What is common between the northernmost district of Kerala and the South Korean city of Daegu? And what is the connection between them and the Pink City of India and Chicago? Also, what links them to Malaysia and a small town in eastern France?
All these places have become infamous for the rapid spread of COVID-19 through those described as “super spreaders”.
A super spreader is broadly defined as an individual or group who spreads the infection to many people.
This concept is not unique to COVID-19. Super spreader cases related to other diseases have been documented as far back as the early 20th century. The most infamous among these was perhaps Typhoid Mary (Mary Mallon), an Irish cook who infected 51 people of typhoid in the early 1900s.
One of the first reported super spreaders of COVID-19 was 'patient 31', a 61-year-old woman who participated in a gathering in the Shincheonji Church in the South Korean city of Daegu. She was tested positive for COVID-19 on February 18. The number of cases jumped from below-50 to above 2,000 in ten days. South Korea until then had done a great job of containment, but it suddenly saw an exponential rise in the number of cases. Patient 31 ignored the advice of doctors and travelled extensively through the country, coming in contact with approximately 1,160 people.
“The situation here was not really serious until mid-February. It began to get very serious starting with patient 31. Before patient 31, our strategies to contain the virus were working. But after countless people were infected by patient 31, it became very difficult to control," said Hwang Seung-sik, a spatio-temporal epidemiologist at Seoul National University.
Another super spreader was the the Islamic missionary movement Tablighi Jamaat’s event in Malaysia where 16,000 people (including 1,500 foreigners) attended a gathering at the Sri Petaling mosque compound in Kuala Lumpur from February 27 to March 1. Out of Malaysia’s first 673 cases (reported till March 18) almost two-thirds were linked to this four-day gathering.
A similar event was organised by the Jamaat in the Nizamuddin area of Delhi from March 13-15. Of the 4,400 confirmed cases in India as of April 7, a third were linked to the Nizammudin Markaz spread across 17 states of India.
In another incident, at least 40,000 people were quarantined in Punjab following a coronavirus outbreak linked to a Sikh priest. The 70-year-old came back from Germany via Italy and after returning to his village Pathwala ignored advice of self-isolation and attended several religious gatherings. He also travelled to the Hola Mohalla festival in the nearby city of Anandpur Sahib, where between March 10 and 12, thousands attended the cultural event. Singh died shortly after on March 18 because of COVID-19.
A prayer meeting at an evangelical church in Mulhouse, a small town in eastern France in late February, seeded the growth of the virus in the country, according to their health minister, Olivier Veran. “The tipping point was the evangelical gathering in Mulhouse. The epidemic spread across the country from the gathering,” Veran told France’s Le Journal du Dimanche newspaper.
Amesh Adalja, an expert in emerging infectious diseases at Johns Hopkins University stated that although the term 'super spreader' does not have any set scientific definition, one does see a higher number of cases related to such individuals or events. "In general, it is usually a markedly higher figure when compared to that of other individuals," she told AFP.
The connection between the spread of COVID-19, or any virus, and religious gatherings is complicated and difficult to control and contain – the primary reason being the power of faith and people’s beliefs. For centuries people have been indoctrinated and taught not to question faith. They believe God will save them and they can’t get affected where they worship. Then to suddenly develop a scientific temperament and be told to keep away from places they regard as sacred is, to say the least, a Herculean task.
But not all the COVID-19 super spreaders around the world are related to some religious meeting.
A resident of Chicago with respiratory symptoms went to pay his respects at a funeral and took part in a birthday celebration with his family three days later. Unknowingly, he set off a chain of transmissions that infected 15 people, three of whom died.
There are many cases of super spreaders not linked with any religious gathering back home in India too.
A native of Kudla in Kasargod in northern Kerala violated the isolation protocol after his friend from Dubai tested positive on March 19. He attended public and marriage functions and did not cooperate with the police when asked about his whereabouts and travel history. A total of 609 people were placed under observation in Kasargod.
Ramganj, a locality of Jaipur, saw almost 100 people infected by a 45-year-old man who returned from Oman and ignored quarantine rules.
Noida witnessed a surge in cases after an auditor of a fire safety company, Ceasefire in Sector 135, visited from the UK earlier in March. 41 of the 62 cases reported till April 9 in the neighbourhood are linked to Ceasefire.
In Mumbai’s Prabhadevi, a 65-year old woman, who served lunch to a corporate office in the area, tested positive, sending hundreds who bought meals from her into isolation at Kasturba Hospital.
A doctor from a mohalla clinic in east Delhi tested positive after treating a COVID-19 patient from Saudi Arabia. Nine hundred people in contact with the doctor have now been quarantined.
Another doctor from Rajasthan’s Bhilwara, a city famous for textiles, allegedly contracted the virus from relatives visiting from Saudi Arabia. He went on to infect 16 others in the hospital which has forced 8,000 people to be kept in isolation.
Dr Rajeev Jayadevan, senior consultant gastroenterologist and deputy medical director, Sunrise Group of Hospitals, has an interesting theory which relates the super spreader to aerosols (fine liquid droplets in air). “The SARS-CoV-2 virus is present in large numbers in the throat of a person before the onset of symptoms. Even though such people do not cough or sneeze, they are well-known to spread the virus, sometimes even as super spreaders,” he says.
“There is evidence that when a person talks in a closed space, the throat secretions get aerosolised. This is an efficient way to spread the virus to the next person. The longer the time spent sharing the closed space, the greater the dose of virus inhaled by others.”
Dr Jayadevan further says that speaking louder can produce up to 10 times more droplets. This potentially explains the devastation caused by super spreaders especially in religious gatherings where there are prayer services in close proximity by thousands of people often in a closed environment.
Historically there is a lot of stigma associated with being a super spreader which perhaps explains the non-cooperation of some who may have unknowingly spread the virus. Yet, there are others who have broken the law due to sheer carelessness and selfishness, violating the isolation guidelines, creating panic, and putting the lives of thousands in the community in danger.
Comments
0 comment