Explaining the rationale behind the decision to step up testing in hotspots, the source said that by the 100 cases to one death surveillance ballpark, India’s current number of cases is less than half of what it should be.
As Covid-19 cases reached 1,071 across the country (99 recovered, 29 dead), India is set to ramp up testing in 10 identified “hotspots” where “unusual” transmission has been detected. Of these, two — Dilshad Garden and Nizamuddin —are in Delhi, apart from Noida, Meerut, Bhilwara, Ahmedabad, Kasaragod, Pathanamthitta, Mumbai and Pune.
A source in the Integrated Disease Surveillance Programme said, “Normally, we define any area where there are more than 10 cases as a cluster. Places where there are several clusters are treated as hotspots. Sometimes the cases are localised, sometimes so widespread that the entire city has to be covered. Ahmedabad is an exception — there were just five cases, but three deaths. Our assessment normally is that there are 100 cases for every death. That is why Ahmedabad is a hotspot in our list. Three deaths and five cases do not add up.”
A senior official in the health ministry confirmed, “We are stepping up testing in the hotspots. But testing will be done only as per testing protocol.” The government position remains that there is no community transmission so far.
Joint secretary (ministry of health) Lav Agarwal said on Monday, “We are studying the emerging hotspots. We will follow rigorous surveillance and containment measures in these places.” He added that only a “minuscule percentage” of asymptomatic people have tested positive in the country. India has so far done 38,432 tests.
Explaining the rationale behind the decision to step up testing in hotspots, the source said that by the 100 cases to one death surveillance ballpark, India’s current number of cases is less than half of what it should be. “There have been 29 deaths so far, the rough estimate then would be 2,900 cases. But that’s not what we have detected. We may be missing out something. There is as of now no change in testing strategy but we are pulling out all the stops in the door-to-door containment plan.”
The cluster containment plan, as per the notified guidelines of the ministry of health, mandates: “If the epidemiological assessment process is to take time (>12-24 hrs), then a containment zone of 3 Kms and a buffer zone of 7 Kms will be decided which may be subsequently revised, if required, based on epidemiologic investigation. Except for rural Settings.”
Nizamuddin in Delhi has emerged as a hotspot after a religious meeting there was attended by people with travel history to Indonesia and Malaysia, who later also visited homes in the area. The Dilshad Garden index patient had returned from Saudi Arabia, passed on the virus to a doctor, who in turn exposed over 1,200 people to Covid-19.
The Meerut case concerns a resident of Baghpat who came back from Dubai and took public transport to visit his in-laws in the city. Apart from the homes he visited in the neighbourhood, his family is suspected to have exposed many people.
In Mumbai, officials suspect several clusters have developed. One hospital had to be closed down after a retired urologist who died and his son who tested positive were found to have had contact with a large number of people. Several doctors and staff members of another hospital had to be quarantined after a patient tested positive. There have also been cases in several slum clusters, where social distancing is unrealistic. In Bhilwara, with several doctors testing positive, the district administration has taken over five hospitals.