Migrant workers, heading home, cross the Chambal bridge on the Dholpur-Morena border in Madhya Pradesh, Monday. (Express photo by Gajendra Yadav) Migrant workers, heading home, cross the Chambal bridge on the Dholpur-Morena border in Madhya Pradesh, Monday. (Express photo by Gajendra Yadav)

As the number of COVID-19 cases reached 1,251 across the country (101 recovered, 32 dead), India is set to ramp up testing in 10 identified “hotspots” where “unusual” transmission has been detected. Of these, two — Dilshad Garden and Nizamuddin — are in Delhi, the others being Noida, Meerut, Bhilwara, Ahmedabad, Kasaragod, Pathanamthitta, Mumbai and Pune. In the last 24 hours, 227 cases and five deaths have been reported.

A source in the Integrated Disease Surveillance Programme said, “Normally we define any area where there are more than 10 cases as a cluster. Places, where there are several clusters, are treated as hotspots. Sometimes the cases are localised, sometimes so widespread that the entire city has to be covered. Ahmedabad is an exception — there have been just five cases, but three deaths. Our assessment normally is that there are 100 cases for every death. That is why Ahmedabad is a hotspot in our list. Three deaths and five cases do not add up.”

A senior official in the Health Ministry confirmed, “We are stepping up testing in the hotspots. But testing will be done only as per testing protocol.” The government position remains that there is no community transmission so far.

Joint Secretary, Ministry of Health, Lav Agarwal said Monday, “We are studying the emerging hotspots. We will follow rigorous surveillance and containment measures in these places.” He added that only a “minuscule percentage” of asymptomatic people have tested positive in the country. India has so far done 38,432 tests.

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Explaining the rationale behind the decision to step up testing in hotspots, the source said that by the 100 cases to one death surveillance ballpark, India’s current number of cases is less than half of what it should be. “We may be missing out something. There is as of now no change in testing strategy, but we are pulling out all the stops in the door-to-door containment plan.”

The cluster containment plan, as per the notified guidelines of the Ministry of Health, mandates: “If the epidemiological assessment process is to take time (>12-24 hrs), then a containment zone of 3 Kms and a buffer zone of 7 Kms will be decided which may be subsequently revised, if required, based on epidemiologic investigation. Except for rural settings.”

Nizamuddin in Delhi has emerged as a hotspot after a religious meeting there was attended by people with travel history to Indonesia and Malaysia. The Dilshad Garden index patient had returned from Saudi Arabia, passed on the virus to a doctor, who in turn saw over 1,000 patients at a mohalla clinic before being diagnosed.

Jain Manav Seva Mandal distribute food packets to the homeless at Kalbadevi, Mumbai, on Sunday. (Express photo/Nirmal Harindran) Jain Manav Seva Mandal distribute food packets to the homeless at Kalbadevi, Mumbai, on Sunday. (Express photo/Nirmal Harindran)

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The Meerut case concerns a man who came back from Dubai and took public transport to visit his in-laws in the city. Apart from the homes he himself went to in the neighbourhood, his family is suspected to have exposed many people to the virus.

In Mumbai, officials suspect several clusters have developed. One hospital had to be closed down after a retired urologist who died and his son who tested positive were found to have had contact with a large number of people. Several doctors and staff members of another hospital had to be quarantined after a patient tested positive.

There have also been cases in several slum clusters, where social distancing is unrealistic.

In Bhilwara, several medical staff of a popular private hospital have tested positive, leading to more than 20 lakh people across the district being surveyed.

Here’s a quick Coronavirus guide from Express Explained to keep you updated: What can cause a COVID-19 patient to relapse after recovery? | COVID-19 lockdown has cleaned up the air, but this may not be good news. Here’s why | Can alternative medicine work against the coronavirus? | A five-minute test for COVID-19 has been readied, India may get it too | How India is building up defence during lockdown | Why only a fraction of those with coronavirus suffer acutely | How do healthcare workers protect themselves from getting infected? | What does it take to set up isolation wards?

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