Those who recover from infection also should follow COVID-appropriate behaviors

More than 4.5 crore tests have been conducted till date, taking India to the second position globally in terms of cumulative testing. A record number of 11.72 lakh tests have been done in the last 24 hours. This apart, around 29.70 lakh patients have recovered till date. Another record has been set on Wednesday (September 2, 2020) with the recovery of 68,584 patients which is the highest single-day recovery. This has been stated by Shri Rajesh Bhushan, Secretary, Ministry of Health and Family Welfare in a press briefing on the actions taken, preparedness and updates on COVID-19, held at National Media Centre today. In an important development of the bygone week, the Ministry of Home Affairs has issued the guidelines for Unlock 4.0, further stated the Health Secretary.

Speaking about the exponential increase in testing, the Health Secretary pointed out that the present record has been achieved starting from just 10,000 tests around the second week of April. Similarly, the number of recovered patients is also on the rise. Presently, when there are 8,15,538 active cases in the country, the count of recovered patients is 3.6 times of the total active cases. Shri Bhushan further stated, even as the number of infected persons is rising, India having 2972 cases per million population stands amongst countries having the lowest cases per million population. The global average is 3359 cases per million population.  India has recorded 49 deaths per million population, which is also amongst the lowest in the world.

The Health Secretary also shared information about state-level week-on-week average daily active cases trajectory. He said, 5 states, namely, Maharashtra, Andhra Pradesh, Karnataka, Uttar Pradesh and Tamil Nadu account for more than 62 percent of the active cases. Maharashtra accounts for almost 24.77% of the active cases, followed by Andhra Pradesh with 12.64% cases and then Karnataka with 11.58% of the active cases. As per data received from these 5 states on Wednesday (September 2, 2020), Maharashtra has recorded a 6.8% decrease in the number of active cases over a period of three weeks. Starting from an average of more than 2 lakh active cases in the week falling between August 13-19, it decreased to around 1.66 lakh active cases between August 20-26 and then was around 1.86 lakh in between August 27-September 2, 2020.

Similarly, Andhra Pradesh recorded almost 13.7% decrease in the average number of active cases over the last three weeks. Karnataka recorded almost 16.1% decrease in active cases, Tamil Nadu recorded almost 23.9% decrease and Uttar Pradesh recorded almost 17.1% decrease in the number of active cases in the same period. Again, 5 states account for 70.15% of COVID-19 related deaths that have occurred in the country. These are Maharashtra (accounting for 37.39% of deaths), Tamil Nadu (11.16% COVID-19 deaths), Karnataka (8.83% COVID-19 deaths), Delhi (6.65% COVID-19 deaths) and Andhra Pradesh (6.12% COVID-19 deaths). Again, the average daily case fatality trajectory over the past three weeks in these states show that only Karnataka and Delhi has recorded an increase in the case fatality trajectory. Over the past three weeks (August 13-19, August 20-26 and August 27-September 2), Andhra Pradesh recorded a decrease in fatalities by 4.5%, Maharashtra recorded a 11.5% decrease and Tamil Nadu showed a 18.2% decrease in fatalities.

While Karnataka recorded a 9.6% increase in fatalities over this period, Delhi recorded a 50% surge in fatalities over the past three weeks. The number of active cases has also increased in Delhi over the past few days, for which Union Home Affairs Ministry is actively engaging with the Delhi Government to take necessary action. The Health Ministry tracks cases on a daily, weekly and cumulative basis and these data are shared with states so that every state and UT can decide upon their strategy based on this information.

Informing about the rate of positivity among health care workers in various states and UTs, Health Secretary stated, certain states having a high positivity rate among healthcare workers are: Telangana – 18%, Maharashtra – 16%, Delhi – 14%, Karnataka – 13%, Puducherry – 12% and Punjab -11%. Shri Bhushan further informed attention of these states and UTs have been drawn to this issue. It has to be seen whether the standard protocol for hospital infection practices is being followed and adequate protection is being taken by the healthcare workers, added Shri Bhushan. The concerned states and UTs have also been alerted to check the infection status of the localities from where the healthcare workers come, added Shri Bhushan.

In reply to another media query, Shri Bhushan said, “Although the cumulative number of testing has increased, positivity rate remains 7.20%. The Government has adopted a graded approach to unlock and open up various economic activities. Prior to this, the Government has ensured all the pre-requisites are in place. It has been ensured that the testing capacity is adequate, clear-cut guidelines of standard clinical treatment protocol, hospital infrastructure is enhanced with adequate number of ICU beds, isolation beds and oxygen beds. All these have been firmed up, shared with states and only then, the Government has gone in for a graded opening of the economy. At the end of the day, the Government firmly believes that while lives are important, livelihoods are equally important.”

In reply to another query, the Health Secretary said, testing data will show that Rapid Antigen Tests were not available in the months of March and April and then maximum was RT-PCR tests. Presently, certain states like Tamil Nadu’s cumulative testing data shows that more than 90% are RT-PCR tests. However, there are states where optimal capacity of RT-PCR test is not being utilized. The Health Ministry has drawn their attention to the fact that they do have an installed capacity of conducting more RT-PCR tests and hence they need to scale it up. There are states where the RT-PCR, TRUENAT and CB-NAAT testing capacity is limited. A public health manager cannot be satisfied with limited testing in containment zones and buffer zones. ICMR’s guidelines clearly lay down that Rapid Antigen Tests are ideal screening tests for densely populated areas, containment and buffer zones. So, these tests are being used in those areas, stated the Health Secretary. DG, ICMR stated, WHO has lauded India for use of Rapid Antigen Tests in a calibrated and distributive manner.

In reply to a query on sero-survey, DG, ICMR stated, 50 out of 70 districts have completed the second round of sero-survey. The results of the entire country’s sero-survey should be available within two weeks.

In reply to a media query on attaining immunity after recovering from COVID-19 infection, the Health Secretary replied that various scientific studies across the world suggest that a person may possess antibodies from 5-6 months to many years. Stating this, Shri Bhushan also stated that those who recover from the infection should also follow the social distancing norms. The DG, ICMR, Prof. (Dr.) Balram Bhargava stated it is a new disease and hence, no definite answer can now be given on the duration of immunity. In this connection, DG, ICMR, also stated that immunity against respiratory viral diseases is short-lived and does not last up to a year. Speaking on PLACID’s trial to assess the safety and efficacy of convalescent plasma conducted over 450 patients conducted across 39 institutions in India, the DG, ICMR stated, final results have been compiled and communicated and may be declared this week.