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Friday, September 25, 2020

Odisha: Ganjam rides out Covid curve with contact tracing, testing

Officials attribute the turnaround in Ganjam to increased testing, extensive contact tracing, testing of all close contacts, and a second round of screening of recovered patients to check for relapse.

Written by Aishwarya Mohanty | Bhubaneswar | Updated: August 30, 2020 10:27:04 am
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Among the non-Tier I and II areas with one of the highest Covid death tolls in the country, Ganjam appears to have turned a corner. The daily positivity rate in the district where a large number of migrants flooded back following the lockdown is now less than 2%, from 14.89% in the beginning of the month. The district has gone three days without any coronavirus deaths.

Ganjam had reported its first positive case on May 2, soon after the first batch of around 200 migrants returned to it from hotspot states such as Gujarat, Maharashtra and Tamil Nadu. As the number of returning migrants gradually climbed to four lakh, before declining in end June, Ganjam Covid numbers rose steadily, from 59 on May 7 to 1,000 by June 22, and crossing 10,000 by end July.

A month later, while Ganjam has 17,456 cases, highest in Odisha, only 1,597 of these are active. Its death toll, at 185, is also the highest in the state. Having averaged seven deaths daily in June and mid-August, Ganjam has seen fatalities drop, while new cases have been falling from 500 per day in July to 200 in early August, to 180 in the last 10 days even as testing has increased to 10,000 daily. The daily positivity rate as on August 28 was 1.74%.

Officials attribute the turnaround in Ganjam to increased testing, extensive contact tracing, testing of all close contacts, and a second round of screening of recovered patients to check for relapse. The district has three Covid-only hospitals with 588 beds (261 occupied), nine Covid Care Centres with 3,744 beds (around 450 occupied), 98 ICU beds (80 occupied), and 1,763 with oxygen cylinders available (121 occupied).

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Siddharth Swain, Project Director, District Rural Development Authority and nodal officer for Covid management in the district, said the testing of contacts had made the difference. “Houses in Ganjam are usually located quite close to each other, sharing the same wall, which increases the chances of transmission if the infection is undetected,” he said.

Even as owners of commercial establishments were encouraged to get themselves tested, District Collector Vijay Kulange said they ramped up antigen testing. “More funds were released for the purpose.”

Senior IAS officer and Covid observer for Ganjam G Mathivathanan said some errors were behind the surge that overwhelmed the district initially, including home quarantine for those coming from outside, which was flouted by many. “That in a way compounded the problem.”

Once the migrant situation was controlled, officials focused on disease management, the goal being “no more deaths”. One major local-level intervention was stationing a private ambulance with a trained health worker at each gram panchayat, apart from the 108 call service for ambulances. “We hired private vehicles, equipped them with oxygen cylinders and positioned them in panchayats. In red zones the ambulances were provided for clusters,” Mathivathanan said.

Another initiative was offering counselling to patients in the first three days after they test positive. “Anxiety management has been one of our prime focus areas, and the initial days for any patient are turbulent. We have a team of counsellors (around 50 of them) available round the clock. Each one makes around 100 calls a day,” the officer said.

For surveillance purposes, a nodal officer with a team of paramedics was appointed for every 400 houses. The house mapping exercise also helped officials prepare a list of patients with comorbidities.

A help desk with four lines and an outbound call centre with 10 lines monitors all the positive cases, especially those in home isolation, with calls thrice a day. Every patient has a health card, which is shared with call centre executives to help them frame questions accordingly.

As a further precaution, a plasma collection centre was opened in the district, and has seen 102 donors so far, of the 492 identified. Authorities say 25 people have recovered after receiving plasma.

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