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Published on: May 17, 2020
3 minute read
By: Dr Rajan Choudhary

Contact Tracing During Covid Times

Testing is quickly becoming a statistic of national pride. Countries are clamoring to test more and more people and increase accessibility for the population to receive testing. We will cover testing, its aims, and its future in a separate blog. Testing people is only half the story. It gives us information on who is infected, but to minimize the spread of infection other measures must be introduced alongside it. Contact tracing is one of these measures.

WHAT IS CONTACT TRACING

Most people who fall ill or test positive for COVID can spread the virus 2-3 days before getting the first symptoms. They can unintentionally infect the people they meet in public or work with. If infected, these people can also spread the infection without knowing it, and this leads to a rapid spread of COVID in the community, as we saw at the start of this pandemic.

Lockdown has been very good at reducing R0 (rate of infection spread), but this is done crudely by physically keeping people separated in their own homes. As R0 reduces and lockdown restrictions ease, this will no longer be feasible. By aggressively testing the population we can identify people who may be infected and instruct them and their household to remain in lockdown.

Contact tracing aims to identify the people who have been in close proximity to a person who has tested positive. This is traditionally done by questioning the infected person about their recent travel, people they met, where they work, and so on. These contacts are then instructed to isolate as well and can be tested to confirm infection. By preventing these potentially infected patients from spreading the infection, the R0 decreases and the second peak in infections is prevented.

This is not a new concept and is used often for communicable diseases such as tuberculosis or sexually transmitted infections. It has also been used in previous pandemics including 2003 SARS outbreak. In 2014 Liberia experienced one of the largest contact tracing efforts in history, with 25,000 people identified annually. Similarly in the US 29,000 people were monitored by state and local health departments after returning from West Africa, and this laid the groundwork for future COVID-19 contact tracing efforts.

The WHO has laid out guidelines for identifying potential contacts, including:

Being within 1 metre of a COVID-19 case for >15 minutes;
Direct physical contact with a COVID-19 case;
Providing direct care for patients with COVID-19 disease without using proper personal protective equipment (PPE);

COVID TRACING

Today countries have updated their methodology for contact tracing, utilizing technology and smartphones to increase the accuracy and volume of data available to public health officials.

South Korea had contact tracing plans in place due to the MERS epidemic in 2015, and this was built upon for COVID. Contact tracing utilizes smartphone GPS data, credit card transaction records, and surveillance camera footage. At Seoul’s Incheon International Airport, there are walkthrough facilities to test people with symptoms of COVID and follow up those without symptoms in 3 days. New arrivals also have to download a government smartphone app to track their location and provide info on symptoms.

Singapore’s mobile app also utilizes Bluetooth data to determine devices that have been in close proximity to the infected persons’ phone and tracking these devices can identify potential contacts. It has over 1.1 million users, just under one-fifth of the country’s population.

Apple and Google together own almost the entire mobile operating system market with their respective iOS and Android platforms. They have worked together to create a framework that can allow governments to efficiently create and utilize contact tracing apps. Their efforts use Bluetooth Low Energy beacons. Nearby devices that wirelessly “shake hands” create randomly generated codes without any user-identifiable details (name, location etc). Based off Bluetooth data it can provide an estimate on distance and length of contact. If one of the devices is identified as belonging to an infected person, all devices that have been in close proximity are alerted.

LIMITATIONS

There are limitations present, both with the methodology used and with contact tracing itself. For one, it is quite a laborious and expensive process, and works well when there are low levels of infection in the community. During pandemics, it can quickly overwhelm the contact tracing departments if they are not adequately prepared and provide excessive information that cannot be utilized effectively. It is also not useful during a lockdown, as the lockdown itself artificially lowers infectivity. Instead, it must be implemented once the peak has passed.

Effective contact tracing is also expensive and labor-intensive. The state of Massachusetts has budgeted $44 million for its contact tracing program with 2,000 tracers. If implemented nationally it would cost the US an estimated $3.6 billion and require as many as 300,000 tracers. For app-based contact tracing to work around 80% of the population needs to have the app installed, and we have seen even small countries like Singapore struggle to push past 20%.

Finally, a major issue is a privacy. Poorly coded apps with little transparency can fail to anonymize vital personally identifiable data. This may be accessed by third parties or sold on to others, putting the privacy of millions of people at risk. There are also concerns by privacy watchdogs on the unfettered access by governments to this data, and whether this can be used in an oppressive manor.

If implemented correctly contact tracing has the potential to have a significant impact on reducing infectivity and allowing states and countries to open up their economies quickly and safely. Of course, this depends on the widespread use of contact tracing, and people abiding by government suggestions. Sadly, in the news, it is now too common to see resistance to basic measures such as use of masks in public, so we will have to see whether contact tracing will have any better success.

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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Role of Nutrition in Disease Prevention: How Food Choices Shape Long-Term Health

Disease prevention is no longer limited to vaccinations and medical screenings. Modern healthcare increasingly recognises nutrition as one of the most powerful tools for preventing illness before it begins. The role of nutrition in disease prevention is especially important in India, where lifestyle-related diseases account for a large share of premature illness and mortality.

