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There was evidence for community transmission — or instances of coronavirus (COVID-19) in patients who had no established contact with someone who had picked up the disease from abroad — from as early as March 22, suggests a research study in the Indian Journal of Medical Research, authored by several ICMR scientists.

The ICMR’s official position continues to be that there is no evidence for community transmission.

Background

  • On March 24, Prime Minister Narendra Modi imposed a nationwide lockdown for three weeks.
  • With the case load increasing on an average of 500 per day for nearly a week, the Health Ministry and the States have stepped up surveillance and testing at hotspots and announced indefinite extensions of the 21-day lockdown.
  • The ICMR’s testing strategy has been to check those who showed symptoms of the disease — cough, fever and laboured breathing — in those with international travel history, their contacts and health-workers tending to those with Severe Acute Respiratory Illness (SARI-a syndrome of COVID-19).
Percentage of Patients hospitalized Severe Acute Respiratory Illness SARI Positive for COVID 19

Expansion of testing strategy

  • When the COVID testing strategy was expanded to include all SARI patients (from March 21), a total of 4,946 samples yielded 102 (2.1%) cases.
  • The positivity increased from zero during the initial weeks to 2.6% in the 14th week.
  • Of the 102 COVID-19 positive SARI patients, 40 (39.2%) did not report any history of contact or international travel.
  • Details of the States from which these cases were emerging also point to why certain districts are under increased surveillance.
  • About a third of the COVID-19 positive SARI cases did not have any history of contact with laboratory-confirmed cases or international travel, and such cases were reported from 36 districts in 15 States.
  • These districts need to be prioritised to target COVID-19 containment activities, the study underlines. 2.3% of those SARI patients who tested positive were male, and positivity among women was only 0.8%.

Significance of Testing

  • Tracking the spread of COVID-19 is critical to inform response activities, including testing, containment and mitigation measures.
  • The current SARI testing strategy will complement and strengthen the routine COVID-19 surveillance activities.
  • In the last two weeks as cases have ballooned, the ICMR has significantly increased testing and roped in more laboratories — state and private — for assessment.
  • It has increased testing, and has tested 1.3 million samples (including repeats) in the last month.
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