Can neglegence toward COVID-19 symptoms initiate third wave of COVID-19 in India

ABSTRACT

Background: The second wave of Covid-19 had a huge number of asymptomatic, false negative (indeterminant) and symptomatic untested cases (query Covid). Objective: The aim is to understand the dynamics among these groups to know their impact on the spread of the diseases. Methods: In a prospective online survey we collected data using snowball sampling method via social media, from in and around Kolkata with the help of Google forms. The data included Covid related symptoms, evaluation, and behavior related to treatment during first and second wave of the disease. The discrepancies and duplicities were first excluded, and 989 respondents' data were statistically analyzed using SPSSver26. Results: The percentage of RT-PCR confirmed symptomatic and asymptomatic Covid cases were 21.84% (n=216) and 2.12% (n=21) respectively. Symptomatic but unconfirmed cases (query Covid) were 17.18% (n=170) and symptomatic false-negative cases (indeterminant) were 93 (9.40%). Rest 489 (49.44%) did not have any symptoms or never tested positive. The analysis revealed the reasons for doing RT-PCR test include a) less symptoms severity (47.06%), b)considering test unnecessary (22.94%),c) home collection unavailability(14.71%) and d)longer waiting time for results(8.82%). According to regression analysis, compared to confirmed Covid symptomatic group, only 47% [OR 0.13(0.57-0.30) p<0.0001] of query covid patients consulted doctor for test or treatment and 21% [OR9.55 (1.97-46.16), p<0.001] of indeterminant cases took medicine based on advice of friends/ relatives. Conclusion: There is a high percentage of untested (query Covid) and probable false negative cases (indeterminant) likely going unreported. The reasons for poor testing and seeking medical attention inadequately needs to be addressed and further investigated.