The Union health ministry has asked 14 states to control the Covid-19 pandemic by reducing the test positivity rate (TPR) below 5% and keep a close watch on ‘evolving situation’ in view of the festive season.
In a communication to these states having high Covid numbers, the Centre stressed on the need to increase the number of RT-PCR (reverse transcription- polymerase chain reaction) tests to identify Covid patients in a bid to reduce TPR and fatality rates.
The Centre’s directive came during a review meeting held with representatives of various states through a video conferencing earlier this month.
The Centre’s report containing challenges and action plan for 14 states say , “The high caseload districts including Hyderabad (Telangana), Chennai & Salem (Tamil Nadu), Alwar & Kota (Rajasthan), Nagpur (Maharashtra), East Godavari & Chittoor (Andhra Pradesh) and Kamrup district (Assam) need high degree of alertness to be maintained."
All the states were asked to have an intensive IEC (information, education and communication) campaign under a Jan-Andolan to create mass awareness among people against Covid-19 and plan, install and operationalize PSA (pressure swing adsorption) oxygen generation plants in government hospitals.
“Delhi has seen a drop in number of tests. The split of tests is heavily skewed towards antigen tests. Delhi should follow the ICMR protocol and ramp up testing by RT-PCR. Despite a decrease in absolute number of deaths, Delhi needs to ensure decline in fatality rate. It also needs to restart monitoring of hospital wise fatalities," the report said.
In regard with Maharashtra which has the highest Covid numbers, it said, “Though the average daily new cases are showing a declining trend, Maharashtra’s week on week average number of tests done is declining. The state is also witnessing a high positivity rate. The week on week case fatality rate is also increasing which is an area of concern."
The report further says, “The death in the first 48 hours is very high among hospitalised patients. The state needs to ensure effective surveillance for early case detection and an ambulance system that would promptly shift the patients to hospital."
On Kerala which was once hailed as a role model for its fight against the pandemic the report states, “The weekly new cases have increased manifold which is a matter of concern. The testing has gone down and the positivity rate has gone up."
Andhra Pradesh, Assam, Chhattisgarh, Karnataka, Kerala, Madhya Pradesh, Odisha, Rajasthan, Telangana, Uttar Pradesh and West Bengal were asked to ramp up testing particularly through RT-PCR.
About Telangana, the report says, “As compared to mid-September there is a reversal of testing strategy from RT-PCR (90% in mid-September) to RAT (rapid antigen test) (89% in October). If this is due to data discrepancy the same needs to be corrected with ICMR."
The report warns Tamil Nadu stating that the state is witnessing a migration in hotspot areas to newer districts.
On infection and deaths among health care workers (HCWs) the centre asked Chhattisgarh, Karnataka, Odisha to work on it by training and re-training HCWs on infection, prevention and control practices.
The report also said high death rate in the first 24 to 72 hours in the states like Madhya Pradesh (26% of Covid deaths in first 24 hours), West Bengal (20% of Covid deaths in first 24 hours) and Rajasthan (25.6% of Covid deaths in first 24 hours) was an issue of concern.
The report said these states with Andhra Pradesh and Karnataka have a positivity rate of 12% or more. Besides these states, Assam, Chhattisgarh, Delhi, Odisha and Uttar Pradesh too were asked to reduce the fatality rate among Covid patients.
Madhya Pradesh Health Commissioner Dr Sanjay Goyal said, “We are working on the action plan including PSA oxygen generation plants. The situation is much under control in the state which is far better than that in many other states. We are constantly working on strengthening our health system."
Principal secretary, department of Medical and Health, Rajasthan Akhil Arora said, “Concerns raised by GoI were suitably addressed. However, the kind of information available with them had certain gaps. We apprised them with the action plan and steps taken by the state, the union secretary and DG ICMR, appreciated five things Rajasthan is practicing – pre-Covid suspect treatment; post-Covid treatment; overall arrangement of oxygen; testing strategy and Jan Andolan for awareness, which we started prior to GoI."
He said, “Rajasthan and Tamil Nadu are the only two states, which are conducting 100% RT-PCR tests. Our confirmation percentage is around 5% as compared to the national average, which is over 7%. Less than 10% of patients are dying within 24 hours due to Covid-19."
Odisha health secretary Pradipta Mohapatra said, “Currently Odisha has less than 3,000 patients in hospitals and oxygen supply is not an issue. Besides, since last 8 days Odisha has continued to report less than 2,000 new Covid-19 cases bringing down the daily positivity rate to 4%."
Managing director of National Health Mission, Odisha, Shalini Pandit, who is looking after the Covid tests, however, did not comment on the declining number of tests as well as RT-PCR tests.
As per Kerala health officials the test positivity rate (TPR) is almost triple the national average (14.19% against 5%) and in active caseload it is on third spot. Officials said a Union health ministry expert team that visited Kerala two weeks back was satisfied with the state government’s initiatives.
(With inputs from Rajasthan, Odisha and Kerala bureaux)
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