Gurugram: Without rapid testing kits, health dept races against time to check Covid-19 spread in Jharsa, Sec 39Updated: Apr 28, 2020 23:02 IST
The containment zones of Sector 39 and Jharsa village, which account for the highest number of cases in the city, have become critical hot spots as they are inhabited by health workers employed at the Medanta Hospital, which is barely 500 metres away. Six hospital employees who live here had tested positive for the coronavirus disease (Covid-19) on April 24. Of them, four were asymptomatic, making the health department officials race against time to trace those who may have contracted it from these silent carriers.
In this backdrop, Medanta Hospital, too, has restricted the entry of all its staffers from these areas, which includes junior nurses and sanitation staff.
“Medical staff from Jharsa has been restricted from coming to the hospital. We are managing with limited staff to prevent further spread and contamination,” said Dr Yatin Mehta, chairman, critical care, Medanta Hospital.
The hospital refused to disclose how many members of its staff life in these containment zones.
“We recently collected samples of all the medical staff on duty in the Covid ward and other wards of the hospital. Test results showed that senior doctors, nurses and health staff in the Covid-19 ward were negative. The staff who tested positive were junior nurses and paramedical staff of other wards,” Dr Mehta said, adding that these patients may have contracted the disease locally in Jharsa, which was declared a containment zone on April 9. “They might have contracted the virus from their area or any other source while commuting,” he said.
Of the 51 cases reported in Gurugram till now, at least 9 cases are reported from the two containment zones. Out of these, six are health care workers.
TROJAN HORSE EFFECT
Dr Dhruv Chaudhary, nodal officer for Covid-19 in Haryana, said any asymptomatic case is like a Trojan Horse. “Coronavirus in an asymptomatic patient works in concealment. A person can remain asymptomatic throughout the 14 day quarantine period, but he can easily transmit the virus to others in this time frame. In all likelihood, the other person who contracts the coronavirus might get influenza-like illness (ILI) or get critically unwell. The concern is to trace this Trojan Horse.”
Usually, symptoms of Covid-19 start developing after 5-6 days, but patients can remain asymptomatic or show very mild symptoms for up to 14 days.
According to Dr Chaudhary, the state is adopting two epidemiological strategies to trace asymptomatic cases. “To trace asymptomatic cases one of the ways is contact tracing and the other is selecting containment zone residents randomly for sampling and testing,” he said.
Dr Chaudhary added that random testing cases through antibody testing kits, which is currently on hold due to faulty kits, was a useful tool. “Since we are waiting for the approval from ICMR on the use of rapid testing kits (RTKs), teams deployed on ground are going door-to-door and visiting the same house every fourth or fifth day to check whether the asymptomatic case has developed any symptoms. If required, samples are being taken.”
The health team, engaged in contact tracing, has mapped 1,900 houses in the 1km radius covering a population of more than 8,000 people, and is now going to each house. A mobile van to collect samples for RT-PCR has also been stationed for easy collection of samples.
Gurugram chief medical officer Dr Jaswant Singh Punia said, “We are taking the samples of all suspected cases through this van to trace maximum cases in limited time. We have also increased the number of teams doing surveillance in the area. Our ASHAs/ANMs are visiting every household enquiring about ILI symptoms in all families.”
RAPID TESTING ONLY WAY TO CHECK ASYMPTOMATIC CASES
Public health expert Dr K Srinath Reddy, president of the Public Health Foundation of India (PHFI), agrees that RTKs are required for tracing asymptomatic cases through random sampling in hot spots.
“Random sampling is done for profiling the disease in a particular area. By doing door-to-door surveillance we are only tracing symptomatic cases with ILI but we are missing out on asymptomatic cases. To trace a proportion of the population in a hotspot zone, who are exposed to the virus and are not aware of it, RT-PCR testing is expensive and time consuming. Rapid testing helps in validating such asymptomatic cases while being less time taking and cost-effective,” said Dr Reddy.