From Our Bureau
8TH AUGUST 2020
India witnessed a big surge with 61,537 fresh COVID-19 positive cases reported on Saturday, taking the country’s cumulative tally to 20,88,611. The death toll rose to 42,518, with 933 fatalities recorded in the last 24 hours.
Focused and effective efforts of containment, testing, isolation and treatment by the Central Government and State/Union Territory governments have resulted in increasing percentage of recovery rates and steadily falling Case Fatality Rates.
Effective surveillance and improved testing network have ensured early detection of cases and consequentially leading to timely clinical management of the severe and critical cases. Compared globally, India has one of the lowest cases per million at 1,469 as against the global average of 2,425.
Coordinated implementation of “Test, Track, Treat” strategy by the Central Government and State/UT governments has ensured that the CFR has been low when compared to the global scenario and it has continued to fall progressively. The Case Fatality Rate stands at 2.04 percent today.
With focused efforts to reduce mortalities due to COVID-19, India has registered one of the lowest deaths per million at 30 as compared to the global average of 91 deaths per million.
There has been a sharp increase in COVID-19 recoveries. With 48,900 patients discharged in the last 24 hours, India’s total recoveries from COVID-19 have reached 14,27,005. The recovery rate, on a steady upward rise, stands at 68.32 percent.
The active cases, which are the actual case load for India at 6,19,088 today, account for 29.64 percent of total positive cases. These are under medical supervision either at hospitals or in home isolation.
Expanded diagnostic lab network and facilitation for easy testing across the country has resulted in India testing total of 2,33,87,171 samples for COVID-19 infection. 5,98,778 tests were conducted in last 24 hours. The Tests Per Million have seen a sharp increase to 16,947 today.
A key factor in this widespread testing is the continuously expanding network of diagnostic labs. With 936 labs in the government sector and 460 private labs, India has 1,396 labs for COVID-19 testing. These include: Real-Time RT PCR based testing labs: 711 (Govt: 428 + Private: 283), TrueNat based testing labs: 574 (Govt: 476 + Private: 98) and CBNAAT based testing labs: 111 (Govt: 32 + Private: 79).
Central Government directs the States to focus all efforts on reducing COVID-19 mortality by improving clinical management
As part of the continuous process of review and handholding of States/UTs for collaborative management of COVID-19, two high level virtual meetings were chaired by Rajesh Bhushan, Health Secretary, on 7th and 8th August to engage with the States reporting high case load and higher CFR than the national average, in order to advise and support them on efforts to prevent and reduce mortality due to COVID-19.
Today’s meeting focused on 13 districts concentrated in eight States/UTs. These are Kamrup Metro in Assam; Patna in Bihar; Ranchi in Jharkhand; Alappuzha and Thiruvananthapuram in Kerala; Ganjam in Odisha; Lucknow in Uttar Pradesh; 24 Paraganas North, Hooghly, Howrah, Kolkata and Maldah in West Bengal; and Delhi.
These districts account for nearly 9 percent of India’s active cases and about 14 percent of COVID deaths. They also report low tests per million and high confirmation percentage. A surge has been observed in the daily new cases in four districts, namely, Kamrup Metro in Assam; Lucknow in Uttar Pradesh; Alappuzha and Thiruvananthapuram in Kerala.
Principal Secretary (Health) and MD (NHM) from the eight States along with district surveillance officers, district collectors, commissioners of the municipal corporation, Chief Medical Officers, and Medical Superintendent of Medical Colleges participated in the virtual meeting.
Several issues critical to reducing case fatality rate were discussed during the meeting. The States were advised to address the issues of low lab utilisation i.e. less than 100 tests per day for RT-PCR and 10 for others; low tests per million population; decrease in absolute tests from last week; delay in test results; and high confirmation percentage among the health care workers. They were advised to ensure timely referral and hospitalization in view of reports from some districts of patients dying within 48 hours of admission.
States were directed to ensure availability of ambulances with zero tolerance for refusal. The need to ensure monitoring asymptomatic cases under home isolation with special focus on physical visits/ phone consultation on daily basis was underscored. States were asked to ensure a timely assessment and make advance preparedness for infrastructure viz. ICU beds, oxygen supply etc., based on the prevailing case load and the estimated growth rate.
It was reiterated that AIIMS, New Delhi, is holding virtual sessions twice very week on Tuesdays and Fridays where a specialist team of doctors provides guidance on effective clinical management of COVID-19 patients in the ICUs of different State hospitals through tele/video consultation, to reduce the case fatality rate. The State authorities were advised to ensure that State Centers of Excellence and other hospitals participate in these VCs regularly to improve clinical practices.
The States were advised to follow all Ministry protocols for effective management of containment and buffer zones along with seamless patient and clinical management of patients with special focus on critical cases. Another major area highlighted was that of preventable deaths by strict surveillance among high-risk population like people with co-morbidities, pregnant women, the elderly and children. (eom)