From Our Bureau

27TH JUNE 2020

India witnessed a big surge in COVID-19 positive cases for yet another day, with record 18,552 fresh cases reported on Saturday, taking the country’s cumulative tally to 5,08,953. The death toll mounted to 15,685, with 384 fatalities in the last 24 hours.

As a result of the collective, graded, pre-emptive and pro-active steps taken by Government of India in tandem with the States/Union Territories for prevention, the total number of recovered COVID-19 cases has fast outgrown the number of active COVID-19 cases. The difference between recoveries and active cases is fast nearing 1 lakh. The recovered cases have exceeded the active cases by 98,494 as of today.

While the number of active cases stands at 1,97,387, the number of cured cases is 2,95,881, including 10,244 recovered cases in the last 24 hours. With this encouraging status, the recovery rate touched 58.13 percent amongst COVID-19 patients.

As a testimony to the ramped up testing facilities, India now has 1,026 diagnostic labs dedicated to COVID-19–741 in the government sector and 285 private labs. These facilities include Real-Time RT PCR-based testing labs: 565 (Govt: 360 + Private: 205), TrueNat- based testing labs : 374 (Govt: 349 + Private: 25) and  CBNAAT-based testing labs : 87 (Govt: 32 + Private: 55). The samples tested in the last 24 hours have further increased to 2,20,479. The total number of samples tested, as on date, is 79,96,707.

The 17th meeting of the high-level Group of Ministers (GoM) on COVID-19 was held under the chairpersonship of Dr. Harsh Vardhan, Union Minister of Health & Family Welfare by a video-conference hosted today. Dr S. Jaishankar, Union Foreign Minister, Hardeep S. Puri, Union Minister of Civil Aviation, and Ashwini Kumar Choubey, Minister of State, Health & Family Welfare attended the video-conference. .

The GOM was briefed on the current status of COVID-19 cases in the country, the recovery and mortality rates, doubling rate, ramped up testing and strengthened healthcare infrastructure in various States.  It was mentioned that presently eight States (Maharashtra, Gujarat, Delhi, Uttar Pradesh,  West Bengal, Tamil Nadu, Telangana and Andhra Pradesh) contribute 85.5 percent of active caseload and 87 percent of total deaths in India.

It was also informed that, as on date, 15 Central Teams consisting of public health experts/epidemiologists/clinicians and a senior Joint Secretary level have been deployed to provide technical support to the States. Another Central Team is currently visiting Gujarat, Maharashtra and Telangana to strengthen ongoing efforts for management of COVID-19. The GoM was also briefed about the utility of ITIHAS and Aarogya Setu in contact tracing and prediction of potential hotspot areas which have been extensively used by State/UT Governments in preparing the COVID-19 containment strategy.

The Group of Ministers was informed that the key focus areas which are continually communicated to the States/UTs are strict containment measures and surveillance; utilizing full testing capacity; focus on monitoring of co-morbid and elderly population; predicting emerging hotspots leveraging digital tools such as Aarogya Setu; ensuring seamless patient admission processes; fatality mitigation by effective clinical management; focus on infrastructure preparedness (critical care beds, oxygen, ventilators and logistics); and ensuring that non-Covid healthcare services are not impacted.

Dr. Bhargava, DG (ICMR) gave a detailed presentation on the Testing strategy of ICMR. He explained about the serological survey, and the increasing capacity for enhanced per day testing through various tests. 

GoM was also apprised about the growing medical infrastructure in the country. As of 27th June, the COVID related health infrastructure has been strengthened with the availability of 1,039 dedicated COVID Hospitals with 1,76,275 isolation beds, 22,940 ICU beds and 77,268 oxygen supported beds, Another 2,398 dedicated COVID Health Centres with 1,39,483 Isolation beds, 11,539 ICU beds and 51,321 oxygen supported beds have also been operationalised.

Moreover, 8,958 COVID Care Centres with 8,10,621 beds are now available to combat COVID-19 in the country. The Central Government has also provided 185.18 lakh N95 masks and 116.74 lakh Personal Protective Equipments (PPEs) to the States/ UTs / Central Institutions.

Meanwhile, keeping pace with evolving knowledge about COVID-19, especially in terms of effective drugs, the Union Ministry of Health & Family Welfare has today released an updated clinical management protocol for managing COVID-19 cases. The updated protocol includes the advice to use Dexamethasone as an alternative choice to Methylprednisolone for managing moderate to severe cases of COVID-19. The change has been made after considering the latest available evidence and expert consultation.

