NEW DELHI : The government on Saturday unveiled an aggressive containment strategy that would be scaled down only if no new cases of covid-19 are reported for at least four weeks after the last confirmed test has been isolated and all contacts of the patient have been followed up for 28 days.

“However, if the containment plan is not able to contain the outbreak and large numbers of cases start appearing, then a decision will need to be taken by State administration to abandon the containment plan and start on mitigation activities," the 20-page strategy document said.

India is under a lockdown till 14 April, with the government signaling that it could be extended for areas where there are a high number of cases.

So far, the deadly virus has affected 3,082 people in India, according to information available on Johns Hopkins University website. There have been 86 deaths while 212 have recovered.

“Clusters have appeared in multiple states, particularly Kerala, Maharashtra, Rajasthan, Uttar Pradesh, Delhi, Punjab, Karnataka, Telangana and UT of Ladakh. 211 districts are now reporting covid-19 cases and the risk of further spread remains very high," the strategy document read.

The new cluster containment strategy has pictured five possible scenarios for the pandemic, a significant shift by the government from the earlier classification of the outbreak as then the disease had only four stages—travel-related cases, local transmission, community transmission and the disease becoming endemic.

According to the government document, the country currently in the third stage of the disease, where a large outbreak happens but it can be contained, while the fourth stage is when there is wide-spread community transmission.

The first two stages refer to the period when only international travel history of the patients show up, and when the disease is transmitted locally from them to their primary contact.

Finally, the government will consider covid-19 to have reached the fifth stage when the disease becomes endemic and is regularly found among people.

As per the document, the plan to tackle third stage of transmission will be to define geographic zones which have become hotspots for the infection and conduct active surveillance for cases and contacts in the identified areas.

Healthcare workers will test all suspect cases, high risk contacts and patients of severe acute respiratory infection (SARI) and expand laboratory capacity for it.

Earlier, all symptomatic individuals with history of international travel in the last two weeks, contacts of patients and healthcare workers showing symptoms themselves and patients with SARI were only tested.

Now, even direct and high-risk contacts of a confirmed case who is not showing symptoms, will be tested between the fifth and fourteenth day of coming in contact with the patient.

“The testing will continue till 14 days from the date the last confirmed case is declared negative by laboratory test," the strategy said.

A controversial part of the strategy is to provide the drug hydroxychloroquine to all asymptomatic healthcare workers and asymptomatic household contacts of laboratory confirmed cases. The drug, which is an anti-malarial medicine, has been repurposed for treatment of covid-19 without sufficient clinical data, with some health experts raising concern about its effect on cardiac patients.

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