Five months after the first Covid-19 case was reported from Gujarat, the government is largely relying on data collected via ITIHAS (IT-enabled lntegrated Hotspot Analysis System) developed by an IIT-Madras professor, for surveillance and containment strategies, apart from manual contact tracing.
ITIHAS is a predictive, back-end tool to fine-tune Aarogya Setu data “strictly for surveillance purposes”, according to Ahmedabad Municipal Corporation (AMC) officials.
In Gujarat, it was first used in Ahmedabad from May 23, and is now expanded to Surat, Vadodara, Rajkot and Navsari districts, while also being used for state-wide prediction of emerging hotspots. According to the Gujarat health department, as of August 19, there are 883 emerging hotspots across the state.
This tool takes data via two channels once a patient tests positive — one from ICMR, the nodal agency which is notified of positive cases tested in labs, or via Aarogya Setu application depending on the declaration and self assessment by the user.
At a media presentation on Thursday, principal secretary, health and family welfare, Jayanti Ravi, called the tool a “game-changer in surveillance activities… with an intelligent way of pin-pointing (areas) by use of a complex, artificial intelligence algorithm”. However, an AMC official on condition of anonymity opined that the tool “may see privacy concerns”.
AMC that has used ITIHAS the longest with constant feedback, now sees an improved version and accuracy. It uses mobile network tower pings, which are around 11,000-plus across Ahmedabad, divided across the 133 pincode areas.
Once tested positive, the tool traces the movement of the patient’s past 20 days and based on duration spent calculated by mobile pings sent to the tower, an exposure score is calculated, which is further fine-tuned and mapped geographically to undertake surveillance activities.
Analysts from Raksha Shakti University in Gandhinagar, coordinate with a team of professor V Kamakoti from IIT-Madras who then processes the raw data and reverts to AMC and AUDA (Ahmedabad Urban Development Authority) officials. Kamakoti was among the developers of Aarogya Setu app.
Ravi, also said while Aarogya Setu is not mandatory on the user-end for the tool to function on the back-end, although it was recommended to be downloaded. This can be attributed to the fact that each phone device pings off a tower, regardless of Aarogya Setu.
According to the state health department, as of August 19, there has been nearly 94 lakh Aarogya Setu downloads in Gujarat. ITIHAS has been used for identifying 4,696 hotspots till date.
The Gujarat government had earlier this week told the Gujarat High Court that is hearing Covid-19 related petitions about Surat Municipal Corporation using the ITIHAS tool.
Rajkot municipal commissioner Udit Agrawal says ITIHAS has been in use in Rajkot for a month. “On August 15, there was presence of people with Covid-19 in range of 192 towers of mobile phones. Within two days, we managed to eliminate 53 towers from the list by intense contact tracing and sending our Dhanvantri Raths for surveillance and screening,” Agrawal told The Indian Express.
He added that thanks to the timely alert by the ITIHAS system, the health department of Rajkot Municipal Corporation managed to reduce the the score of positive persons by 300 in five tower locations, in the range of 200 -300 in 10 tower locations, and in the range of 100 – 200 in 45 tower locations.
“Overall, there was reduction of cases in 127 towers (range). The score increased in case of 11 towers but one of them is near a Covid care centre, the other near the PDU Hospital and the remaining in busy commercial areas,” Agrawal said.
A top AMC official said, “Based on this (detection with the help of Aarogya Setu linked to ITIHAS), along with intelligence surveillance of CDR details of mobile numbers through mobile tower locations of an infected person’s movement, the areas that require surveillance and testing are decided on a daily basis.”
The official added that an authentic mobile number was sufficient to track a Covid patient and accordingly plan surveillance and testing. To authenticate this data the AMC mandated OTPs to be shown at private and government testing centres.
“Incorrect addresses and mobile numbers shared by residents before testing make it impossible to track the person if he is tested positive. Every tested resident will have a confirmed mobile number which will automatically assist in tracking,” the AMC official said.
According to a health official, the AMC limits contact tracing to 10 persons per positive patient on an average. “There is little point of contact-tracing when we have crossed 20,000 cases. With limited resources, we have to prioritise among testing, treating, containment, surveillance and contact-tracing,” the official told The Indian Express.
Secretary, Education Vinod Rao who is deployed as Officer on Special Duty at Vadodara finds Aarogya Setu “sufficient” to contain Covid-19. “The only solution is maximum surveillance and isolation of people with symptoms,” he says.
SMC health department does active and passive surveillance by the Jamini application launched around two-and-half years ago, to track malaria cases, now used to track suspected Covid-19 cases, and the Covid-19 tracker for Android phones.
Medical Officer of Health at SMC, Dr Swapnil Patel ,who handles the Jamini application, says, it is largely used by doctors who keep a log of their patients’ medical history. “We have registered 1,734 private clinics, 675 private hosptials, 51 urban health centres, 35 radiologists centres, and 100 private laboratories in Surat city,” says Dr Patel.
Till date 1.58 lakh ARI cases have been reported through Covid-19 Tracker, of which over 21,000 patients were referred to hospitals.
Through Radiology centre details, over 14,425 patients had been registered on Jamini. “Daily we get 1,500 to 1800 patients registered under Jamini app,” says Patel.
Surat Deputy Health commissioner Dr Ashish Naik said, “The Covid-19 tracker application works on TTT strategy (Tracking, Testing, Treatment).
This application is also useful to track and monitor patients with travel history.”
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