According to the Indian Council of Medical Research (ICMR) and the National Family Health Survey (NFHS-5), poor dietary patterns contribute significantly to rising cases of diabetes, heart disease, obesity and hypertension. Unlike genetic factors, nutrition is a modifiable risk factor, meaning everyday food choices can actively protect health.

Why Nutrition Is Central to Disease Prevention

1. Nutrition regulates metabolic health

Balanced diets help maintain:

healthy blood sugar levels
optimal cholesterol balance
stable blood pressure

Disruption in these systems increases disease risk.

2. Nutrition strengthens immunity

WHO highlights that immune function depends heavily on adequate intake of vitamins, minerals and protein.

3. Nutrition controls inflammation

Chronic low-grade inflammation is linked to most lifestyle diseases. Diets rich in whole foods reduce inflammatory markers.

Major Diseases Influenced by Nutrition

Diabetes and Prediabetes

Excess refined carbohydrates and sugar drive insulin resistance.

Preventive nutrition focuses on:

whole grains
fibre-rich vegetables
adequate protein
controlled portion sizes

ICMR data shows that dietary modification can delay or prevent type 2 diabetes in high-risk individuals.

Cardiovascular Disease

Heart disease remains a leading cause of death in India.

Nutrition impacts:

cholesterol levels
blood pressure
arterial inflammation

Diets low in trans fats and high in fibre significantly reduce cardiovascular risk, as confirmed by WHO and Lancet studies.

Obesity

Obesity increases the risk of multiple chronic diseases.

Preventive nutrition addresses:

calorie density
food quality
satiety regulation

NFHS-5 reports a steady rise in overweight and obesity across age groups.

Hypertension

High sodium intake and low potassium intake contribute to high blood pressure.

Preventive dietary strategies include:

reducing processed foods
increasing fruits and vegetables
maintaining mineral balance

Certain Cancers

Diet influences cancer risk through:

antioxidant intake
fibre consumption
reduced exposure to carcinogenic compounds

WHO estimates that a significant percentage of cancers are preventable through diet and lifestyle changes.

Key Nutrients That Support Disease Prevention

Fibre

Supports gut health, blood sugar control and cholesterol reduction.

Protein

Essential for muscle health, immune function and metabolic balance.

Healthy Fats

Omega-3 fats reduce inflammation and protect heart health.

Micronutrients

Iron, zinc, vitamin D and B vitamins are essential for metabolic and immune regulation.

NFHS-5 highlights widespread micronutrient deficiencies in India, increasing disease vulnerability.

Role of Gut Health in Prevention

The gut microbiome plays a major role in:

immune regulation
inflammation control
nutrient absorption

Fermented foods and fibre-rich diets support healthy gut bacteria, strengthening disease resistance.

Why Preventive Nutrition Works Best Early

Nutrition is most effective when applied:

before disease onset
during pre-disease stages
alongside regular health screening

Once disease progresses, nutrition remains supportive but may not reverse damage fully.

Nutrition vs Medication in Prevention

Medication treats disease; nutrition reduces risk.

WHO and NITI Aayog emphasize that:

preventive nutrition reduces disease incidence
lifestyle modification lowers healthcare burden
early nutrition changes reduce dependency on long-term medication

Both approaches work best when combined appropriately.

Workplace and Community Role in Preventive Nutrition

Structured nutrition programs at workplaces and communities:

improve awareness
support behaviour change
reduce population-level disease burden

Lancet studies show that group-based nutrition interventions improve long-term adherence.

Common Myths About Nutrition and Disease Prevention

Myth 1: Supplements replace healthy food

Whole foods provide better long-term protection.

Myth 2: Prevention requires extreme diets

Consistency matters more than restriction.

Myth 3: Nutrition only matters after diagnosis

Early nutrition is most effective before disease develops.

Building a Preventive Nutrition Routine

Effective preventive nutrition includes:

regular meals
diverse food groups
portion awareness
minimal processed foods
hydration

Small daily choices compound into long-term health benefits.

Long-Term Impact of Preventive Nutrition

Consistent healthy eating leads to:

reduced disease risk
improved energy and productivity
better immune resilience
lower healthcare costs
improved quality of life

NITI Aayog identifies nutrition as a cornerstone of sustainable healthcare systems.

Conclusion

Understanding the role of nutrition in disease prevention empowers individuals to take control of their health long before illness develops. Balanced, consistent nutrition reduces inflammation, supports immunity and protects against chronic diseases that burden India’s healthcare system. Preventive nutrition is not about short-term fixes but about building lifelong habits that support health, resilience and longevity.

References

ICMR – Nutrition and Lifestyle Disease Prevention Reports
National Family Health Survey (NFHS-5) – Dietary and Metabolic Health Data
NITI Aayog – Preventive Healthcare and Nutrition Strategy Reports
WHO – Diet, Nutrition and Chronic Disease Prevention Guidelines
Lancet – Nutrition and Disease Risk Reduction Studies
Statista – Dietary Trends and Health Outcomes India
EY-FICCI – Preventive Healthcare and Nutrition Economics

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