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With first deaths reported in Bihar and Gujarat, toll rises to seven; inter-State transport, suburban trains, bus services suspended

All train, metro and inter-State transport services across the country were suspended on Sunday till March 31 as the death toll from COVID-19 rose to seven nationwide, and the number of confirmed cases stood at 396. Unprecedented restrictions were imposed in 80 districts across 17 States and five Union Territories affected by the pandemic.

The Union Health Ministry said Bihar and Gujarat had reported their first casualties from COVID-19. A 38-year-old man with a kidney ailment and recent travel history to Qatar died at AIIMS-Patna and a 67-year-old man died at a hospital in Surat. Another death of a 63-year-old man was reported from Mumbai.

Only essential services

“State governments will issue orders allowing only essential services to operate in districts with confirmed COVID-19 cases. The focus should be on closure of all activities except essential services such as hospitals, telecom, medicine shops and provision stores,” an official release said.

Cabinet Secretary Rajiv Gauba described the new measures as further “pre-emptive” actions, given the “sharp increase” in the number of confirmed COVID-19 cases in the country after curbs on international travel, contact tracing and efforts at social distancing.

Indicating that the ‘Janata Curfew’ on Sunday was a precursor of more stringent measures, Mr. Gauba, in a letter to the Chief Secretaries, said the States need to “build on the momentum” of the 14-hour lockdown.

Calling on the States to operate transport within their boundaries at a “skeletal level”, the Centre said all these measures were temporary in nature but “vital to break” the chain of transmission of the pandemic.

Earlier in the day, the Railways announced suspension of all passenger services until March 31, including suburban services. Only goods trains will run during the period, the Railways said, adding that trains that had commenced their journey prior to 4 a.m. on March 22 would complete their journeys.

Joint Secretary in the Health Ministry Lav Agarwal said the nature of “essential services” would be decided by the individual States. “We want to control the movement of people,” he said at a press briefing.

In response to questions, Mr. Agarwal was clear that more districts could be brought under curbs if they were affected. According to him, the lockdown was temporary in nature.

‘Probe-free detection assay’ sent to NIV, Pune

Researchers at the Indian Institute of Technology here have developed a method to detect COVID-19 that can significantly reduce the test cost, making it affordable for large sections.

The National Institute of Virology, Pune, is in the process of validating this test on clinical samples.

The “probe-free detection assay” has been optimised and tested for sensitivity at the research laboratories of IIT.

The Centre on Saturday recommended that the maximum charge for a COVID-19 test by private laboratories should not exceed ₹4,500.

However, the team at IIT claimed their test could be performed at a much cheaper cost. “Using comparative sequence analysis, we have identified unique regions in COVID-19. These unique regions are not present in other human coronaviruses, providing an opportunity to specifically detect COVID-19,” said Prof. Vivekanandan Perumal, lead member of the team.

‘Accurate results’

According to Professor Manoj Menon, the current testing methods available are “probe-based”, while the one developed by his team is “probe-free”, which reduces the testing cost without compromising on accuracy. “Primer sets targeting unique regions in the spike protein of COVID-19 were designed and tested using real time polymerase chain reaction. The primers designed by the group specifically bind to regions conserved in over 200 fully sequenced COVID-19 genomes. The sensitivity of this in-house assay is comparable to that of commercially available kits,” said Parul Gupta and Prashant Pradhan, members of the team.

“This assay can be used as a qualitative (yes or no) assay without the need for extensive instrumentation. In addition, it can also quantitatively assess virus loads,” they added.

The research team also includes Ashutosh Pandey, Praveen Tripathi, Akhilesh Mishra, James Gomes and Bishwajit Kundu.

States have been told to marshal all resources to contain the virus, says NITI Aayog member

Co-chair of the Empowered Committee for COVID-19 Response, India, and Member of the National Institution for Transforming India, NITI Aayog, Dr. V.K. Paul said the changed circumstances of the spread of the disease called for a revised testing strategy and marshalling of all resources to contain the pandemic.

Why has India revised its testing strategy making it more inclusive and now also allowing private laboratories to test? Is this an indication of the trends that you may be seeing in terms of a wider spread of COVID-19?

It’s best to align our thoughts with what the Prime Minister has articulated. We know we have a problem. We have been containing it to a large extent but the way these things pan out, emerging scenarios are unpredictable and can be very serious, so let us put our act together.

