Surveillance and management now top on govt agenda

NEWDELHI: As the number of coronavirus disease (Covid-19) patients increases, India has changed its approach from screening people at entry points to the country to reinforcing community surveillance and disease management.

In a little over two weeks, from 50 positive cases, India has seen an increase to 878, suggesting the spread of infection within the community although local scientists deny this. And from no deaths until March 11, 18 people have succumbed to the viral infection as of Friday, March 27.

“When the disease has spread to 192 countries, then it means screening at entry points will serve no purpose. India anyway is in a state of lockdown that will show benefits if people follow the do’s and don’ts. Since the disease is here what we need to do now is improve our case management and strengthen surveillance within the community. Our efforts now are concentrating on not letting it spread further,” said Lav Aggarwal, joint secretary in the Union ministry of health .

Since the number of Covid-19 infections is rising, the government will need more hospital beds to keep patients in isolation; for treatment of critically ill patients, there will be an increased need for ventilators. Keeping the surge in cases in mind, the Centre has directed the states and UTs to create a dedicated facility for Covid-19 positive cases. Close to 20 states have already started the process.

Delhi, for example, has three hospitals run by the Delhi government that are being converted into dedicated facilities for Covid-19 patients. Together, these hospitals will add 3,400 beds for Covid-19 patients, if needed.

The initial effort is to stop the spread of infection in certain pockets where cases have seen an unusual jump. The government still maintains there is no community transmission of Covid-19.

“There is no evidence to support community transmission. Our experts at the Indian Council of Medical Research (ICMR) and other bodies are constantly maintaining a vigil and there is no case to suggest there is spread of transmission within the community that should worry us,” said Aggarwal.

Dr Sujeet K Singh, director, National Centre for Disease Control (NCDC), said, “Localised clustering does not mean community transmission. There have been a few incidences of localised outbreaks, some of which we have managed to contain and some we are in the process of containment. And in most clusters we have managed to trace the source.”

Close to 200,000 people are under close monitoring by the local units of Integrated Disease Surveillance Programme (IDSP).

The government is conducting orientation exercises for grassroots-level healthcare workers and also doctors managing patients so that a uniform screening and treatment protocol is followed across India.

“AIIMS, Delhi, has begun conducting webinars to train master trainers that has already been attended by at least 3,000 healthcare workers from across the country,” said Aggarwal.