At the over-100-year-old Epidemic Diseases or Isolation Hospital in east Bengaluru, a key location to quarantine patients with infectious disease, 42 beds have been set aside for Covid-19 suspects at a newly created ward. Until a week ago, the isolation ward was empty. In the last two days, 14 of 42 beds have been occupied.
“We are awaiting test reports of the suspected cases who are in the Covid-19 ward. If the reports are positive, then we will immediately move the patient to a designated Covid-19 hospital in the city,” said Dr Ansar Ahmed, the district surgeon for Bengaluru and the medical superintendent of the Epidemic Diseases Hospital.
A change in protocol for testing and quarantining suspected Covid-19 cases and tracing of attendees of a religious congregation at the Nizamuddin Tablighi Markaz in Delhi has resulted in a sharp increase in the number of suspected Covid-19 cases in hospitals. While there is also a resultant increase in samples being tested for the virus, the actual numbers of samples testing positive remains low and is restricted to clusters in the state, statistics reveal.
On March 22, two days after ICMR revised its testing protocols beyond symptomatic persons who returned from other countries to “all hospitalised patients with Severe Acute Respiratory Illness(fever and cough and/or shortness of breath)”, the total number of persons in isolation was 107 and the number of samples collected for testing was in the range of 64.
Over the last week, the number of persons in hospital isolation hovered around 188 before rising to 256 on March 31, 367 on April 1 and 425 on April 2 while samples sent for testing were 206 on March 31, 244 on April 1 and 384 on April 2.
“There has been an increase in the flow of suspected cases in hospitals because people from fever clinics showing symptoms are getting tested. There is also a large number of persons from the Tablighi Jamaat Markaz in Delhi who are suspected cases,” state health secretary Jawaid Akhtar said.
“The cases linked to the Delhi Nizamuddin event and new guidelines for screening high risk persons has caused a spike in persons admitted in isolation at hospitals as suspected Covid-19 cases,” the state joint director for communicable diseases B G Prakash Kumar said.
One of the key factors in the increased number of patients admitted in hospital wards as suspected coronavirus cases in Karnataka is a change in policy for screening people for the virus – where every person showing symptoms of the disease is now being put in isolation — unlike earlier when people showing symptoms for Covid-19 infection were sent home after collection of throat/nasal swabs for laboratory testing, said doctors.
“Earlier we were taking samples and sending people home and were isolating people only if their test results were positive. This was because there was only one hospital for isolation but now there are 50 first-responder hospitals,” said a doctor working as an epidemiologist and tracking Covid-19 cases and their contacts for the state government. Other doctors link the spurt in suspected cases to the aggressive screening of primary contacts of persons who have tested positive for coronavirus.
The state health department decided on March 30 to place all high-risk primary contacts of patients in quarantine at first-responder hospitals instead of allowing them to be at home for 14 days.
“The high-risk primary contacts are persons above the age of 60 with co-morbidities like diabetes, hypertension, heart problems,” said Dr H D R Radhakrishna, the superintendent of the C V Raman General Hospital, where 66 high-risk persons were isolated over two days.
There are a total of 1,150 primary contacts and 7,287 secondary contacts for the 124 Covid 19 patients found in Karnataka till April 1 – including the three who died and eight discharged.
The low-risk category of primary contacts will be put in quarantine in 16 private institutions, including economy hotels and paying guest facilities, taken over by the state government.
One of the issues that has arisen out of the new policy to quarantine all suspected Covid 19 cases in first-responder hospitals – especially in government hospitals – is the intermingling of the suspected cases ahead of the arrival of their Covid-19 test reports.
The spread of the coronavirus in Karnataka has followed a clear pattern of clusters like a four-person cluster in Kalaburagi – where a 76-year-old man died; a six person cluster at the Bengaluru home of a 51-year-old man who came from London; a six member cluster in the Chikaballapura area; an 18-member cluster in a pharma firm in Mysuru and a 13-person cluster linked to the Nizamuddin Markaz which has emerged in the last two days.
The cluster from the Tablighi Jamaat event in Delh is currently the main source of concern since the social distancing efforts seemed to have been succeeding in reducing the numbers of samples testing positive for the coronavirus beyond clusters, say health officials.”We have screened 800 persons from Karnataka who may have attended the Delhi event of the Tablighi Jamaat and have collected 143 samples of symptomatic persons for testing on Wednesday,” health secretary Akhtar said.
One person, a 60-year-old man hailing from Tumkur and who is linked to the Tablighi Jamaat cluster, died of Covid 19 infection on March 27 while his 13-year-old son has tested positive. On Thurday, 11 more persons linked to the Delhi event tested positive in Karnataka.
Health authorities have pointed out that the numbers of persons testing positive in Karnataka has slowed down despite the rise in the number of samples being tested. “In most labs we are seeing a gradual trend of decline in the number of positive cases with respect to the number of samples being sent. There have been very few cases in Bengaluru for the last few days,” Akhtar said. ‘
The trend has also been reported from laboratories testing for the coronavirus in Karnataka.
“The work load has increased in terms of samples that require testing but we are seeing a decline in positive cases. Seven days ago, there were around eight positive cases a day but in recent days there were only one or two cases,” a scientist at an NIV lab in Bengaluru said.
Meanwhile, the testing of around 75 samples collected from random persons reporting at various fever clinics and respiratory illness clinics in Bengaluru has not thrown up any cases of Covid-19 infections, suggesting there is still no community transmission, said the scientist from the NIV lab in Bengaluru
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