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We are chasing the virus, say officials as new cases rise in Maharashtra, T.N.

India’s death toll from COVID-19 rose to 83 on Sunday, with 11 fatalities since Saturday. The number of confirmed infections across the country stood at 3,577 cases, with 505 new cases; 274 persons have recovered, the Union Health Ministry said.

“We are chasing the virus rather than the other way around and India’s strategy continues to be preventive. We rather be over prepared,” Joint Secretary in the Union Health Ministry Lav Agarwal said at Sunday’s press briefing.

The Ministry maintained that last month’s Tablighi Jamaat gathering in Delhi has pushed up the doubling rate of cases in India to 4.1 days from the estimated 7.4 days.

Reports from State Health Departments put the death toll across the country at 127, with 3,603 active cases. The maximum number of cases continued to be reported from Maharashtra at 748, with 13 fatalities in the past 24 hours. Tamil Nadu followed with 559 active cases, reporting two fatalities since Saturday.

Stating that there is no evidence to suggest airborne transmission of the novel coronavirus, head of Epidemiology and Communicable Diseases with the Indian Council of Medical Research Raman Gangakhedkar said rapid antibody-based blood test for COVID-19 would be deployed by Wednesday for high prevalence areas and hotspots across India.

Asked about concerns raised by doctors of AIIMS, Delhi, and other cities on the shortage of personal protective equipment (PPE), Mr. Agarwal said the situation should ease in a few days.

The rollout is likely on Wednesday

The Indian Council of Medical Research (ICMR) said the rapid antibody-based blood test for COVID-19 will be deployed by this Wednesday in clusters and hotspots showing high incidence of confirmed cases.

Raman R. Gangakhedkar, head of the Epidemiology and Communicable Diseases Division of the ICMR, explained that overall testing for COVID-19 using real-time reverse transcription polymerase chain reaction (RT-PCR), a laboratory technique combining reverse transcription of RNA into DNA, is increasing and that India would be approaching full capacity soon.

“At the same time, we are expecting delivery of rapid test kits (blood-based) for use in response to COVID-19 situation. By Wednesday, this should be up and running,” he added.

The Health Ministry added that all States/UTs had been issued guidelines for implementing these tests and reports may be entered into the ICMR portal, similar to results of real-time RT PCR tests for COVID-19.

DDL to start sample collection at Punjabi Bagh centre today

To work around the challenges of home-based testing in the country, Dr. Dangs Lab (DDL) plans to offer ‘drive-through test’ for COVID-19.

South Korea leads the world in the number of tests per million to check for coronavirus infection and it has been able to do it, partly, by allowing those who feel sick to drive up to a test centre where nurses wearing protective gear collect a nose or throat sample from the car itself. Results are mailed or messaged in a day. This method of mass testing has allowed reduced contact between patients and healthcare workers, thereby lessening the chances of transmission.

“Inspired” by the South Korean approach, Arjun Dang, CEO, DDL, said the test would conform with the guidelines of the Indian Council of Medical Research that mandates only those who have a doctor’s prescription to be offered a test.

“What we have seen so far is that many are uncomfortable with the home collection process. They are worried that lab personnel — despite being fully protected — may infect family members,” Dr. Arjun told The Hindu.

Testing apprehensions

Navin Dang, president, DDL, said that some people are worried that lab personnel visiting home in full protective gear would scare the neighbours. “There are also instances when spouses of some of our own lab personnel have been told by their partners to live separately for a month. It’s to address such concerns that we are offering this facility,” he said.

The drive-through test, which the lab will begin to offer at its Punjabi Bagh centre in west Delhi from Monday, would require those wanting a test to pre-register, pay online and provide details of their car. There would be a 30-metre gap between cars. “A stretch in the parking lot will be used for this purpose. The cars will be parked in designated spots, windows rolled down, samples collected and they will drive off. Each test should take about 20 minutes,” Dr. Arjun said.

Testing for COVID-19 costs ₹4,500 and the drive-through test cost will be “similar”, he added, but didn’t specify the exact price. People are already signing up online for the test, but the days ahead are likely to see an uptick in such visits, he said.

22 people in Karnataka had no foreign travel history

With 22 of the 151 positive cases, including the 75-year-old person who succumbed to the infection in Bagalkot on Friday, not having any foreign travel or contact history, Karnataka health officials are at a loss to understand how they could have contracted the infection.

While these 22 cases, whose detailed investigation is still under process, raise questions as to whether it is the beginning of community transmission in the State, officials have been continuously denying it. These 22 people have so far spread the infection to eight others. Also, as a precautionary measure, hundreds of their secondary contacts have been isolated in their homes.

For instance, despite detailed investigation, health officials have still been unable to find out the cause of infection in the Nanjangud case of a pharma company employee, who is the first of the 17 who tested positive there. The 35-year-old person (patient number 52), who did not have any foreign travel or contact history, tested positive on March 26. Subsequently, 14 more employees from the same company got infected and tested positive “simultaneously”.

