Covid-19 challenge in India: How to break chain of transmission

Daily fresh cases remain above 83,000: States urged to bring mortality rate below 1%

GN Bureau | September 4, 2020


#testing   #helth ministry   #healthcare   #Novel Coronavirus   #Covid-19   #recovery   #health secretary  
Testing has been the key of the government`s strategy to contain the spread of the virus. (File photo)
Testing has been the key of the government`s strategy to contain the spread of the virus. (File photo)

India is leading the world in the highest number of new Covid-19 cases a day, as the centre exhorted the states to find ways to break the chain of transmission and bring down the mortality rate below one percent, keeping up with the strategy of testing-tracking-treating.

The health ministry’s bulletin Friday, covering 24 hours till morning, had 83,341 fresh cases – the number remaining above 83,000 for the second consecutive day, which has been a new record. The total confirmed cases in the country so far has been 39.36,747. The period also registered 1,096 deaths, bringing the total to 68,472.

Meanwhile, 66,659 patients also recovered, taking the number of recoveries to 30,37,151. This means the country has a total of 8,31,124 active cases as of date.

Union health secretary Rajesh Bhushan held a review meeting through video conference with the health secretaries the states of Andhra Pradesh, Punjab, Karnataka, Tamil Nadu and Uttar Pradesh. They focused on 15 districts: Chittoor, Prakasam, Mysuru, Bengaluru Urban, Ballari, Koppal, Dakshina Kannada, Davangere, Ludhiana, Patiala, Chennai, Coimbatore, Salem, Lucknow and Kanpur Nagar. These districts have been exhibiting higher active caseload, fatality rates and a surge in the Covid cases for the past four weeks. The respective district collectors, municipal commissioners and other local functionaries also participated in the meeting.

Bhushan shared the overall status and performance of the districts on the key parameters of testing, positivity, case fatality etc., focusing on the need of continuing containment measures, increasing testing, effective clinical management of patients. State health secretaries provided an in-depth analysis on the current status of Covid-19 in the 15 districts covering aspects of containment measures, contact tracing, surveillance activities, facility-wise case fatality rates, trends in terms of weekly new cases and deaths, etc. and shared their detailed roadmaps and action plans for the next one month.

Granularities in terms of split of RT-PCR and Rapid Antigen tests conducted in the district, re-testing percentage of symptomatic negatives from Antigen tests, testing lab utilization, home isolation status, hospitalization status and bed occupancies of oxygen-supported beds, ICU beds and ventilator etc., were also shared with the centre.

The states were advised to take steps on the following specific areas:

1.    Limiting and eventually breaking the spread of the infection by implementing stringent containment measures and following social distancing measures, strict peri-meter control, and active house-to-house case search.
2.    Early identification by ramping up testing across the districts, optional utilization of RT-PCR testing capacity and use of Rapid Antigen Tests as a screening test in hotspots and densely populated areas.
3.    Effective monitoring of home isolation cases and early hospitalization in case of disease progression.
4.    Seamless hospitalization and early admission for patients requiring medical support, especially in cases of co-morbid and elderly population.
5.    Following effective infection control measures in hospitals to safeguard healthcare workers from contracting the infection.
6.    District Collectors and other functionaries to prepare and update district specific plans to continue their efforts to manage the pandemic with the same rigor.

Total recoveries surpass 30 lakh
One of the goals of the Test-Track-Treat strategy is to reduce the Covid mortality and keep the case fatality rate low. There has been sharp attention on sustaining high levels of recoveries and to strengthen the clinical treatment protocols to provide a uniform standardised level of medical care to save lives.

Not only is India’s Case Fatality Rate lower than the global average and progressively declining (currently 1.74%), but a very small proportion of the active cases, amounting to less than 0.5%, are on ventilator support. Data also shows that 2% cases are in ICUs and less than 3.5% of the active cases occupy oxygen supported beds.

As a result of these measures, India's total COVID-19 recoveries have crossed 30 lakh (30,37,151) on Friday. With the recovery of 66,659 in the 24 hours, India has continued its trajectory of posting more than 60,000 recoveries for the eighth consecutive day. The Recovery Rate amongst the COVID-19 patients is 77.15% demonstrating that the number of patients recovering is on a steady rise over the past several months.

The higher number of recoveries has also led to a steady enhancement in the difference between the recovered and active ones. This difference has crossed 22 lakh, as on date. This ensured that the actual caseload of the country viz. the active cases (8,31,124 which are under active medical care), has reduced and currently comprises only 21.11% of the total positive cases.

More than 11.70 lakh samples tested
After having successfully achieved the goal of enhancing the daily testing capacity to more than 10 lakhs daily tests, India has scaled new peaks in Covid-19 testing for the last two successive days. For these two successive days, more than 11.70 lakh samples have been tested across the country. As many as 11,69,765 samples were tested in the 24 hours to Friday morning.

No other country has achieved these levels of very high daily testing, the health ministry said in a statement.

With this steep exponential rise in daily testing, the cumulative tests are nearing 4.7 crore. The cumulative tests as on date have reached 4,66,79,145.

Even with this very high daily testing, the daily Positivity Rate is still below 7.5%, while cumulative Positivity Rate is less than 8.5%. These results reflect the strategy of Test-Track-Treat, being effectively implemented by most of the states/UTs.
 
The sustained higher testing on a wide scale enables early diagnosis, prompt isolation and timely hospitalisation. Effective treatment based on Standard Treatment Protocol both in supervised home isolation and in hospitals, also results in lower mortality rate. With the aim to reduce the fatality rate below 1%, India’s Case Fatality Rate (CFR) has touched 1.74% following a gradient of steady and sustained decline.

India’s substantial increase in the testing levels is anchored in the daily expanding diagnostic lab network across the country. As on date, with 1,025 labs in the government sector and 606 private labs, the country-wide network is strengthened with 1,631 total lab facilities.

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