No change in testing strategy, says ICMR; Kerala reports first death in Ernakulam.

With 185 new cases and two deaths due to COVID-19 reported in the last 24 hours, the Union Health Ministry on March 28 announced a change in strategy with increased focus on high-disease burden hotspots across India. Working with the State governments, there will be intensified efforts to strengthen community surveillance, contact tracking and containment strategy, officials said.

There, however, is no change in testing strategy, the Indian Council of Medical Research (ICMR) said.

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Joint Secretary in the Health Ministry Lav Agarwal said details regarding high disease burden hotspots would be announced soon.

Dedicated hospitals

Considerable spikes in cases have been reported from Kasargod district of Kerala and Bhilwara in Rajasthan. Kerala also reported its first COVID-19 death after a 69-year-old man being treated for the virus died at Ernakulam Medical College Hospital.

“While social distancing and lockdown continue to be vital, our focus is also on setting up dedicated COVID-19 hospitals in every State, ensuring that there are adequate number of beds, ventilators and ICU facilities,” Mr. Agarwal told reporters.

“Over 17 States across India have already started work on identifying dedicated hospitals. As for the other States we are constantly engaged in discussion for earmarking dedicated COVID-19 hospitals,” he added.

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The number of confirmed cases, according to data from the Union Health Ministry stood at 909 cases (862 Indian and 47 foreigners), with 819 active cases and 19 deaths so far. Maharashtra (177), and Kerala (168) have reported the highest number of cases so far.

870 active cases

Reports from State health departments put number of confirmed cases at 974 with 870 active cases. In addition to Kerala’s first fatality, Maharahstra, Gujarat and Telangana also reported one more death each, taking the nationwide toll to 24.

Uttar Pradesh now has 61 confirmed patients with 11 new cases while 28 new cases were confirmed in Maharashtra.

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Twelve new cases were confirmed by the Karnataka Health Department, taking the total number of in the State to 76. Punjab has 38 cases, while Haryana reported 33 including 14 foreigners. Madhya Pradesh has recorded 30 cases, Jammu and Kashmir 20 with eight fresh cases, West Bengal 15, Andhra Pradesh 14 and Ladakh has reported 13.

The Central Government Health Scheme (CGHS) beneficiaries have been allowed to take three month stock of medicines. “But we request CGHS beneficiaries who have long-standing ailments, organ replacement and long-term diabetes to stay away from health care centres and have a representative collect the medicines,” noted Mr. Agarwal.

He announced that All India Institute of Medical Sciences (AIIMS), Delhi will now offer not just doctors but also nurses on-line training programs for management of COVID-19 patients. “Also AIIMS, Delhi has started a tele-consultation facility for doctors across India to ensure that uniform clinical care is offered to all COVID-19 patients,” he said.

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Stating that all patients having severe acute respiratory illness are now being tested for COVID-19 as per the previously revised testing protocol, Head of Epidemiology and Communicable diseases at ICMR Raman Gangakhedkar said though the Council has picked up small numbers of people with ‘untraceable’ COVID-19 illness history “the numbers are few and we aren’t entirely sure of the contact and travel details that they are sharing with us.”

Speaking about the ICMR’s choice of Hydroxychloroquine ( as prohylactic for health care workers and those directly involved in care of COVID-19 patients) Dr. Gangakhedkar said: “This drug showed reduction in the viral-load when given to COVID- 9 patients in some international studies. It is at testing stage in India and should under no circumstance be used by the general public. Also no vaccine currently is at human trial level yet.”

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Joint Secretary in the Home Ministry Punya Salila Srivastava, said migrant workers are a focus group to protect during this period. “We have asked all States to provide all possible support to migrant workers in the form of relief camps with adequate medical facilities etc. States have been also advised to set up relief camps along the highways for people moving on highways, including setting up of tented accommodation to ensure that these persons will stay in the relief camps till the lockdown orders are in place. The shelters are to be organised, keeping in view various precautions including social distancing, with adequate medical check up drives to identify and separate cases requiring quarantine or hospitalization,’’ she added.