NEW DELHI: Lack of rigorous active case search, ineffective contact tracing and improper management of patients with acute respiratory distress could be the reasons why COVID-19 cases and deaths are rising at alarming rates in the worst affected districts in India, the Centre believes.
In a meeting with state chief secretaries on Sunday, Union health secretary Preeti Sudan on Sunday had pointed out that there are 20 districts in the country which contribute to 68 per cent of the total disease load in the country and are particularly worrisome.
These districts include Mumbai, Ahmedabad, South East Delhi, Central Delhi, Indore, Pune, Jaipur, Thane, Surat, Chennai, Hyderabad, Bhopal, Jodhpur, Kolkata, Kurnool, Vadodara, Guntur, Krishna and Lucknow.
“Apart from sending central teams of public health specialists, we are also offering to guide these states on the specific issues that they are facing,” a senior official in the Union Ministry of Health and Family Welfare said.
The Centre has informed states that eight of the 20 worst-hit districts are seeing cases doubling faster than 10 days and seven have a case fatality rate much worse than the national average.
The ministry has analysed that poor social distancing, ineffective contact tracing and lack of active case search in the past -- which means testing people with influenza like symptoms and hospitalised patients with acute respiratory issues --- besides violations in home quarantine and isolation guidelines and high infection rate among healthcare workers could be the reasons behind rapid case doubling rates.
To curb these, the Centre has suggested actions such as forming field units to verify whether social distancing is being implemented properly in the containment zone, verifying perimeter control, ensuring rigorous contact tracing and active case search, counselling patients and contacts to explain importance of properly following isolation and quarantine guidelines to control spread and ensuring prophylaxis with hydroxychloroquine among healthcare workers.
States have also been directed to ensure sufficient personal protective equipment for medical personnel.
The ministry has also advised the states to train all doctors to treat patients with acute respiratory distress syndrome through ventilators and manage the underlying conditions of COVID-19 patients, the lack of which could be resulting in high mortalities due to the infection.
Some independent researchers too have pointed to a surge in new cases in the past two days and expressed concern that states may not be doing enough.
“Confirmed cases continue to rise, and active cases now growing at 5.5% - so doubling every 13 days. Not good. It has picked up speed in last 2 days (from 4.7%). Hotspot management (containment, contact tracing and testing) needs to be much better,” tweeted Shamika Ravi, a former member on the PM’s Economic Advisory Council who has been analyzing COVID-19 data in India.