One month into the national lockdown, the coronavirus outbreak has spread to more than half the total number of districts across the country, but remains concentrated in the same areas, an analysis of official figures show.
The figures show that while districts on the COVID-19 map have more than doubled in the last three weeks — from 211 districts on April 1 to 429 on April 22 — the heavy load remains confined to 12 administrative districts that recorded over 200 cases each.
In fact, these 12 accounted for over 50 per cent of the 18,985 cases for which district-wise statistics have been made available by the Union Health Ministry.
The data also shows that only 24 districts have recorded more than 100 positive cases each. Signalling the thin spread in other areas, 223 districts have recorded less than 10 cases each while 182 others recorded double digits.
When it comes to urban centres, at least 13 accounted for well over half the number of cases: Mumbai, Ahmedabad, Indore, Pune, Jaipur, Hyderabad, Thane, Surat, Chennai, Bhopal, Agra, Jaipur and Delhi.
Meanwhile, NITI Aayog CEO Amitabh Kant revealed that the weekly doubling rate — the time taken for the cases to double — has shifted from a low of 3.54 days a month ago to 10.13 days now. In other words, while the numbers have mounted since the lockdown came into force on March 24, the pace of the outbreak appears to have moderated.
The government said that 78 districts on the virus map did not record any fresh case in the last 14 days — of these, it said, 12 districts reported no new case in the last 28 days. A majority of these, however, appear to be low case-load districts. For instance, a comparison of the Health Ministry’s district-wise data with that of April 6 shows that at least 54 districts did not see any jump in cases — of these, 49 had less than 10 cases.
With India’s case count reaching 21,700 Thursday, with a recovery rate of about 19.8%, AIIMS director and top pulmonologist Dr Randeep Guleria called for voluntary testing by all those with flu-like symptoms to prevent unnecessary delays in treatment.
Guleria’s call to those with “ILI (influenza-like illness)” symptoms signals a shift in the government’s focus, which so far has been on those who displayed COVID-19 symptoms, and had travel and contact history with positive cases.
Currently, the ICMR’s strategy focusses on testing of those with ILI symptoms — fever, cough, sore throat, runny nose — only in hotspots or clusters and in large migration or evacuee centres.
Guleria, who is a member of the empowered group on medical facilities and strategy for COVID-19, also appealed against stigmatisation so that people with such symptoms can get tested.
“We have to work on this strategy… If you test early, treatment is started early and that can save your life. If you come gasping for breath, it will lead to higher mortality. It is important to encourage everyone to seek medical attention, get themselves tested. We have ramped up testing to a large extent, there is no shortage… we should be able to support all those people who need to be tested,” Guleria said at the government’s media briefing.
“The stigma is not justified. It is causing increased mortality and morbidity. Many patients who have flu-like symptoms are not coming to health facilities or are coming late with breathlessness, leading to higher mortality when many could have been saved by oxygen,” he said.
Speaking to The Indian Express later, Guleria said, “We are advocating voluntary testing for all those with ILIs. The experience from Mumbai shows that many of the patients came to the hospital late. That is why it is important that the stigma is removed.”
The Indian Express had reported on April 15 that an analysis of the first 50 COVID-19 deaths in Mumbai showed that just over half of them died within hours or a day of hospitalisation. In almost half of these cases that led to deaths, the patients tested positive after or just before their death.
According to the Health Ministry’s latest figures, India reported 1,229 new cases and 34 deaths in the last 24 hours, taking the overall toll to 686. About 19.8% patients — 4,324 — have recovered from the disease.
At the media briefing earlier, C K Mishra, environment secretary who heads the empowered group on medical infrastructure, made a global comparison of where countries stood by the time they had conducted 5 lakh tests.
He said that the US reached the mark on March 26 with 80,000 cases, Italy on March 31 with 100,000 cases, UK on April 20 with 120,000 cases and Turkey on April 16 with 80,000 cases.
India had tested 5,00,542 samples by Thursday morning, he said, from just 14,915 tests on March 23.
“If we make a comparison, we seem to be doing well with our strategy, which is intensely focussed on areas of high positivity — of course, countries like South Korea have done better. This shows that our testing strategy has been targeted and continues to expand. It’s an evolving strategy, we are learning every day and as we are learning we are expanding…we will expand it again in future as the scale of the challenge keeps changing,” Mishra said.
He said that India’s positivity percentage has remained constant at around 4%. “Which shows we are on the right track but we are conscious that we need to ramp up testing and will continue to do that,” he said.
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