Updated: June 23, 2020 8:52:18 pm
Thirty-five-year-old Shaik Mujahid Ali, a lawyer from Bahadurpura in Hyderabad, has had high fever for the last four days. Though he is having medicines prescribed by a neighbourhood doctor, his fever persists and he has also developed body pain. The doctor has now asked him to get a COVID-19 test done. “I have been working from home and always wear a mask. I have been ensuring personal hygiene and physical distancing too. I don’t think I can be infected with the virus, but let’s see,” said Ali as he stood outside a corporate diagnostic centre at Himayatnagar on Tuesday morning.
At the centre, however, a banner reading — “No COVID-19 test sample collection” — hangs near the main gate. For those wanting to undergo the test, it directed them to the diagnostic centre’s testing centres at four places — Gachibowli, Karkhana, Karmanghat, and Moosapet.
The security guards manning the premises, and also controlling the traffic outside the gate, could be seen having a tough time with scores of people coming for COVID-19 test over the past week.
Ever since the state government on June 15 permitted ICMR-approved private laboratories and diagnostic centres to carry out COVID-19 tests while capping the cost of a test at Rs 2,200 and Rs 2800 if samples are collected from home, the number of people wanting to undergo the RT-PCR test for the virus is on the rise.
The Himayatnagar centre, too, has been listed as one of the 17 ICMR-approved private RT-PCR-based testing laboratories in Telangana to test those with symptoms of Severe Acute Respiratory Infections (SARI) and Influenza-like-Illnesses (ILI).
Asked why he wouldn’t visit the nearby government centre at King Koti hospital, Ali said he would prefer a private hospital over a government facility.
A laser therapist by profession, Shaik Abdul Rabbani (22) had arrived at the diagnostic centre on a two-wheeler along with his colleague. Upon reading the banner, he was discussing with his colleague where to go for the test that their employer had asked both of them to get done. “I have a cough and headache but no other issues. Just to be on the safer side, my company has asked me to undergo a test,” he said.
The rising number of cases
Over the last one week, Telangana has reported a sharp spike in COVID-19 cases with each day recording a new high. Since June 15, the state has witnessed 3,268 new cases. This also means, nearly 42 per cent of its overall cases to date have been recorded in the last week. As of June 22, the total confirmed positive cases stands at 8674. Of them, 4,452 are active cases. With 872 positive cases against 3189 samples tested on Monday, the positivity ratio was at 28 per cent.
— Rahul V Pisharody (@rahulvpisharody) June 17, 2020
The sharp spike in cases, according to government officials, is the result of increased testing. After facing much criticism over low testing and not allowing private hospitals and diagnostic centres to carry out COVID-19 testing despite ICMR’s approval, the state government finally permitted the private players to join the fight against COVID.
This apart, chief minister K Chandrasekhar Rao also announced his decision to conduct 50,000 tests across 30 assembly constituencies in the districts of Hyderabad, Rangareddy, Vikarabad, Sangareddy, and Medchal Malkajgiri, starting June 16. These tests were to be conducted among the frontline workers involved in healthcare, sanitation, municipal, and police departments, and also those people living in containment zones.
The government planned to test all the contacts of existing positive cases and those people who showed symptoms of SARI and ILI. According to Chief Secretary Somesh Kumar, the government’s decision was a mere confidence-building measure among the vulnerable categories. He reiterated there was no community transmission in Telangana, as reports of ICMR-conducted serosurveillance data suggested.
— Rahul V Pisharody (@rahulvpisharody) June 21, 2020
Between June 16 and June 22, the state tested 15,812 samples to detect 3,268 positive cases. With three more days to complete the 10-day deadline, the state now faces a difficult target of testing 34188 samples in three days.
This week, the death toll breached the 200-figure mark and stands at 217 now. According to the statistics shared by the office of the director of Public Health, the highest number of coronavirus deaths has been of patients with comorbidities like hypertension, diabetes, and cardiovascular diseases. Of the total of 202 deaths, as per the data shared on June 17, as many as 35 persons have died with no comorbidities. As for the age-wise distribution of cases, the data reveals that the maximum number of patients were in the age group of 26 to 40 years.
The spike in cases was expected: DME, Telangana
Speaking to indianexpress.com, the Director of Medical Education Dr. K Ramesh Reddy attributed the recent surge to the increased number of tests conducted by the state. According to him, what makes Telangana different from other states is its focus on testing vulnerable people from target groups, and hence an increased positivity ratio.
After one week of testing more samples, he said there was no change in the pool of asymptomatic patients in the state. “Up to 85 per cent of those tested positive have no symptoms at all. They are counseled by public health channels and being monitored. Only 70 to 80 cases come to hospitals every day. We are keeping only those with symptoms and also severe comorbidities in hospitals as a precautionary measure,” said Dr. Reddy.
According to data shared by the office of the director of Public Health, Telangana has 34 government identified hospitals and 17,081 beds earmarked for COVID-19 treatment. The number of beds occupied as of June 19 is only 976, which is 5.71 percent of the capacity. There are 10,970 vacant isolation beds in COVID hospitals, 3227 vacant beds with oxygen support in COVID hospitals, 1448 ICU beds, and 460 ventilator beds in COVID hospitals across the state.
The DME says that even the present surge of cases is not worrisome as enough facilities are available. “The basic difference between Telangana and other states is that we are strictly following the ICMR guidelines. Because of the proper implementation of home quarantine as soon as the guidelines were passed by the Centre, we do not have any clogging in hospitals. The hospital beds are meant for moderate, severe, or severe comorbidities,” he added. The government is ensuring institutional isolation at hospitals for those who don’t have proper accommodation or isolation facilities at home. “Even as of today, the hospital occupancy in Gandhi hospital is hardly 560. People need not get panicky over the situation,” he said.
When asked about neighboring Andhra Pradesh which is currently testing over 24,000 samples a day, the DME said the difference between AP and Telangana is that the latter is focused on the target group instead of randomly picking up samples where several of them are negative for infection.
Is targeted testing sufficient?
A public health expert with the Public Health Foundation of India, V Ramana Dhara, wonders the purpose behind testing the entire population. “The point of testing is to, first of all, find the cases, isolate them, and then trace the contacts. The recommendation is that it should be done through syndromic surveillance approach by testing the ILI cases. But also trace the contacts. That’s what should be done,” says Dr. Dhara, who is also an additional professor at the Indian Institute of Public Health, Hyderabad,
Dr. Mahesh Kumar, the president of the healthcare reforms doctors association (HRDA), feels that the state government should not be complacent and must prepare itself for the peak of the disease. The government must expedite all pending recruitments to strengthen human resources and prepare the necessary infrastructure. According to him, the government-run facilities are not equipped to handle a peak.
“There should be no capping on the number of tests. We should test as many as possible. Why not follow Maharashtra, Andhra Pradesh, Haryana or Punjab and do household surveys to look out for SARI cases at their homes and isolate them. Early identification and observation is the key to prevent one’s condition from deteriorating,” says Dr. Kumar, adding that the government should do everything possible to spread more and more awareness as well.
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