Deep into community transmission, MP to start screening SARI, ILI patients outside hotspot areas

New Delhi: With a quickly rising COVID-19 count and one of the highest case fatality rates in its commercial hub city of Indore, the government of Madhya Pradesh has prepared a strategy to identify and contact all residents in the state who might be having Influenza-like Illnesses (ILI) or Severe Acute Respiratory Illness (SARI), especially those who are not in hotspot or containment zones.

In addition, the administration has ordered that all of Indore's nearly 30 lakh residents be screened for ILIs and SARI — mounting a challenging few weeks ahead for a city with the third-highest case prevalence, one of the highest fatality rates at around 12 per cent and a place that has lost at least 10 healthcare workers to COVID-19 due to a lack of PPE kits.

According to a new containment strategy for the state, released on Friday, the administration has ordered that SARI and ILI patients outside hotspot areas also be specifically identified and screened. In addition to contact tracing of laboratory-confirmed cases, the state government has advised that all respiratory illness cases in the state be monitored for COVID-19 symptoms and be screened.

As of Friday, MP has recorded a total of 1,310 COVID-19 cases, with 842 just in Indore. The city also accounts for an unusually large proportion of COVID-19 deaths — 47 out of total 69 — as the state administration continues to grapple with the epidemic without a health minister or a Cabinet.

However, what has triggered such mass surveillance from the local administration is the fact that most cases being detected in Indore and the state now have no known source of infection, making it extremely difficult for healthcare workers to establish epidemiological links — putting it in the clutches of community transmission.

Despite the alarming rate of infection, the MP administration has not yet ordered for testing asymptomatic individuals, who might potentially become transmitters.

While Indore already has one of the highest testing rates per million of its population, it is running out of test kits sooner than its orders are being delivered. Now that the administration has decided to expand the testing criteria, more tests will be conducted. But as of Friday, while the state had ordered for over 1.16 RNA Extraction Kits and 1.02 lakh RT-PCR kits, its stockpile only showed a balance of 200 RNA Extraction Kits and 5,300 RT-PCR Kits.

Significantly, MP is also quickly running out of Viral Transmission Media (VTM), the equipment used to collect and transport viral samples. As of Friday night, state stockpile had only 171 VTMs left, with another 2,884 yet to arrive.

An Indian Council of Medical Research study to check for community transmission had shown that MP had one of the highest prevalence rates of COVID-19 among hospitalised SARI patients as of early April when the prevalence rate was at 2 per cent. However, the study had admitted that only around 250 SARI patients from select few government hospitals were tested till April 2.