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Total cases of COVID-19 in India touch 162, including 25 foreigners; global figure crosses 2,00,000

With 255 Indians testing positive for the novel coronavirus in Iran and another 21 in other countries, the total number of Indian nationals afflicted with the pandemic rose to 413.

The cases within the country touched 162, including 25 foreigners, on Wednesday.

Globally, the number of cases crossed 2,00,000.

The Ministry of External Affairs confirmed in the Lok Sabha that 255 pilgrims visiting Iran from Kashmir and Ladakh had been affected.

A third batch of 195 Indians from Iran were brought to Jaisalmer by an Air India aircraft on Wednesday evening.

Cases in India

According to reports from the States, 19 new COVID-19 cases were reported within the country, while 14 persons had been discharged. The number of active cases is now 145. Over 5,700 people, who had come in contact with positive cases, continue to be under surveillance, the government said.

Karnataka reported three fresh cases on Wednesday, taking the number of infections to 14. The number of cases in Maharashtra rose to 45, including three foreigners, while in Ladakh it rose to eight, in J&K to four and in Tamil Nadu to two.

Telangana has reported six cases, which include two foreigners. Rajasthan reported seven cases, including two foreigners. Andhra Pradesh, Odisha, Uttarakhand and Punjab reported one case each.

In Haryana, there were two cases, while 14 foreign nationals are being treated in a private Gurugram hospital.

A 34-year-old soldier tested positive in Leh, Army sources said on Wednesday.

At least 13 States and Delhi have opposed the new format

At least 13 States, and Delhi, covering almost 60% of the total population of India, are opposed to the National Population Register (NPR) being updated in the format being prepared by the Centre, even as the nationwide exercise is scheduled to kick off on April 1.

Union Home Minister Amit Shah told Parliament last week that people could choose to not respond to questions, but Chief Ministers and activists have said that this is no guarantee that they would not face any problems in the future.

On March 3, the Ministry of Home Affairs (MHA) informed the Lok Sabha that it was in discussion with the States that had expressed concerns over the controversial additional questions in the NPR form. There has, however, been no further clarification since then.

On February 18, the MHA informed a parliamentary panel that “during the updation of NPR 2020, it is proposed to collect data on some additional items like place of last residence, mother tongue, Aadhaar number (voluntary), mobile number, passport (Indian passport holder), voter ID card, driving licence number, date and place of birth of father and mother”.

The Centre hasn’t as yet officially published a pro forma for the NPR.

“The Centre has said it is not mandatory, but hasn’t dropped the questions,” West Bengal Chief Minister Mamata Banerjee observed earlier this month. “Now, if you don’t provide these documents, they won’t ask for it. They will simply mark you as a D (doubtful) voter,” asserted Ms. Banerjee, who spoke before Mr. Shah’s statement last week that nobody would be marked ‘D’ for their inability to provide such documents.

From the second phase, when local transmission takes place, it is an integral part of fighting the epidemic on the ground

With the Hyderabad techie reportedly spreading his infection to a large number of people that he came into contact with, the issue of tracing contacts becomes very crucial.

Beginning from the second phase of the epidemic — local transmission — which Indian Council of Medical Research Director-General (ICMR) Balram Bargava claims the nation is currently couched in, contact tracing is an integral part of fighting the epidemic on the ground.

Also read | Interactive map of confirmed coronavirus cases in India | State Helpline numbers for COVID-19

Properly done, contact tracing and follow-up health interventions will ensure that the infection spread is limited and retard or stop the pace of the epidemic to the third stage — community transmission.

What is contact tracing?

Contract tracing is the process of identifying, assessing, and managing people who have been exposed to a disease to prevent transmission. As per ICMR guidelines, which are also directions that have sound public health sense behind them, people who may have been exposed to the virus are to be followed for 28 days from the date of the probable last exposure/arrival from affected countries.

 Any person who has had contact with the index patient under investigation/treatment for suspected, probable or confirmed case of SARS-COV-2, should be monitored for the appearance of symptoms.

Who is a contact?

Anyone who provided care for the suspect or confirmed case, including a health care worker (including those involved in cleaning, waste management, laboratory technicians, doctors) or family member, or any one who had close physical contact; anyone who stayed at the same place (lived with, or visited) while the index patient was symptomatic.

Coronavirus | The importance of ‘contact tracing’

If symptoms appear within the first 28 days following the contact, the individual should be considered a ‘probable’ case and reported through the Integrated Diseases Surveillance Programme network to the National Centre for Disease Control.

Tracing contacts

As soon as the single event (confirmed SARS-CoV-2) is detected, contact tracing must be aggressively implemented, and preferably to be completed within 48 hours.

The contact tracing shall preferably be done by visiting the local residence of the contact(s) by a member of the health services team. In certain circumstances or for follow-up, phone calls may be made too, as per the rules.

On meeting the ‘contact person’, the visiting health worker should explain the purpose of contact tracing and collect data in a prescribed format. It is important to identify the social networks of the first patient and travel history during the 28 days after the onset of illness.

Also read: Data | COVID-19 is deadliest for the elderly

The patient, his or her family members, colleagues, school or college mates are sources of information about the contacts, as are others with knowledge of the patient’s recent travel and activities.

Contacts should be traced and monitored for at least 28 days after the last exposure to the case patient for evidence of COVID-19 symptoms to emerge. Case-wise line listing of all exposed contacts will be maintained, with the following information: demographic information, date of last exposure or date of contact with the case patient, and date of onset of fever or other symptoms, if any.

