From one lab that tested 100 samples, we crossed the 1-crore Covid-19 test landmark: UP additional chief secretaryUpdated: Sep 30, 2020, 23:39 IST
On Wednesday, Uttar Pradesh crossed 10-million Covid-19 tests, a first in the country. State additional chief secretary for health Amit Mohan Prasad spoke about the initial hurdles in containing the pandemic and the way forward.
What was the state’s plan of action when the Covid-19 outbreak started?
Uttar Pradesh is the most populous state of the country with a very high population density. We were aware, right from the beginning, that we cannot let the epidemic grow unchecked in such a vast state. Test, track and treat has been the strategy of choice. The Chief Minister took the reins from the beginning and has been chairing a Covid-19 review meeting with all the senior officers of the state continuously for the last six months. This has kept the motivation level of the workforce high. The focus has been on expanding the capacity of the state to track the suspected and susceptible population early, test them quickly and treat wherever necessary.
As a result of the continuous efforts of doctors, nurses, paramedical staff and personnel from other departments like revenue, police, urban local bodies and panchayati raj institutions we have seen that the cases have remained controlled. Recently, we are witnessing a continuous reduction in positivity rate and cases of new infection. In a period of two weeks, the number of active cases has gone down by almost 25%.
Testing was a concern in the initial days. How did you manage and enhance it?
When Covid-19 broke, we just had one laboratory with a capacity of less than 100 samples per day and then we used to send samples to NIV, Pune for the confirmatory test. We started expanding our capacity quickly with medical colleges setting up RT-PCR laboratories across the state. UP was the first state to introduce pool testing in the country. We also equipped all district hospitals with TruNat machines very early. Once rapid antigen test was introduced, we quickly expanded our testing capacity to more than 1.5 lakh tests per day with a healthy mix of 1:2 ratio for RT-PCR and antigen tests, respectively. Today, we crossed the landmark of 10 million Covid-19 tests, a first in the country. Out of this, RT-PCR is about 3.5 million, while the remaining is antigen tests. We are making preparations to double the number of RT-PCR tests also. A proper and better infrastructure and increasing the number of labs are needed for this and we have already started looking for that. Through testing on a very large scale, we have been able to keep the positivity rate below 5% in the state.
How do you analyse the action taken reports from all the districts of the state? And, what are the grey areas where more focus is needed?
UP has used digital technology very well for data collection and analysis. With the help of UP Technical Support Unit, we have developed a portal which provides end to end solution for Covid-19. Govt of India also recognized this later when it gave us the go ahead to send data on their portal directly from our portal. We analyse the data for surveillance, testing, home isolation, hospital treatment, Covid-19 deaths, etc. from the portal. This has helped us to analyse the performance of the districts quickly. Chief Minister has been reviewing the performance of the districts on a regular basis through video conferencing. We keep them on their toes but also handhold them. This has been a collaborative affair which has resulted in great team work and exceptional results.
Every district in UP has an Integrated Covid-19 Control and Command Centre, which works as the nerve centre of Covid-19 battle in the district. It is manned by people from health and other departments and is equipped with modern equipments for communication and decision making. We are continuously focussing on improving our surveillance and contact tracing as that is the key for early detection of cases and containing the pandemic.
What will be government’s next step in terms of containment and surveillance?
Though continuous monitoring of efforts of districts’ efforts in the containment zones and outside, we will try to keep the number of cases and the positivity rate low. Surveillance has been a key focus area and this will be further ramped up for early detection of cases, particularly the more vulnerable ones.
Till a vaccine arrives, we have to focus on non pharmaceutical interventions like enforcement of social distancing norms, hand washing practices and wearing of masks by the people. Effective communication for behaviour change remains a key priority. As things open up more and more, it is necessary that people understand and voluntarily adopt Covid-19 appropriate behaviour.
How did the state reduce case fatality rate (CFR)?
A. CFR has been kept low by focussing on patient care and adopting the right treatment protocol by the Covid-dedicated hospitals. Virtual ICU has helped treatment centres across the state to get the benefit of expert advice of doctors from eminent institutes like SGPGI and KGMU. Government has deputed senior nodal administrative officers and doctors as nodal officers for each and every district, who analyse the deaths on a continuous basis. CFR is a statistical tool; however every death is unfortunate and we must try to avoid every avoidable death. Government provides free of cost treatment to patients coming to its facilities through more than 1.5 lakh beds including oxygen supported beds and ICUs and all drugs and consumables, howsoever expensive. We are trying to bring the CFR below the level of 1%.