Coronavirus COVID-19 ‘superspreaders’ are emerging as the lepers of the 21st century
Posted on July 28th, 2020

By Rebecca Armitage, Lucia Stein Courtesy ABC News

A Sri Lankan man in a face mask  shot through a window
Sri Lankan auto rickshaw driver Prasad Dinesh was linked by officials to nearly half the country’s more than 2,600 coronavirus cases.(AP: Eranga Jayawardena)

With governments around the world actively pursuing contact tracing of COVID-19 cases, it’s becoming more common to see a certain term emerge around specific clusters.

The people at the centre of these outbreaks are being called superspreaders — which has been loosely interpreted to mean an individual responsible for infecting a high number of others with a virus.

While science suggests some people are more infectious than others, history has taught us that society often treats these individuals during disease outbreaks as outcasts and lepers.

It was the case for Typhoid Mary, who was forced to spend nearly three decades in isolation in the US after she was blamed for several outbreaks in New York from the turn of the century.

But while that may have been a true case of a superspreader, more recently the term has been used to broadly label someone considered to be at the centre of a larger outbreak.

A row of women lying in beds in a hospital dorm
Mary Mallon (foreground), who was nicknamed Typhoid Mary by the media, was forcibly quarantined as a carrier of typhoid fever in 1907 for three years and then again from 1915 until her death in 1938.(Wikimedia Commons: The New York American)

In many cases they have been the villains of the COVID-19 pandemic. You’ve probably read about some of the stories.

There was the case in South Korea where an alleged “superspreader” was dubbed a “public harm auntie” by locals after it was reported that she spread the disease to dozens of people who attended religious services at her church.

And in India, there was controversy early on around a preacher who died of COVID-19. He was dubbed a superspreader after 19 of his relatives tested positive.

Certainly it appears as if both individuals didn’t follow appropriate public safety measures, but some experts have raised concerns about whether one person can truly be responsible for a large outbreak.

“We have this tendency to scapegoat a population or individuals,” said Dr Diego Silva, a lecturer in bioethics at the University of Sydney.

“Why that’s the case, whether it’s fear or ignorance, I’m not entirely sure, but certainly in the case of politicians, they’re using it to further their agendas.

“We are definitely seeing that in the context of COVID-19.”

Three women in hazmat suits holding umbrellas
Early on in South Korea blame centred around a “public harm auntie”.(ABC News: Brant Cumming)

It was no surprise then that a similar story began to emerge in Sri Lanka, where nearly half of the country’s coronavirus cases have been blamed on one man.

As the country’s infection rate spiralled in April, ‘Patient 206’ was slammed by the government as an irresponsible superspreader on television and social media.

The criticism was swift as further details came to light. Patient 206 was accused of infecting 1,100 people — including 900 sailors — when he robbed houses to support his heroin addiction.

How fast is coronavirus growing around the world?

050100150Days since 100th case1001k10k100k1MCumulative known casessince 100th caseAustraliaBrazilChinaIndiaJapanMexicoRussiaSwedenUSS. KoreaNZTaiwanUK

Data sources: Johns Hopkins Coronavirus Resource Center, Our World in Data, ABC

But then the accused superspreader came forward and cast doubt on the Government’s claims.

“I can’t accept that I am responsible for infecting so many, including the navy sailors,” 33-year-old Prasad Dinesh said.

It is not clear if Mr Dinesh is actually more infectious than others.

But he says he makes a useful scapegoat for a government that has regularly demonised drug users.

How coconut robberies allegedly started the spread

According to local authorities, on April 5 Mr Dinesh was caught by village residents for a robbery and handed over to police.

A man in shorts, t-shirt and face mask swings a small child on a hammock
Prasad Dinesh says he’s had difficulty finding work to support his family since being slammed by the Sri Lankan government as ‘Patient 206’.(AP: Eranga Jayawardena)

While he was at the station, police said they noticed he had a fever as well as a leg injury sustained during the robbery.

He was admitted at a nearby hospital, where he tested positive for the coronavirus and stayed for 31 days.

AP reports that Mr Dinesh hasn’t contested charges that he and the others he was with broke into a house in a nearby village to take coconuts they could sell in order to buy heroin.

Once he had tested positive, those associated with the arrest — including the police involved and Mr Dinesh’s friends — as well as more than 100 people in his neighbourhood were ordered to quarantine at home.

A man in a face mask looks out a window
Prasad Dinesh says he is being blamed for Sri Lanka’s outbreak because he used to be a drug user.(AP: Eranga Jayawardena)

Amid concerns not everyone was following the rules, Sri Lanka sent in a navy team to the outbreak area.For the latest news on the COVID-19 pandemic follow our live updates.

It sparked a panic among some of Mr Dinesh’s associates — some of whom reportedly tried to climb fences and trees when the sailors arrived.

AP has reported that of the 28 people seized from the community and quarantined, 16 tested positive. Two weeks later, some sailors involved in the operation did, too.

It took more than one man to spread the virus

According to the World Health Organisation, the problem with using the term superspreaders in these situations is that it puts the blame on the person.

“[It is] the circumstances and the situation that makes transmission exist, not the person,” spokesperson Sylvie Briand said.

In the Sri Lankan case, questions have been raised over whether the navy were equipped to handle tracing COVID-19 cases.

Navy spokesperson Lieutenant Commander Isuru Suriyabandara has defended the navy, saying troops were well-trained and wore protective gear. He said the group were quarantined for 21 days after the operation.

Read more about coronavirus:

On April 22, the first infected sailorwas reported. He was on leave in the town of Polonnaruwa, about 225 kilometres northeast of Colombo, prompting health officials to isolate 12 nearby villages.

The next day, 30 other sailors tested positive.

A group of men wait in a line with masks on as a woman sits in a chair as a man in scrubs moves to swab her nose
Under President Gotabaya Rajapaksa, the country has used the armed forces to combat the virus.(AP: Eranga Jayawardena)

In response, authorities ordered troops from all arms of the military to report back to their camps.

Some 4,000 navy sailors were quarantined inside a single camp, while more than 200 relatives were taken to navy-run quarantine centres.

At least 15 villages were isolated in different parts of Sri Lanka for about two weeks, and about 1,300 other people underwent self-quarantine.

Stay up-to-date on the coronavirus outbreak

Ultimately, about 900 navy sailors tested positive, with around 50 other infected people also part of that cluster.

Two other clusters also blamed on Mr Dinesh had at least 150 coronavirus cases, according to authorities.

But given how things unfolded, experts have suggested this is more likely a result of a superspreading event rather than one person.

Experts concerned with how superspreaders are treated

Mr Dinesh is not the only person who has been personally blamed during the coronavirus pandemic.

Ms Briand warned back in February that calling people superspreaders puts them at risk of stigma.

While social pressure from public health officials and the media might encourage people to stay home, experts say COVID-19 shame could dissuade people from being tested.

“We know from previous infectious diseases that people often defy public health orders, not because they’re malicious, but because they have other issues at play, like needing to feed their family and pay their rent,” Dr Silva said.

Dr Silva said we all have a shared responsibility during a pandemic to practice social distancing and stay home when sick.

But he warned against singling out individuals who have fallen ill and unknowingly passed on the disease.

“Responsibility should be shared in a pandemic, and I think it’s very dangerous — especially when it’s an airborne virus — to blame one person,” he said.

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