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104 of 5,911 respiratory illness cases have Covid, 40 with no travel, contact history: ICMR




A doctor places a thermometer into a patient's ear during coronavirus symptom tests. (Representational Image) | Photographer: Krisztian Bocsi | Bloomberg
A doctor places a thermometer into a patient’s ear during coronavirus symptom tests. (Representational Image) | Photographer: Krisztian Bocsi | Bloomberg

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New Delhi: The novel coronavirus has been found in 104 patients hospitalised across the country for severe respiratory illnesses, 40 of whom had no history of international travel or contact with confirmed cases, said a new study looking to identify the spread of Covid-19 transmission in India.

Among 5,911 severe acute respiratory illnesses (SARI) cases tested from 15 February to 2 April across the country, the Indian Council of Medical Research (ICMR) study found 104 — or 1.8 per cent — Covid-19 positive cases in 52 districts of 20 states.

SARI patients are those who show symptoms of fever, dry cough and difficulty in breathing.

The ICMR study was published in the Indian Journal of Medical Research Thursday.

Tarun Bhatnagar, scientist, National Institute of Epidemiology, Chennai, and co-author of the paper told ThePrint that since only those SARI patients who developed severe cases were tested, there would be a large number of mild cases in the area and many of them would be infecting others for at least 1-3 weeks.

“These cases represent the tip of the iceberg, this means the infection was spread in the area,” he said.

Most of these Covid-19 cases were reported from Maharashtra (21), Delhi (14) and Gujarat (13) with a case positivity rate of 3.2 per cent, 5.1 per cent and 1.6 per cent, respectively.

At 11.1 per cent, Tripura saw the highest average of SARI samples testing positive for Covid-19, followed by Delhi and Telangana (4.2 per cent).

The results of the SARI surveillance should be matched with the confirmed cases reported from the area to find if cases are being missed, said Bhatnagar. As the samples were testing positive, the local Integrated Disease Surveillance Programme teams were alerted to start contact tracing, he added.

“These districts need to be prioritised to target COVID-19 containment activities,” said the study.

A standard operating protocol by the Ministry of Health had earlier mentioned that India’s disease pandemic is in local transmission and limited community transmission stage.

Also read: ICMR allows clinical trials of plasma therapy. What this means for fight against Covid-19

Other observations

Only two cases had a contact with a confirmed case, and one had a recent history of international travel.

While 40 of them did not have any history of contact or travel, no exposure history was available for 57.

The median age for the entire sample size was 54 years. Nearly 85 per cent of these were male, while 83 per cent were above the age of 40.

Wider testing, more cases

As India was initially testing only symptomatic patients with foreign travel history, contacts of the confirmed cases and later symptomatic healthcare workers attending to SARI patients, questions were raised about whether ICMR was testing a narrow group of people.

The ICMR then started random testing of stored samples of hospitalised SARI patients as part of a sentinel surveillance to find signs of community transmission of the novel coronavirus.

Sentinel surveillance means a select number of centres actively test samples looking for particular pathogens to check their spread in the community.

The testing criteria changed on 20 March to include SARI patients admitted in the intensive care units with severe acute respiratory illnesses across the country.

Among 965 randomly selected samples tested until 19 March, 2 cases were found positive. When the strategy changed, a total of 4,946 samples were tested yielding 102 cases.

Even if the study doesn’t mention it, Bhatnagar said the results showed the spread of infection and this sentinel surveillance exercise should continue to guide India’s efforts to find and contain the cases.

India has so far reported 6,412 confirmed coronavirus cases and 199 deaths.

Many states have announced stricter measures in areas marked as containment zones to stop the transmission of disease. The ICMR has also revised its testing protocol to include all patients showing influenza-like symptoms in such zones.

Also read: Why Maharashtra has India’s highest Covid-19 mortality numbers


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Andhra doctor, suspended for alleging PPE shortage, now beaten by cops for ‘creating nuisance’




doctor with a stethoscope
A doctor with a stethoscope (Representative image) | Pixabay

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Bengaluru: A doctor with a government hospital in Andhra Pradesh, who was suspended for questioning the shortage of PPE kits, was admitted to a mental health facility Sunday, a day after he was allegedly manhandled by the police and arrested for creating nuisance in Visakhapatnam.

Dr Sudhakar Rao, a government civil surgeon, was beaten, his hands tied behind his back and dragged by police officers Sunday. During the incident, Sudhakar allegedly verbally abused the Jagan Mohan Reddy government in an inebriated state. Videos of the incident have since been widely shared online.

“The police control room received a call about a person creating nuisance on Beach Road Hospital in Visakhapatnam. The Fourth Town police was rushed there and found that the person was the suspended doctor, Sudhakar.

“When the police tried to control him, he snatched the mobile phone of an officer and threw it away. He is suffering from mental disorder and he was drunk. He was sent for a medical examination,” Vishakapatnam Police Commissioner R.K. Meena told the media Sunday.

Sudhakar was admitted to a mental hospital Sunday after doctors at the King George Hospital in Vishakapatnam said he suffered from anxiety.

“Since the doctor is in anxiety and talking irrelevant things, I have referred him to a mental care hospital in Visakhapatnam,” said Dr Radha Rani, medical superintendent, King George Hospital.

A statement released by the hospital said: “Dr Sudhakar was brought to the KGH casualty ward at 6.30 pm. From the smell, it was found that he was in a drunk condition. Under the influence of alcohol, he did not cooperate with anybody there and kept abusing all. Still, his pulse, BP were checked. Pulse was 98, BP 140/100. Blood samples were sent to forensic lab to ascertain alcohol content in his blood.”

Also read: 6 toilets for 20 houses, inadequate testing: Why Mumbai’s Worli chawls are a Covid hotspot

‘Treatment towards Sudhakar was inhuman’

Sudhakar, who spent more than 10 years at the Narsipatnam Government Hospital in Andhra Pradesh, was suspended from his duties in March after he openly criticised the Reddy government for failing to provide PPE kits and N95 masks to doctors treating Covid-19 patients.

He had alleged that the state government was giving N95 masks and PPE kits meant for doctors to politicians and the police.

A video of Sudhakar criticising the government was also shared widely. In the clip, he can be heard saying: “We are putting our lives at risk here. We are asked to use the same mask for 15 days and a fresh mask will be provided only twice a month.”

Speaking to ThePrint, Dr P. Gangadhar Rao, member of the National COVID Committee of the Indian Medical Association, said the manner in which Sudhakar was manhandled by the police was “inhuman” and “violated” human rights.

“We strongly condemn the way he was taken into custody. He was not carrying a weapon, he was alone, the number of policemen outnumbered him. Why treat him like that? We also saw a video where a policeman beats him with a lathi,” said Dr Gangadhar.

He added that Rao was one of the most experienced anaesthetists the Andhra Pradesh government had.

“Our next step of action is to get Sudhakar to write an unconditional apology for having used filthy language, abusing the chief minister and the government. We will then take our appeal to the CM seeking that he be reinstated,” Gangadhar said.

Also read: Face shields, gowns, masks — the new attire for cabin crew post lockdown


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