Updated: June 19, 2020 8:03:54 am
At 827 cases and 43 deaths as on Wednesday, Bengaluru has among the lowest Covid burden among cities with population of 10 million or more. Sample this: Mumbai has 60,228 positive cases and 3,167 deaths; Delhi 44,688 cases and 1,837 deaths; and Chennai 34,245 cases and 422 deaths.
Epidemiologists say central to the city’s Covid-19 control programme has been its continuing practice of quarantining positive cases and identifying contacts within 24 hours of a positive test result — a practice many of the other metros have struggled to keep up with as numbers started swelling.
This emphasis on isolating positive cases and identifying their contacts has meant that health and civic officials from the city municipal corporation have knocked on the doors of those who tested positive at all possible hours of the day and night.
“If I have to summarise the Bengaluru model in one sentence, it is the retrospective tracing of contacts,” said Dr Giridhar R Babu, a member of the epidemiology, surveillance and research group constituted by the ICMR National Task Force for Covid-19, and the co-author of a recent ICMR paper that highlighted the variations in contact testing among states in the early stages of the spread of the virus.
As curbs ease, a note of caution
While Bengaluru has so far managed to focus on the basics of any disease control programme, with the lockdown easing, the challenge would be to continue its testing and tracking programme as effectively. Already, cases have begun to rise — while from March 8 to May 31, there were only 358 cases and 10 deaths, so far this month, there have already been 469 cases and 33 deaths.
The analysis done by the ICMR group revealed that between January 22 and April 30, Karnataka tested 93 contacts per confirmed Covid-positive case compared to the national average of 20. In comparison, during the same period, states with high disease burden such as Maharashtra and Delhi tested only 8 and 9 contacts respectively for every Covid-positive person.
“Unlike in other places, we shifted primary and secondary contacts to institutional quarantine,” said Hephsiba Rani, an IAS officer who is in charge of the Covid-19 war room for Bengaluru city.
Besides the testing-tracking policy, experts point to the effective use of data to understand the spread of the disease.
As many as six apps have been developed for functions ranging from contact tracing to quarantine watch, from tracking new arrivals to monitoring critical patients. The data teams have also churned out daily analysis and trends for officials to act upon. For instance, when the data identified patients with Severe Acute Respiratory Infection (SARI) as being a high-risk group in terms of deaths, experts recommend the use of pulse oximetry at all fever clinics to test for oxygen saturation levels.
What also helped was that in the early stages of the spread of the virus and during the lockdown period, cases were restricted to a few containment zones – Padarayanapura, Hongasandra and Shivajinagar – where people lived in close quarters.
“We did random sampling by factoring mobility of people in relation to a positive case – to figure out whether the infection had spread to other streets or whether it was confined to where the person lived. We also tested pregnant women and those with co-morbid conditions and we realised that the positivity rate was below one per cent,” added Rani.
According to the BBMP’s Chief Health Officer Dr B K Vijendra, the early closure of big markets contributed to keeping the Covid count low. “We shut the big markets early in the first lockdown. Nobody noticed it but this was a key step in stopping the spread of the virus. The market in Chennai (Koyambedu) was shut only after the disease started to spread,” he said.
However, since the easing of the lockdown, cases have begun to rise in Bengaluru. While from March 8 to May 31, there were only 358 cases, 10 deaths and five ICU patients in Bengaluru, between June 1 and until June 17, there have been 469 cases, 33 deaths and 36 patients in ICU.
On June 15, the government set up 17 task forces headed by IAS officers to bring the situation under control.
Post lockdown, we have had a high incidence of SARI and ILI (Influenza-like Illnesses) cases. Almost 30 per cent of our cases are SARI/ILI – which means people with no travel history or contacts. We are trying to have a testing strategy where we identify them quickly and carry out tests instead of waiting for symptoms to show up,” said Rani.
In a sign that authorities are expecting the case load to rise over the next few weeks, Karnataka Medical Education Minister Dr K Sudhakar on Tuesday announced a slew of new measures, among them dedicating Covid hospitals only for symptomatic positives and utilising institutional facilities such as hotels for asymptomatic patients.
To avoid a situation where patients are forced to run from one hospital to the other looking for beds, the minister has sought a patient-flow plan between hospitals. “We have seen what is happening in other states. We want to be prepared,” he said.
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