A smoker stops by a neighbourhood paan shop, picks up a single cigarette, places it between the lips, lights it and then with a sense of gratification blows out a whirl of smoke or inhales deeply into the lungs. This would rate as the most commonplace of activities in India, where buying loose cigarettes is a deeply-ingrained habit.
But, wait a minute. What happens if, by chance, the vendor happens to be an asymptomatic COVID-19 individual? From an infected finger, the cigarette stick goes straight into the mouth of the smoker.
Amid the COVID-19 pandemic, something as routine as buying loose cigarettes is suddenly a high-risk act. For the uninitiated, cigarettes are packed with the filter-end on top which is what comes in contact with the finger when it is picked out of the pack, and that is the part of the cigarette that is placed between the lips.
The habit is not restricted to a few isolated paan shops, but is widely prevalent across the lanes and by-lanes of the country. Strangely, buying loose cigarettes has somehow escaped the radar of do’s and dont’s that have been drilled into our brains that include “maintain social distancing, disinfect hands often, wear a mask” etc. etc.
Recently, an entire family, whose details are being withheld for privacy reasons, was infected with COVID-19. The family, comprising an elderly woman, a middle-aged couple and their son—all of them were tested positive. Fortunately, they have almost recovered, but the question is: How did they get infected?
They were home-bound and except for one individual, who took the dog for a walk and bought groceries, the rest stayed indoors all the time. It then transpired that the individual, a smoker, who stepped out occasionally, picked up loose cigarettes. Though not confirmed if that was the reason for catching the infection, chances are that this may have been a cause too as the family lived near a market that turned out to be a COVID-19 cluster.
The point is while there are many ways of getting infected, buying loose cigarettes could well be one among them. The habit of buying loose is so deep-rooted that this may have not been thought of by a smoker. When this question was posed to an ENT specialist, he said it was possible to get infected if the vendor is COVID-19 positive.
The alternative is to buy an entire pack of cigarettes, which reduces the chances of transmitting an infection, but not eliminate it entirely. But the question is how many among the poorer sections can afford to buy a full pack at a time. It’s a tough call, undoubtedly, like many other dilemmas the pandemic has forced the world to deal with.
At a time when government-imposed restrictions seem to have limited use and cases of COVID-19 are rising continuously across the country, the government led by Prime Minister Narendra Modi has indicated that it is the responsibility of the individual to take care of themselves.
However, it is not clear how many take the advice seriously as there are still scores of people moving outdoors without masks and spitting in public spaces, among other things.
Dr Renuka David, managing director of Chennai-based The Radiant Medical Services, who has been conducting at least two awareness webinars every week, says that over a period of time, people have become casual about the pandemic.
“This can only be worked out through counselling and reiterating the need to follow protocols of social distancing, hand washing and wearing masks, at all levels. We probably have to show examples of people who were asymptomatic a few days back and died later due to COVID-19 to make them understand the need to take preventive measures seriously. They need to understand that as mature individuals they have to behave more responsibly, as they are harming themselves and those around them,” she says.
Dr Renuka says that while India’s recovery rate has jumped to over 60 per cent, the death rate too has increased a little to over three per cent.
In West Bengal, the pressure from the population has forced the authorities to relax social distancing norms in public transport services.
Initially, when public transport services in green zone districts of the state resumed from May 18, buses were allowed to ply only with 20 passengers. Taxis and autos could not carry more than two passengers. The guideline was modified in view of an increase in the number of commuters after the unlocking process started from June 8.
According to one theory – the Hill’s criteria for causation—a single or fleeting exposure to the coronavirus may not be enough to get infected. It is exposure over time that causes infection.
An entry in Wikipedia states that “there are nine principles that can be useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect and have been widely used in public health research”.
Though by no means definitive, as many such theories in science are, The Hill’s criteria list the strength of the virus, or the virus load, consistency and specificity, among others as needed for an infection.
But, anecdotally and statistically, the steady and expansive growth of COVID-19 would lead a layperson to fear the coronavirus that seems to be all-pervasive and potent. Even more worrisome is the fact that epidemiologists themselves are divided on various aspects of the pandemic, leaving the common person on the street gobsmacked.
Ultimately, as some in the scientific community have said, “the world has to learn to live with the virus”, and the most effective way to ward off an infection is to probably re-examine several personal habits that one has become accustomed to, and if found to be a risk factor for COVID, to simply drop it or take a chance, with eyes open.