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Monday, October 18, 2021

Behind Mizoram’s Covid numbers: Aggressive testing & long, strict curbs

About 16% of the cases registered in August and September have been in the 0-10 age group, which is twice the national average, though none of them is serious.

Written by Tora Agarwala | Guwahati |
Updated: October 2, 2021 11:38:32 am
Mizoram news, Mizoram covid-19 cases, Mizoram coronavirus cases, Mizoram covid news, Mizoram news, Mizoram latest news, indian express, north east news, india newsLast week, it recorded its highest single-day surge, with 1,846 cases -- the third highest count in the country that day. (File)

As Covid-19 seems to be on the wane in the rest of the country, the small hill state of Mizoram is not only reporting a disproportionately large number of cases, but also the highest prevalence amongst children.

About 16% of the cases registered in August and September have been in the 0-10 age group, which is twice the national average, though none of them is serious. Some of these infections were reported from outbreaks in residential schools and orphanages.

“About 30% of the new cases (in the last few days) are among those less than 18 years old. Children are unvaccinated and, moreover, people are fed up with following Covid-appropriate behaviour,” said Eric Zomawia, Director, National Health Mission, Mizoram, explaining the infections.

With a population of barely 12 lakh, Mizoram has been consistently among the top five in fresh infections the past few weeks, alongside much bigger states such as Kerala and Maharashtra. It currently has nearly 16,000 active cases.

Mizoram news, Mizoram covid-19 cases, Mizoram coronavirus cases, Mizoram covid news, Mizoram news, Mizoram latest news, indian express, north east news, india news Mizoram has been consistently among the top five in fresh infections the past few weeks.

Last week, it recorded its highest single day surge, with 1,846 cases — the third highest count in the country that day. On Monday, its positivity rate was 31.77%, against the national average of 1.42%. Its September count of 32,000 infections was a 60% rise over August.

Even decent vaccine coverage has not been able to control the infections — 88% of the eligible population of the state (or 6,80,690 people) have received at least one dose, while about 63% (4,42,602) are fully vaccinated. PTI reported that a Central team was expected to visit the state soon to assess the situation.

What explains the surge in cases? Several health officials The Indian Express reached out to said it was because Mizoram was “simply good at reporting its cases”.

Dr Pachuau Lalmalsawma, State Nodal officer of the Integrated Disease Surveillance Programme, said the surge could be attributed to “aggressive” testing and reporting of infections in Mizoram, as well as contact tracing.

He said children too were tested as part of the contact tracing model. “In a family, if one person shows symptoms, we will test every other member, including a baby,” he said. “Even if family members test negative, they are quarantined for three days, after which an RT-PCR test is done.”

Health Minister R Lalthangliana attributed the high number of cases to their testing model. “No other state is carrying out mass testing, contact tracing with the police force involved,” he said, adding that they “search all corners of the state for suspected cases”. The contact tracing team is under the Mizoram Police.

Lalmalsawma said the high positivity rate was due to testing of “targeted populations”. “So we do not get many negatives.”

Besides, in “restricted areas” that report a high number of cases, officials do “active case searches”. “We seek out people with Covid symptoms, go house to house,” said an official with the contact tracing team, who did not wish to be named.

Lalmalsawma referred to the “Mizo ethic” which helped in reporting cases. “Mizo society is very disciplined in general so there is cooperation from the public and very few people have the tendency to hide cases. This makes our job easier,” said Lalmalsawma

Ensuring that this testing model is thorough are not just health department officials, but civil society organisations and NGOs, which yield a lot of power in Mizoram. “Local Level Task Forces and Village Level Task Forces are responsible for carrying contact tracing plus enforcing various Covid-related orders. So it is a very thorough process,” said the official.

Another reason for the surge, experts believe, is the prolonged lockdown in the state — which might have ended up proving counter-productive. Even as other states began to unlock after the first wave ebbed, Mizoram didn’t ease restrictions, and continued to enforce lockdown after lockdown. Since March 2020, the state has been under some form of curfew, and “lockdown-like” restrictions imposed during the second wave — when it did not report many cases — are partially in place even five months later. “It is like a world-record lockdown,” said an official.

While in both the first and second wave, the Northeastern states witnessed surges somewhat after the rest of the country, the Mizoram situation still seems to be unique. Probably because of the stringent measures, the state took almost seven months to record its first 1,000 infections. Until a 62-year-old man, with comorbid conditions, died in October 2020, it remained the only state in the country with zero fatalities during the pandemic.

A senior official of the ICMR-Regional Medical Research Centre, Dibrugarh, said: “The stringent lockdown measures during the first and second wave may have resulted in still a large chunk of population still being vulnerable to Covid-19.” While a full serological survey has not been done in Mizoram, Lalmalsawma said mass testing in areas shows most people are not “immune” to the virus.

A health official in Mizoram, who did not want to be named, said that the government’s prolonged and strict lockdown “backfired”. “We used too many fear tactics in the beginning. In some localities, if someone who went to a shop tested positive, everyone who went to the shop was tested,” he said.

He added that containment zone orders were lifted only if a particular area reported zero cases for seven consecutive days. “Now, on the sixth day if someone tested positive, then containment would be extended for another seven days. Sometimes containment zones were in place for several weeks. People are worn out and have developed a sense of fatigue,” he said.

Since September 2020, the state has had guidelines for home quarantine for asymptomatic patients. Officials said they will soon come up with guidelines to introduce home quarantine for the symptomatic as well.

The silver lining is that most cases have been mild. That is why despite not having the adequate medical infrastructure, it has been able to cope with the current infections. With 313 deaths, the death rate is at 0.03%.

Pointing to this, the Health Minister said: “Our main aim is to reduce the fatality rate. In the first wave, we had 140 beds and 13 ICU beds. We have now increased it to 307 beds and 34 ICU beds. We will continue to expand that.”

The state currently has one major hospital — the government-run Zoram Medical College (ZMC), which houses its sole RT-PCR testing laboratory. Apart from that there are 18 Dedicated Covid Health Centres in districts, and a network of over 400 Community Covid Care Centres. “In the last two months, we ramped up our network of Community Covid Care Centres in localities, so the pressure on ZMC is less,” Lalmalsawma said, adding that the the health system was not “overwhelmed” but they were “keeping their guard up.”

Noted virologist Gagandeep Kang said children getting infected was not yet a cause of concern as the cases were mild. “Also, the data is not presenting a very clear picture right now. In some places, for example, a rise in confirmed infections amongst children is mainly because more tests are being conducted amongst them as compared to earlier,” she said.

To deal with the surge, health minister Lalthangliana said that the state’s Covid Management Committee was meeting to “relook” at their testing strategy and lockdown restrictions. “There will be some changes which I can only share once the meeting is over. We will be reviewing some of our measures,” he said.

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