Gurugram keeps case count, fatalities below ‘red zone’ limitsUpdated: May 21, 2020 22:36 IST
At 239, Gurugram district has the highest number of coronavirus cases in the state. Despite this, it is not in the Red Zone -- an area-wise categorisation that would entail strict restrictions-- as it was within the “critical limits” set by the Indian Council of Medical Research (ICMR), the country’s apex biomedical research body.
On Wednesday the Haryana state government declared all 22 districts in the Orange Zone, one step below Red Zone and one above Green Zone (which has nearly nil cases). On May 18, the central government, while extending the lockdown a third time till the end of the month, had given greater say to states to decide on which areas fall under Red, Orange and Green zone categories.
According to them, weekly reviews of certain parameters like active cases, doubling rate among others, will be carried out to further categorise districts into different colour codes.
Six parameters – total active case, active case per 100,000 population, doubling rate, case fatality rate, testing ratio (number of tests per 100,000 population), and sample positivity rate – with critical and desirable limits to colour code districts has been set by the ICMR, India’s apex medical research body.
Gurugram, said additional chief secretary (health) Rajeev Arora, was below critical limit for each of the six parameters. “These are important for monitoring Covid-19 prevalence across all the districts. Since there has been an ease in the lockdown, the data analysis will tell us about the impact on the Covid-19 situation. Every week, will be monitoring districts on the six parameters and take action accordingly. It is a dynamic process,” said Arora. According to him, the next review will be on May 25.
Total active cases are the number of Covid-19 patients hospitalised. As per the ICMR, the situation is critical if it exceeds 200. In Gurugram, 95 are under treatment, while 131 have recovered and discharged and the rest do not require hospitalisation.
Dr. Sudha Garg, district surveillance officer, said, “We are discharging patients after taking their samples on the tenth day of their treatment. The reports are received in a day or two after which the patient is discharged. As per revised guidelines, we are doing only one confirmatory test before releasing a patient.” Earlier, Covid-19 patients were discharged after two confirmatory tests.
This number is arrived by taking into consideration the 2011 census. As per ICMR guideline, the limit is 15.
In Gurugram, the number has come down from 7.40 on May 15 to 6.27 on May 20. Ashok Meena, officer incharge for state’s Covid-19 data, who is also CEO Ayushman Bharat and commissioner, food and drugs department,, said, “It doesn’t mean we are not testing people. It is a parameter to check the extent of coronavirus spread in the overall population, which is currently under control.”
It estimates the number of days it takes for number of cases to double. An increasing doubling rate, therefore, means fewer days until the total number of cases doubles. It is calculated over a seven-day period. The doubling rate till May 8 was almost seven days. It, however, slowed to 15 on May 15 and in the last two days, it has further slowed to 17.
It is one of the important factors in categorising, directly or indirectly impacting other parameters. Testing ratio is the number of tests per 100,000 population. It is critical situation if less than 65. According to government data, testing ratio in Gurugram has increased from 582 to 661 in the last few days. “Besides contact tracing, our focus has been on the vulnerable population who are at higher risk of exposure to the coronavirus. Be it symptomatic or asymptomatic, samples are being taken for RT-PCR to check the community spread,” said Arora.
ICMR requires the fatality rate (number of deaths per case expressed as percentage) to be below 6% and that it is desirable that it be less than 1. The first death in Gurugram was recorded on May 21. Till date, other deaths reported in a few private city hospitals and the sector 10 Civil Hospital were patients from other states. According to health officials, these deaths are included in Covid-19 death list of the respective states.
It is the confirmation rate of the samples taken and the desirable number should be less than 2%. ICMR guidelines states it becomes critical if it exceeds 6%. Data from May 15 shows the sample positivity rate fluctuated between 0.26% to 2.46%. “The numbers are increasing as the testing is increasing with focus on high risk contact. Still, it is below the threshold mark,” said Meena.
Dr. Preeti Kumar, vice president, Public Health Foundation of India (PHFI) said, “Most of the indicators for Gurugram are higher than the state average like the active cases per lakh population and sample positivity rate.Gurugram’s sample positivity rate shows the infection has not yet spread, which is also clear from the doubling rate figure. The case fatality ratio, on the other hand, is impressive as it reflects people have reached for clinical services with the onset symptoms and second there are enough health facilities to look after these patients. ”