Dexamethasone is a corticosteroid drug used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects. The drug has been tested in hospitalized patients with COVID-19 in the RECOVERY clinical trial and was found to have benefits for critically ill patients and has been shown to reduce mortality by about one-third for patients on ventilators, and by about one-fifth for patients being maintained on oxygen therapy. The drug is also a part of the National List of Essential Medicines (NLEM) and is widely available.

The Union Health Secretary, Ms Preeti Sudan has forwarded the updated protocol to all States/UTs to make necessary arrangements for availability and use of the updated protocol and drug Dexamethasone at the institutional level also. The guidance document has also been made available online on the website of the Health Ministry.

Moreover, the Central Government has been supporting States/UTs in their endeavours for combating the COVID-19 outbreak. The Central Government has extended substantial support to NCT of Delhi for containment and management of COVID-19.

Indian Council of Medical Research (ICMR) has supplied diagnostic material for carrying out 4.7 lakh RT-PCR tests to the 12 functional labs in Delhi, till date.  It has also provided 1.57 lakh RNA extraction kits essential for carrying out the test and 2.84 lakh VTMs (Viral Transport Medium) and swabs for collection of Covid-19 samples.

Looking at the sudden surge of cases, ICMR has approved Antigen-based Rapid tests and supplied 50,000 such Antigen Rapid Test Kits to Delhi Government for supporting COVID-19 containment efforts. ICMR has provided all these test kits free of cost to Delhi.

National Centre for Disease Control (NCDC), under Ministry of Health & Family Welfare, has supported the efforts of Delhi Government through technical guidance on all aspects of COVID-19 Surveillance and Response Strategy.

The areas include identification and assessment of quarantine facilities and COVID Care Centres (CCC) in the beginning of epidemic; orientation trainings and technical support on surveillance, contact tracing and lab aspects including infection prevention and control; data analysis and timely feedback to the Delhi Government on the gaps identified and suggested solutions.

NCDC has also provided  laboratory diagnostic support for processing of samples by RT-PCR including trainings of lab professionals of Delhi Government. Technical support by NCDC included deployment of multiple Central Teams of experts for situational analysis and subsequent  recommendations accordingly; deployment of public health experts to coordinate and provide technical inputs to district level teams in implementation of revised Delhi COVID Response Plan; and planning and execution of Sero-prevalence study on COVID 19 in Delhi. The Revised Delhi COVID Response Plan has been prepared with the active support of NCDC.

NCDC will also conduct a Serological Survey across Delhi from 27th June 2020 to 10th July 2020. Blood samples from 20,000 persons will be tested to ascertain the presence of anti-bodies.

As an effort to bolster the containment measures in NCT of Delhi, a 10,000-bedded “Sardar Patel COVID Care Centre” is being developed at Radha Soami Satsang Beas in Chhatarpur, Delhi. The entire operation of this Centre, including ensuring availability of requisite numbers of medical personnel, has been entrusted to the Central Armed Police Forces (CAPFs), with Indo-Tibetan Border Police (ITBP) taking the lead in this process. Around 2,000 beds are being made operational.

A 1,000- bedded new green field hospital constructed by DRDO and manned by doctors and paramedical staff from the Army would start functioning next week from an area near Dhaula Kuan. This new field hospital would have a referral relationship with AIIMS, New Delhi.  The hospital would be equipped with oxygen, ventilators as well as an ICU.

The Government of India has centrally procured and distributed 11.11 lakh N95 masks, 6.81 lakh PPE kits, 44.80 lakhs HCQ tablets in Delhi. 425 ventilators were allocated to Delhi and all have been delivered to various hospitals of GNCT.

Delhi has 34 Dedicated COVID Hospitals (DCH), 4 Dedicated COVID Health Centres (DCHC), 24 Dedicated COVID Centers (DCCC) to treat COVID-19 patients according to their severity. Thus, a total of 62 facilities in Delhi are engaged in treating COVID-19. The number of these facilities is being increased on a daily basis.

Delhi Government has been advised to conduct assessment in respect of every dead individual (from COVID-19) as regards how many days before death the person was brought to hospital and from where. A special focus has to be given about whether the person was in home isolation and whether the person was brought to hospital at the right time or not.

Every death has to be reported in a timely manner to Government of India. All hospitals have been given strict directions that there should be no delays in handing over the dead bodies to their next of kin and performing last rites of COVID-19 deceased patients. (eom)

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