While officials said that three of the 14 employees were in close contact with patient 52, it is still not clear how the remaining 11, who were neither his contacts nor had any travel history, got the infection.

Patient 52 also spread the infection to three of his relatives. Last Thursday, two roommates of one of these 11 employees also tested positive.

On Saturday, two more persons from Mysuru with no foreign travel or contact history, tested positive too. Sources said Mysuru has now become a “cluster hotspot” and aggressive prevention measures should be taken to stop the spread.

Similarly, on March 10, a 10-month-old baby from Dakshina Kannada, who tested positive, is also one such case that officials are concerned about. This baby or his parents did not have any foreign travel history. The only possibility is that the baby’s mother and grandmother had taken him to Kerala to a relative’s house.

In Bengaluru, a 62-year-old woman and a 24-year-old male who did not have any foreign travel or contact history have tested positive.

Admitting that tracing the cause of infection in some of the positive cases has become “complicated”, Jawaid Akhtar, Additional Chief Secretary (Health and Family Welfare), told The Hindu that the officials were very close to finding the cause of infection in the Nanjangud pharma firm employee case. “We have found some clues. However, it is too early to term this spread as community transmission,” he said.

More than 50 crore beneficiaries can get free services in designated private hospitals across India

Expanding coverage: States are in the process of enlisting private hospitals to be converted.Aadesh Choudhari Aadesh Choudhari

The Central government has decided to provide free testing and treatment of COVID-19 under the Ayushman Bharat Scheme.

This, it notes, will help more than 50 crore Ayushman beneficiaries to get free testing and treatment in designated private hospitals across India.

Confirming this, Indu Bhushan, CEO of Ayushman Bharat, said this would allow beneficiaries to get timely and standard treatment.

The announcement comes after India registered an increase of 302 cases in the 12 hours to Sunday morning. The total number of positive cases has risen to 3,374 in India (including 3,030 active cases, 267 cured/discharged/migrated people and 77 deaths), according to the Health Ministry.

Giving details, Dr. Bhushan said: “The empanelled hospitals can use their own authorised testing facilities or tie up with an authorised testing facility for the scheme. These tests would be carried out as per the protocol set by Indian Council for Medical Research (ICMR) and by private labs approved/registered by the ICMR. Similarly, treatment of COVID-19 by private hospitals will be covered under AB-PMJAY.”

The objective of the decision was to increase the supply of testing and treatment facilities and increase access by roping in the private sector through AB-PMJAY scheme as per the ICMR guidelines, he said.

Private sector

Union Health Minister Harsh Vardhan said that “in this unprecedented crisis we have to very actively involve the private sector as a key partner and stakeholder in the fight against COVID-19. Making testing and treatment available under Ayushman Bharat PM-JAY will significantly expand our capacities by including private sector hospitals and labs and mitigate the adverse impact of this catastrophic illness on the poor.”

He added that States were in the process of enlisting private sector hospitals that could be converted into COVID-19 only hospitals.

Information on symptoms, testing and treatment for the disease can be accessed from the website of the Health Ministry and by calling the national COVID-19 helpline 1075.

City has enforced home quarantine and ensured doorstep delivery of essentials

Ahmedabad, which has reported over 50 COVID-19 cases and five deaths, has been identified as one of the hotspots of the pandemic. It is fighting the virus through innovative means: use of technology, home quarantine and delivery of essential services at the doorstep in certain clusters.

The Ahmedabad Municipal Corporation (AMC) has taken several initiatives even before the lockdown started on March 24. On March 5, it announced a plan that mandated home quarantine for all those who returned from abroad. “From March 6 to 22, 6,000 people came to Ahmedabad from abroad. All were compulsorily quarantined for 14 days. When we realised that it was important to quarantine their families too, we ensured that they were quarantined and all essential services were delivered by the civic body,” AMC Commissioner Vijay Nehra said. He said the home quarantine of international passengers had a major effect; only a couple of cases were reported from among them.

As the cases started coming in, the AMC, in a first in the country, declared the names and addresses of infected persons citing public interest. “The names of the persons found positive may be declared in public interest so that others who could have come in contact with them can voluntarily inform the authorities and isolate themselves,” the civic body said. During the lockdown, the civic body started delivering vegetables and fruits in different localities and asked Reliance Fresh, DMart and Big Bazaar to deliver provisions and food items at the doorstep.

When the exodus of migrant workers started, the AMC asked all builders and developers to make sure that the workers from their sites did not flee.

The AMC has created 500 teams of health workers and others for a door-to-door survey. Those with even mild symptoms will be taken to hospitals for testing.

The civic body wants mass testing of people from certain areas from where cases have been reported in order to weed out the potential asymptomatic patients. “In consultation with the Health Department, the next step is to go for mass testing to ascertain the extent of pandemic in the city,” he said.

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