Only three contacts identified for each Covid-19 case in Gurugram

For every Covid-19 positive case reported in the district, three persons on an average are identified in the contact tracing exercise, according to the state health

For every Covid-19 positive case reported in the district, three persons on an average are identified in the contact tracing exercise, according to the state health department data. It is less than the ideal contact tracing average, of at least 10 persons for each case, and the lowest among 22 districts in the state.

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Experts say the current pace of contact tracing in Gurugram is unsatisfactory, considering the accelerated transmission of SARS-CoV-2 virus.

The contact tracing is a targeted approach to control the spread of disease. Close contacts of those who test positive for Covid-19 are identified and quarantined until they develop symptoms. The Niti Aayog, in a meeting held with the officials of Delhi-NCR, also emphasised on contact tracing, quarantine and isolation to control the record spike in cases.

The data prepared by the state health department shows that for 39,000 positive cases detected in Gurugram, nearly 131,394 contacts were identified. Of these, only 129,875 could be traced, which is nearly 98.84%. Among these, over 61% (79,003) were high-risk contacts and 6% contacts were symptomatic. In about 4.5% of cases, no contacts were identified. Based on the figures, it was found that on an average, only 3.3 persons were identified in contact tracing for every positive case.

Faridabad and Palwal also traced only four individuals, on an average, for each positive case. Other districts, such as Panipat, Jind, Panchkula and Charkhi Dadri, are tracing five persons, on an average, per each positive case. The findings show that Nuh does much better, with an average of 11 contacts traced for every positive case, followed by Sirsa, with at least 10 contacts.

With Gurugram recording over 500 new infections every day, the highest among all districts, the health department is already facing challenges in timely contact tracing. The district health department has asked the state for additional workforce, including lab technicians and auxiliary nurse midwife (ANMs), as reported by HT on Wednesday, for timely testing of high-risk symptomatic contacts.

“Gurugram has been reporting record spike in cases compared to other districts. It leads to pendency as tracing high-risk contacts within 72 hours becomes challenging,” said Dr Virender Yadav, chief medical officer.

“The contact tracing activity and its data entry is a time-consuming process, which sometimes leads to delay due to limited staff. Therefore, we have requested for deputation of additional staff,” he said.

As new infections have nearly doubled since mid-October, the health department has set a three-day target to complete the process.

Contact tracing takes into account the people who have been in contact with a lab-confirmed case for more than 15 minutes and at a distance less than one metre. They have to be identified within 24 hours, with symptomatic to be isolated and others to be quarantined.

“The outbreak can be controlled through proper contact tracing. It is poor and unsatisfactory if only three to four contacts are traced for every positive case. It means only family members are being considered in contact tracing. Studies show that in 15% of cases, high-risk contacts are mostly family members. Ideally, on an average 10 contacts per case should be identified,” said Dr Rajesh Kumar, former head of community medicine department and school of public health, PGIMER – Chandigarh.

He said that testing based on tracing is a crucial strategy in controlling the epidemic.

Lalit Kant, former head of the department of epidemiology and infectious disease at the Indian Council of Medical Research said that only widespread testing helps in effective contact tracing. “If the weekly positivity rate is 18% then in every six tests one person is tested Covid-19 positive. The testing has to be increased based on the contacts of lab-confirmed cases, which should include 10 persons for every positive case. The overall testing has to be looked in the context of the people covered under the testing net and increasing positivity rate to slow down the active transmission of the virus.”

Experts agreed that due to shortage of staff, proper contact tracing becomes a task. “It is difficult for the health department to alone conduct contact tracing of 700 cases every day. The task can be performed by non-medical professionals too, therefore, state administration should consider involving field staff of other government departments till the transmission is not controlled,” said Kumar.

Currently, the health department has 206 rapid response teams (RRTs) — 163 in rural and 143 in urban areas — under different primary health centres (PHCs) on the task. It comprises ASHA, ANM or anganwadi workers, who are accompanied by a lab technician.