New Delhi: The Modi government Monday advised people to wear masks even inside their homes and treat all patients who show symptoms of Covid-19 as infected by the SARS-CoV-2 virus regardless of their RT-PCR status. The twin advice comes even as the government maintains that India is not in community transmission despite over 3 lakh cases being recorded daily in the country for the past five days.
Replying to a question about delays in RT-PCR testing in Delhi, AIIMS Director Dr Randeep Guleria said, “There are two things — the question is if one is awaiting RT-PCR test or report is delayed but symptoms are of classical Covid or the CT scan is of classical Covid, should the person be treated as positive? We should do a clinicoradiological diagnosis. The state of the pandemic being what it is, I think we have to treat these people as Covid patients.”
Further, he said it was important that one isolates to break the chain of transmission. “Do not wait for the test report to isolate. If you have a cold at this point, there is a high chance that it is Covid. Isolate and start treatment as per guidelines,” he added.
“Often it can happen that RT-PCR test is negative because the sensitivity of the test is not 100 per cent. In such situations too, if clinical symptoms are classical and there is a close contact who is positive, you should assume you have Covid. If you need admission, some hospitals now have a Covid suspect ward for such patients. They are treated as Covid, but not with Covid patients just to be extra safe,” Dr Guleria said.
Concerns about erroneous RT-PCR negative reports were also flagged last week during a review meeting in the health ministry when Minister of State Ashwini Kumar Choubey pointed out that often doctors have started relying on the CT scan score rather than the gold standard test for diagnosing Covid patients. However, on 16 April, the health ministry in a statement said: “The RT PCR tests being used in India do not miss these mutations as the RT PCR tests being used in India target more than two genes. Sensitivity and specificity of the RT PCR tests remains the same as earlier.”
NITI Aayog member (health) Dr V.K. Paul said there is currently no shortage either of RT-PCR or antigen testing kits. He emphasised the importance of masks and said that it is now imperative that masks are worn indoors too.
“In this situation, masks are absolutely necessary, so do not go out unnecessarily. Stay with family. And also, even within the family, please wear masks. Do not invite people inside homes … be careful. There is a transmissibility angle. [It is] important not to go out, not invite people. We [must] protect ourselves and our family members to the best of our ability,” Dr Paul said.
‘Do not panic & rush to hospitals, hoard medicines’
The message from both experts was that panic rather than inadequate infrastructure is getting the better of India during the second wave.
“In this disease, 85 per cent people will have mild illness. They will get well with fever medication or steam just like normal common cold. There is unnecessary panic that is causing a lot of rush outside hospitals. This causes suffering to genuine patients who miss out on beds. Hoarding of medicine at home is causing unnecessary shortage of drugs. Oxygen misuse is an important factor. There is nothing that is achieved by raising your oxygen saturation from 94-95 per cent to 98-99 per cent by administering extraneous oxygen when that could save somebody else’s life. Remdesivir was not found to have any mortality benefits, not right to think of it as a magic bullet. Only useful in moderate to severe cases,” Dr Guleria said.
Dr Paul reiterated this when he said the disease is severe in a small percentage of patients only and it is important for others to follow home isolation protocol and simpler evidence-based treatment. Highlighting the importance of the Covid vaccination pace to be maintained even as the pandemic spreads, Dr Paul clarified that there is no truth in the rumours doing the rounds that the vaccines cannot be taken by women who are menstruating.
Joint Secretary Lav Agarwal said, “We have found people, who do not need it, occupying hospital beds. Kindly do so only when medically advised.”
‘Oxygen transportation & not production is the problem’
Piyush Goyal, additional secretary in the Ministry of Home Affairs, said the problem currently is not of oxygen production but transportation, as enough tankers are not available.
Goyal, on 24 April, had said 9103 MT of oxygen was produced in the country. He also highlighted the efforts that are being made to improve oxygen transportation, including use of Indian Air Force planes to transport empty trucks and oxygen trains run by the Indian Railways.
(Edited by Neha Mahajan)