Ernakulam district administration’s testing strategy cuts both ways

Physical distancing is a joke on the State Water Transport Department boat plying between Panavally and Poothotta, as it remains crowded despite the COVID-19 protocol. A scene from Poothotta on Friday morning.   | Photo Credit: Thulasi Kakkat

The Ernakulam district administration’s decision to test symptomatic people alone will help diagnose COVID-19 infection in vulnerable people early on, but could leave several cases undetected.

“With the surge now, the strategy is to identify and test symptomatic people as early as possible to contain the spread of infection and reduce mortality. When people with sore throat, cough, fever, diarrhoea, or breathing troubles report these symptoms, they are tested immediately. Peripheral health-care facilities are now focusing their resources on identifying and testing symptomatic people in their vicinity, rather than contacts of patients who might already be in quarantine,” said Dr. Mathews Numpeli, district programme manager, National Health Mission. Vulnerable primary contacts with co-morbidities will continue to be tested, he added.

An official at the district surveillance unit, however, said a policy of not testing contacts of patients could mean that the source of infection goes undetected in a lot more cases. “We will miss asymptomatic positives who might venture out even if they are asked to remain in quarantine for 14 days. After a while, we might even start missing mildly symptomatic patients. Widespread testing among vulnerable populations, among contacts, and in areas where clusters might form, needs to continue, rather than just testing symptomatic people,” he said.

But the disease is now headed towards an endemic stage, which means it is everywhere, said Dr. A. Sukumaran, former State epidemiologist. “For immediate containment early on, testing both asymptomatic and symptomatic people was important. Now, we can no longer prevent the spread, so minimising it is the practical approach. For that, testing only symptomatic people and preventing death is justified,” he said. People without symptoms dying suddenly is very rare, he pointed out.

The flip side to focusing on symptomatic people who might develop severe complications is that the spread can still happen through asymptomatic individuals, said Dr. Rakhal Gaitonde, Professor, Achutha Menon Centre for Health Science Studies at the Sree Chitra Tirunal Institute for Medical Sciences and Technology. “Any strategy that does not test adequately among primary and secondary contacts or at least among primary contacts is likely to miss the way the virus spreads. If people who could potentially spread the disease are not identified, it could lead to new outbreaks. Testing among primary and secondary contacts is a minimum requirement to ensure we don’t have cases that are undiagnosed,” he observed.

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Printable version | Nov 28, 2020 8:25:25 AM | https://www.thehindu.com/news/cities/Kochi/ernakulam-district-administrations-testing-strategy-cuts-both-ways/article32933470.ece

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