Symptomatic contacts

Persons who have fever and cough and a history of contact with a confirmed case within the last 28 days should be referwred for isolation for strict infection control.

Also read: Are diabetics more prone to COVID-19?

Samples must be collected and sent to the designated laboratory for testing, and appropriate wmedical management must begin. If contacts show symptoms, they may be isolated at a health care facility or at home until the results come in. Once confirmed as positive for SARS-CoV-2, they must be shifted to a proper health facility.

Asymptomatic contacts

They must remain at home (home quarantine) for at least 28 days after the last exposure with the patient. The contacts should start monitoring their health and watch for symptoms of fever and cough, within 28 days of the last exposure to the patient, and maintain a list of people they are in contact with, on a daily basis.

If he or she develops symptoms, as defined, the contact must wear a mask, self-isolate at home, and inform the local health authority. For 28 days after this, health officials will do an active monitoring of these people.

Health workers

The rules also require the health officials to follow certain precautions while they meet contacts. They are required to maintain a distance of at least two metres from the contact, wear masks, and maintain standard infection prevention and control measures, especially hand-washing.

Coronavirus has nothing to do with food and people can eat whatever they want and how much ever they want

Will wearing masks prevent the spreading of COVID-19?

If you are travelling to places where the probability of catching the infection is high, say hospitals, you need to wear masks. If you are using public transport system, where you cannot know if somebody will sneeze or cough, you can use a mask. But the main prevention mechanism is to frequently wash your hands and refrain from shaking other people’s hands or hugging them. Follow cough etiquette when you are travelling or outside.

Dr. P. Kuganantham, founder-chairman, Indian Public Health Foundation, and former Chennai City Health Officer

Should people avoid eating meat-based food to prevent transmission?

Coronavirus has nothing to do with food or pet animals or eating chicken and mutton. People can eat whatever they want and how much ever they want.

Dr. V. Ramasubramanian, consultant, Infectious Diseases, Apollo Hospitals

How soon can a vaccine be developed?

Novel viruses happen due to reassortment. They remain for a short period and mutate depending on factors like geography. A vaccine for COVID-19 is likely to be developed in another three to six months because the trials are on at the moment. Like H1N1, a vaccine can be developed for COVID-19 too.

Dr. P. Kuganantham

In the case of a hit-and-run virus like SARS, no vaccine was developed because after six months it did not come back. If COVID-19 too disappears, then there wouldn’t be a need for one.

Dr. K.K. Aggarwal, president, Confederation of Medical Associations of Asia and Oceania, and former president of Indian Medical Association

Is there a link between a person’s immunity and COVID-19 transmission?

Coronavirus is one of the weakest family of viruses. People affected so far could have been ones with less immunity like children or the elderly. It does not affect everybody. Yes, 100% immuno-compromised people like those with HIV, people with cancer, those who have undergone transplant surgeries or people with diabetes are at risk. Children and elderly are at risk as well. If you take the history of all who died in China or Iran, 90% of them would have been suffering from an illness that compromises their immunity.

Dr. P. Kuganantham

The average age of virus death is 59. The mortality rate for people aged 60 and above after contracting a viral infection is 3.4%; above 70 years is 8% and 80 and above is 15%. Generally, if the immunity is good, you can tolerate any viral infection but there is no specific evidence as it pertains to COVID-19.

Dr. K.K. Aggarwal

If I have symptoms of COVID-19, should I approach the hospital directly?

You are not supposed to visit a hospital directly. In Delhi, you must call a hospital or doctor. There are designated centres to give your samples. Depending on your symptoms, a call will be made on what needs to be done, and they will come and collect a sample at your home. You cannot go to a hospital and infect others.

Dr. K.K. Aggarwal

There are helpline numbers to contact. At the Rajiv Gandhi Government General Hospital (RGGGH) in Chennai, there is a separate outpatient section for coronavirus cases.

You can visit here and consult a doctor and leave samples for testing. No other patient will be permitted to access this entrance. RGGGH is the only place in Chennai where samples will be collected for testing.

Dr. J. Euphrasia Latha

Are there any home remedies?

Home remedies and treatment other than allopathy is not proven science. The best thing is precaution only. You must keep away from a patient who coughs and sneezes. If you are coughing, you need to cover your face with a mask and not spread the droplets around. COVID-19 spreads through droplets.

Dr. J. Euphrasia Latha

 

Is India equipped to battle coronavirus?

We have started late. There are two steps in case of a viral outbreak — preparedness and containment. If you cannot contain, you delay and if you cannot delay, you research and mitigate the circumstances. Preparedness phased cannot be considered now when there already is infection. After 43 cases, now we are going through preparedness. It is a bit of a delayed response. You need both preparedness and containment tactics at the moment. At least, in India, community spread has not happened so far.

Dr. K.K. Aggarwal

We must change the focus of our battle to personal hygiene. For example, during the Ebola outbreak in Africa, the governments there were was able to contain not because of drugs and treatment but by improving personal hygiene. They mandated hand-washing frequently at schools and industries, which helped bring down the cases. For COVID-19, the management is only by handling patients with travel history. They need to be isolated for the incubation period and kept under observation.

Dr. P. Kuganantham

(Compiled by Deepa Alexander, Pradeep Kumar and Priyadarshini Paitandy)

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