Contact tracing of COVID-19 positive cases in Delhi has been “very limited since the beginning” and it needs to be “more rationalised”, said a report prepared by the National Centre for Disease Control (NCDC) and submitted to the Delhi government.
The report titled Revised Strategy for control of COVID-19 version 3.0 , which is yet to be made public , also noted that with the resumption of economic activities, workplaces are becoming “hotspots” and infection is spreading from workplaces to families. “Identification of workplace clusters for saturation testing after risk assessment should be undertaken on priority by all districts,” the report said.
On patients being ‘brought dead’ to hospitals, the report said that to “some extent” this could be attributed to “gaps” in the system and “delay” in accessing healthcare.
Critical care
“Mortality analysis of three Central government hospitals revealed that patients brought dead comprise 15% in RML, 6.5% in SJH and 44.6% in Lady Hardinge. Although dramatic course of illness is inevitable, but to some extent it could be attributed to system gaps in proper triaging/selection of patients to put under home isolation and delay in accessing critical care,” said the report, seen by The Hindu .
It has also pointed out multiple shortcomings in the fight against the virus.
‘7-10 contacts only’
“Contact tracing activities in Delhi have been very limited since the beginning. The number of contacts traced per positive cases on an average remained only 7-10 per contact,” the report stated.
It also said that the fatality rate in Delhi (1.9%) is higher than the national average (1.5%), and mortality rate of under 15 and people between 16-44 years of age is a “concern”. The report was prepared in consultation with an expert group headed by V.K Paul, member of NITI Aayog. Last month, L-G Anil Baijal had asked for a revised plan to fight the virus.
The report said that scaling up of daily COVID-19 testing in the city has “not been specific”. “Increase in number of tests should be reflected in increased case finding. Merely increasing number of tests to reduce positivity rate would not be appropriate,” the report said, adding that majority of testing has been done in camps at railway stations and bus stands and hence the majority of people tested are “asymptomatic”.
The report said that positivity rate of Rapid Antigen Test (RAT) is 4.3%, while that of RT-PCR is 20.2%. This again underlines that RT-PCR is more accurate, but the Delhi government has been heavily dependent on RAT. The High Court has also asked the government to increase RT-PCR testing.
The report said that criteria for scaling up of testing should be based on positivity of each district and preferably ward level, and should not be “target driven”.
“Testing should not be target driven rather it should be guided by surveillance in containment zones, number of positive cases and their symptomatic contacts identified and number of symptomatic persons identified at screening sites,” the report read.
It also said that 2,324 healthcare workers have been infected by the virus and recommended that the healthcare workers should be monitored on a weekly basis though rapid antigen tests, RT PCR tests, pooled RT-PCR tests and sero-surveillance.
