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Improve surveillance, screen pneumonia cases — how experts want India to fight coronavirus

According to the experts, there is a need to test pneumonia patients for coronavirus, and do community-level surveillance by engaging multipurpose health staff.

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New Delhi: India needs to improve surveillance and engage multipurpose health staff to actively find coronavirus cases with the number of positive cases rising to 30, multiple experts have said.

Speaking to ThePrint, Oommen Kurian, senior health fellow, Observer Research Foundation said, “It is likely that many people with the virus are missed during (airport) screening. For most travelers, screening was purely based on voluntary disclosure of travel history. It is surprising that we are reporting only a small number of confirmed cases yet.”

India had been primarily screening travellers at airports from a few coronavirus-hit countries so far. On Wednesday, Union Health Minister Harsh Vardhan announced universal screening of all international travellers to India and cancelled e-visas to passengers from Italy, Iran, South Korea and Japan — nations severely hit by the virus.

The number of confirmed coronavirus cases in India has increased to 30 from three at the beginning of March. Out of these, three have recovered, according to the Union government.

Vardhan said the situation is not “grave” yet. However, the number of Covid-19 (strain of coronavirus) positive cases may soon increase as the contacts of the confirmed patients are tested. The long incubation period of the virus, with a mild nature, raises difficulties in detecting it early on.

Dr G. Arunkumar, director of Manipal Institute of Virology, said, “There is an urgent need to do community surveillance to know if there has been a community spread of the virus.”

This means pneumonia cases in hospitals across the country should be tested for the virus at influenza laboratories.

If this surveillance reveals no positive cases, it means the country can be confident the virus is not spreading. But if it does find cases, the government can mobilise the state machinery. This is already being done by Singapore, Arunkumar said.

Also read: Coronavirus impact on India’s trade estimated to be $348 million: UN report

Use multipurpose health staff

Rajeev Sadanandan, a former IAS officer who was the additional chief secretary in Kerala during the Nipah outbreak in 2018, said the Indian government needs to bring in its multipurpose health staff to do community-level surveillance with the number of epicentres increasing.

The retired civil servant was referring to workers like the Accredited Social Health Activists.

According to him, these health workers can go door to door to anyone who has travelled internationally in the last 30 days and ask if they suffer from any of the symptoms and identify them early. While it is a huge task, it is worth doing it now.

“Kerala has started doing surveillance for all travellers who have come from the Gulf,” he said.

According to Dr T. Jacob John, paediatrician and virologist who retired from Christian Medical College, Vellore, India has been able to deal with outbreaks like Nipah which are focussed and present in only one or two locations, but in case of widespread outbreaks, it falters.

In a statement issued Thursday, Sanjeeva Kumar, Special Secretary, Health, said district collectors and states have been asked to form rapid response teams.

The outbreak that started from the Chinese city of Wuhan has now affected over 70 countries, causing over 3,000 deaths.

Also read: Why coronavirus is a global human credit crunch


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