Covid-19 update: Genesis of India’s biggest coronavirus hot spot
On March 25 as Indians woke up to the first day of a three-week lockdown to stave off the Covid-19 epidemic, disease surveillance officials in the national capital had just begun uncovering a problem that would soon turn into an epidemiological headache spanning 19 states: hundreds of members of a religious sect may have already taken the infection to far reaches of the country, sharing flights, buses, trains and community events even before the country could be shut down.
Tips about an infection hotspot at the Tablighi Jamaat’s Nizamuddin headquarters began trickling in to the Delhi Integrated Disease Surveillance Programme office that week, leading the district surveillance officer (DSO) to dispatch a team on March 26. Six people were found with symptoms at the building, isolated and sent for testing.
On March 29, the six were confirmed as having Covid-19. A day later, the number grew to 24. The reports of the 441 people from the Markaz suspected to have the disease are still awaited.
The origin of the infection in the sect possibly goes back to February 27, when 16,000 members began a congregation at the Sri Petaling mosque in Kuala Lumpur, Malaysia. Over four days, hundreds of worshippers prayed shoulder-to-shoulder inside a mosque complex similar to the one in Nizamuddin, while some guests posted selfies as they shared food, social posts from the event would later show.
Among the attendees were those from China and South Korea -- two countries with high rates of coronavirus infections at the time.
Two weeks later, Malaysia’s cases grew to nearly 670 -- 500 of these had been at the congregation, known as an Ijtema. As the foreign attendees headed back home, Brunei confirmed 50 cases linked to the gathering, Singapore identified five, Cambodia 13 and Thailand at least two.
Around the same time, in mid-March, Indonesia cancelled a Tablighi Jamaat Ijtema, but not before thousands had already gathered on the Sulawei islands.
In India, officials are now drawing connections to cases in these countries. According to immigration data accessed by HT, at least 227 foreigners were among the estimated 8,000 who had been at the Nizamuddin headquarters in March – overlapping with other visitors in the six-storey, hostel-like facility with common cooking and dining facilities.
These foreigners included people from Malaysia and Indonesia (where large crowds had already gathered) and China, where infections had by then been widespread.
A significant number of the international arrivals took place around March 10, according to officials in the Delhi Police. It wasn’t until later that the Indian government made quarantine mandatory for arrivals from China (March 13) and banned flights from Malaysia (March 17).
Some of the people who arrived, either with the infection or were subsequently infected at the building in Nizamuddin, began travelling before the outbreak turned into a serious crisis for India. It is these people whose illness would later connect back to the building in Nizamuddin as disease surveillance officers in several states started separately sounding out their Delhi counterparts.
THE INDONESIAN GROUP
The most important alert came from Telangana, where officials found a group of 10 Indonesians who had boarded the Andhra Pradesh Sampark Kranti in Delhi on March 13 to arrive at Ramagundam in Telangana the following day.
From there, they group went to Karimnagar in autorickshaws, took part in an Ijtema a day later and spent nights at a local madarsa. Around March 16, some of their local associates noticed their symptoms – bringing to light what would be the earliest confirmed case linked to the Tablighi Jamaat’s Delhi centre.
According to a health official aware of the contact tracing, the alerts were sent to the Delhi IDSP between March 20 and 24.
“Our surveillance officers went to the Nizamuddin area last week to investigate after we received reports from several states that the people who tested positive there had a history of travel to the area. That’s when we discovered that there were so many people living in the compound and started screening them for symptoms,” said an official from Delhi IDSP cell.
Another alert was sent from neighbouring Andhra Pradesh around the same time when a 52-year-old man tested positive; he had been at the Delhi building.
In all, six of the approximately 12 people linked to the Tablighi Jamaat have succumbed to the infection in Hyderabad.
“It was rigorous contact tracing exercise conducted by the Telangana government for a section of cases reported in their state that led to the zeroing-in on the infection source in Delhi. It was followed up here and the cluster was discovered,” said the official cited above, asking not to be named.
The second alert came from Kashmir. On March 25, a 65-year-old preacher who tested positive for Covid-19 succumbed to his illness in Srinagar. When health department officials worked back his travel history, they found that he had left the Tablighi building on March 9 after staying there for two days.
The man then went to Deoband (March 9-11) – a town considered as being historically linked to the Jamaat – before travelling to Samba (March 12-16) and finally reaching Srinagar, where he was based and was known as a prominent Islamic preacher.
According to officials, it was his reputation as a prominent preacher that came to attention when he died, triggering alerts that were sent to Delhi as well as Uttar Pradesh.
On March 24, the day before the domestic flight ban kicked in, a man in his late 20s reached Port Blair and started showing symptoms for the disease. The individual tested positive on Sunday, triggering the contact-tracing exercise that placed him at the building in Nizamuddin a week ago.
Routinely, officials alert their counterparts in other states if the contact-tracing determines that a Covid-19 patient was in close vicinity to others.
According to disease surveillance official, he took a flight with a stopover at Kolkata. At least one other person who was with him on the flight has also tested positive.
(With inputs from Reuters).