thekkuveettil, explains how the R value is important to study to control the spread of virus.

IMAGE: Family members mourn a COVID-19 victim at the Patna Medical College and Hospital, April 27, 2021. Photograph: PTI Photo

I read that when the R- value of COVID-19 should not go beyond 1 but in India it is 1.5 and in some states it is close to 3. What is R value, and why should we keep it below 1?

R value is the value we calculate for the reproduction of the virus. It is a mathematical modelling system where the reproductive value is calculated based on the number of infections, mortality rate, and the speed at which the virus spreads. All these parameters are put together in a formula, and we calculate the rate at which the virus reproduces.

It is a predictive value that says what future looks like.

If the R value is below 0.5, it means 2 people can spread to 1 person. You see the graph is going down.

If the R value is 1, one person is going to spread the virus to another person. Because the speed at which the virus spreads, the number can go up fast, for example, 1 person becomes 2 and 2 becomes 4 and 4 becomes 8....

If the R value is 2, 2 infected people will give it to 4, and 4 to 8; you can call this an exponential growth and it is scary.

This is the situation in India right now where the R value is more than 2.

We had an R value of 0.9 in January this year. That was when we thought this pandemic was going to go down. That is one of the problems with R value; it is very spontaneous. For example, when the mortality rate doubled in three days, the R value would dramatically change.

Can the R value give a realistic picture of how the virus is behaving?

It is one of the predictive values. We have to look at a number of parameters to get the realistic picture.

How important is R value to understand the behaviour of the virus?

It is found to be very effective. It is one of the main parameters many countries look at to control the virus. For example, Germany, UK etc looked at R value very seriously and planned all their programs to keep it below 1, and this has been found to be effective.

When they see that R value is going down, they will know the controlling measures are working.

IMAGE: Police personnel ask people to stay at home during a Flag March to enforce strict implementation of the coronavirus-induced lockdown in Dara, north central Mumbai, April 27, 2021. Photograph: Shashank Parade/PTI Photo

Reports say that after the second national lockdown in the UK, when the R value came down to 0.7 and 0.9, they started opening up...

Yes, it is a very good indication that the measures taken are working. Still, if some small pockets have higher R value, they can work on that small pockets alone.

This is one way of controlling the pandemic and it has helped the UK a lot.

IMAGE: COVID-19 patients at Shehnai Banquet in New Delhi, which has been turned into a Covid care centre, receive treatment, April 27, 2021. Photograph: PTI Photo

In India, do we look at the R value to take decisions?

We do calculate the R value but we need to have measures to control the spread. Calculation is one thing and just looking at the number going higher and higher and not taking any proactive steps to stop, is another thing.

In Kerala, we are following the R value seriously and when it went higher, the authorities decided to visit each house to do testing to locate the number of positive people, and then isolate them. It is a good way of controlling the virus.

But people are moving around. You have to stop that so that the reproductive rate of the virus is controlled. The virus is reproducing only because it is getting another host.

You should not allow the virus to get another host. That is why 15 days isolation of each positive person is important.

Isolation is the most serious step to take if the R value is going up. In Bihar, Assam, etc, it has gone up to 3 now!

IMAGE: Dead bodies queue up at the Subhash Nagar cremation ground early in the morning for the last rites, New Delhi, April 27, 2021. Photograph: Amanpreet Singh/PTI Photo
IMAGE: Dr Anoop Thekkuveettil. Photograph: Kind courtesy Dr Anoop Thekkuveettil

Is not the R value of 3 very alarming as it means 1 person can infect 3 people, and 3 can infect 6...?

It is very, very alarming. If you look at the graph of the number of cases in India with 3.35 lakh infections per day, you will see it going up in a vertical line with no peak in sight.

That is how the peaks looks like when the R value is going up. You have no idea where the peak is going to be.

It is very scary to look at a vertical line as it can go up to any height.

If this is the kind of reproductive rate we are seeing, we may have 5 lakh-10 lakh infections per day and around 5,000 deaths a day by mid next month. This is what epidemiologists are also predicting looking at the R value graph.

Even with 3 lakh cases a day, we have saturated our resources. It is scary to even think what will happen when the number doubles.

This disease makes a person to be in the hospital for at least 10 days, and we don't have that many beds available. We may have a serious crisis in the country unless something is done immediately.

What can and what should the administration do now?

One option is, you have to think of closing down.

Feature Presentation: Ashish Narsale/