Chennai has been resolutely at the head of the table of COVID-19 positive cases for a while now. While the first case of a COVID-19 infection was reported at the Rajiv Gandhi Government General Hospital on March 7, it was actually a resident of Kancheepuram.
As a tertiary health care centre, it is likely that a large number of referrals or patients themselves seeking care are reporting in Chennai’s hospitals from the neighbouring districts as well. Be that as it may, there is still a pressing need to turn the spotlight on the city, which has had an average of just over 54% of daily new cases since April 19.
April 19 seems to be the day the apple cart was upset in Chennai. For the first time, Chennai accounted for 50 of the 105 positive cases that day. From cruising at about with a share of 14% of the daily Statewide new cases, the figure suddenly shot up to 46%. The next big spike, the highest so far in the epidemic, was on April 21 when with 55 of the 76 new cases, Chennai’s share touched (its peak yet) over 72.4%. However, as a percentage of the total number of active cases in the State, Chennai still remained at under 20, but in subsequent days rose and was at 27.7 % (of active cases) on Sunday.
Public health experts say density of population is at the core of the issue. “With about 26,000 persons per sq. km., the population density in Chennai is unparalleled compared to any other part of the State,” says P. Kuganantham, former Chennai Corporation Health Officer. It is a tertiary care centre with a large number of government and private hospitals serving COVID-19 patients, he points out. Those who test positive in Chennai may not actually be from the city. “I believe that higher number of positive cases per se need not be a source of worry, as in epidemic control it is read as the presence of a good testing mechanism. But we need to do everything to minimise risk to people,” he says.
Higher number of tests
Health Minister C. Vijayabaskar says one other reason for the high number of positives is that higher number of tests being done in Chennai. If 7,000 tests are done daily in the State, at least 1,000 to 2,000 of them are in the capital city and there are plans to increase this.
“The government does feel the need to focus on Chennai and the Chief Minister appointed additional officers to monitor the COVID-19 situation here,” he says. In addition, facilities have been made to provide real time results of tested samples via a mobile portal. The batches of samples are run in three shifts every day, ensuring that the results are delivered faster, he adds.
A senior official says while the epidemic has dispersed by now, the bulk of the cases come from the red zone areas that are under quarantine or termed as hot spot. For instance, the zones that present a real challenge include Royapuram, Tondiarpet, Thiru. Vi. Ka. Nagar, Anna Nagar, Teynampet and Kodambakkam, where population density is also high. In fact, the official says until April 19, there were only 78 wards that had positive cases, but in five days it had spread to about 108 wards.
A health department official says while ‘primary’ contacts initially provided some worry, subsequent mapping has identified their contacts with persons who were positive or contacts of those who were positive. “That way, we are still able to make out who the source was, in some cases, it was a milk delivery man or a grocer too,” the official added. Thanks to the civic body’s outreach efforts, more people with symptoms are now being identified and tested with the highest number of testing centres and collection centres in the city.
There were a large number of people who attended the Tablighi Jamaat conference from Chennai and their families and contacts too were at risk. Public health authorities say a positive case was found even 31 days after known exposure to a positive person and that has foxed them, though they try to explain that the virus continues to shed from the human body long after the person’s swabs have tested negative. There continues to be more movement in Chennai, including inter-State movement, and intra-city as more people go to work than in suburban or rural pockets.
Fatality rate
While the growing number of cases in Chennai, even as a proportion of the new positive cases is cause for concern, officials point out that the fatality is still at about 1%. “So far it is well within the State average too. We need to now, make sure additional attention is paid to senior citizens, and people who have co-morbidities. Make sure their exposure is limited, and that they remain healthy. We have brought in experts from the National Institute of Epidemiology to help us figure out how to bring down numbers in Chennai,” the official added.