Why have we changed criteria? Because we think it is time to get the first indications to know if it is spreading in India. If it spreads, serious patients will come in and we cannot miss this indication. COVID-19 is a new animal in the zoo, we are still understanding the virus. We know that it is a pandemic, it is somewhat explosive and somewhat delayed. We may be better-off currently but be prepared for the worst. We should be sensible for the next two months.

NITI Aayog had advised the government to rectify the lack of health infrastructure, skewed patient-bed and medical staff ratio…keeping this in mind how prepared is India if we do slip into community transmission? The trends currently indicate massive spikes.

It is no secret that India’s health infrastructure needs to be augmented. Currently, States across India have been instructed to marshal all their resources to ensure that we are able to contain the virus. They have been asked to use all legal and emergency powers and funds to cater to any medical situation that may arise. You know, it is a situation for which you have to pull out all the stops and get makeshift arrangements if need be.

How does the 14-hour ‘Janata Curfew’ help?

This one-day bandh is the only way we can cut down or dent transmission. Though we are still at stage 2, what if we moved further? Since we cannot create a perfect situation, social distancing is key and this drill is essential. Perfect social distancing cannot happen under normal situation. What the Prime Minister has done is say “OK guys, we have been making an effort to break this chain.”

Where are we in terms of making available testing kits and vaccine?

We are looking at two types of technologies/products — one is diagnostic kits and the other, of course, vaccine which is a long term solution.

Currently, everything related to COVID-19 is new but I am very happy to be able to tell you that we are very close to making available a simpler and indigenous diagnostic test. There are four to six promising projects being carried out and we are very close to an early validation and early scale up. I am hoping this could be in a matter of weeks.

Also, remember if a vaccine comes out somewhere else, they may find it very sensible to manufacture here in India. So that’s the silver lining, we have a huge vaccine production capability.

(Read the full interview at: https://bit.ly/VKPaulInterview)

Lockdown is the most important step in breaking virus transmission, says its Director-General

Lockdown advantage: With people staying home during the ‘Janata Curfew’ on Sunday, Fire and Emergency Service personnel sprayed disinfectants in Ahmedabad. Vijay Soneji

Isolation, and not indiscriminate testing, is the only way India can limit the spread of COVID-19, Balram Bhargava, Director-General, Indian Council of Medical Research (ICMR) said on Sunday.

A lockdown is the most important step in breaking transmission of the infection, he said, adding that the State governments have now been directed to earmark hospitals specifically to accommodate COVID-19 patients.

India on Sunday reported a total of 376 cases and seven deaths, show Union Health Ministry data, with 14,90,303 persons screened at airports so far. The ICMR noted that it had tested over 16,109 individuals, and over 7,000 were currently under surveillance.

Professor Bhargava told presspersons that testing had been scaled up with 111 labs offering COVID-19 tests. Also, four of 60 online applications received from the private sector to test for the virus had been approved.

“There has been no delay in allowing private labs to test. The idea was to put in place enough safety nets to prevent any accidents to medical personnel handling this highly infectious virus,’’ he said.

Highlighting testing facilities available and the spread of the virus, Professor Bhargava said that very few drug trials across the world were working currently.

“India in the past one week has tested 5,000 samples and has the capacity to scale up to 50,000-70,000 tests a week. Compared to this, France tested 10,000 a week, the U.K. 16,000 a week and the U.S. 26,000 a week. The virus test can be positive between two and 14 days and 80% people experience only mild symptoms and 55% need hospitalisation. But we are dealing with a highly infectious and unknown virus, so isolation is our biggest weapon,” he said.

R. Gangakhedkar, scientist at ICMR, said India was in no way working against World Health Organization (WHO) norms, and the focus now was on breaking transmission. “We are right now not in a position to say that community transmission is happening; maybe, by Tuesday, we will have a clearer picture,” he said.

Ventilators ordered

Responding to the issue of national hospital infrastructure, Lav Agarwal, Joint Secretary, Union Health Ministry, did not give specific numbers of beds and ventilators available. He said that India had placed orders for 1,200 ventilators. “We have enough stock of personal protection equipment and have asked the States to use all their resources to ensure that the poor and disadvantaged groups don’t suffer. Our approach is preventive while being prepared,” he said.

Meanwhile, Thyrocare, Mumbai, Suburban Diagnostics, Mumbai, Metropolis Healthcare, Mumbai, Sir H.N. Reliance Foundation Hospital and Research Centre, Mumbai are the first four private labs to get clearance to test for the novel coronavirus, SARS-Cov-2, which causes COVID-19.

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