India Coronavirus Dispatch: Glaring gaps at local level caused recent spike

UP adds drug without evidence, govt to seek $2.5 mn aid from ADB, and the role of communication in controlling Covid--news on how the country is dealing with the pandemic

UP adds drug without evidence: Uttar Pradesh has added ivermectin, an anti-parasitic drug, as a treatment and prophylaxis against coronavirus. The alarming fact is that the use of this drug against Covid-19 has no scientific basis yet. In fact, experts from the WHO have actually warned against using ivermectin. Similarly, the US FDA hasn’t approved it either and neither has India’s Health Ministry. UP state govt hospitals and rapid response teams, however, have been tasked with distributing the drug to those under quarantine. Experts who have studied the drug over years also advice against its usage in battling the pandemic. State officials, meanwhile, claim the drug was recommended by an expert committee but refuse to identify the experts or any study on the basis of which the recommendation was made. The situation is reminiscent of the use of hydroxychloroquine during the initial days of the pandemic. While some studies have shown ivermectin to work on monkey cells in test tubes, the dosage involved is much higher than the safe limits for human beings. Read more here

Glaring gaps responsible for recent surge: The Centre has received feedback from local officers and identified loopholes in containment, surveillance and clinical strategies. These gaps are believed to be responsible for the recent spike in covid-19 cases across the country. The centre decided to communicate directly to Chief Medical Officers and other officials who are battling the pandemic at the district-level instead of reaching out to state health secretaries. The Centre soon realised that while districts have roving teams of contract tracers and other medical workers, none of them have been trained and are unaware of what they’re actually supposed to. For example, the number of people to be traced per positive patient was not known to a lot of local officials. The Centre has now adopted two manuals, one for district officials and another for surveillance officers on the ground. Read more here

ADB aid: The government has decided to seek $2.5 million in technical assistance from the Asian Development Bank for updating the Health Ministry’s Covid War Room. In addition to this, it has requested the ADB to help select organisations that can help with data analysis and visualisation on the pandemic. The Covid War Room is where data analysis and projections are being done on a daily, weekly and monthly basis and is currently run by seven private companies. Among other things, the Health Ministry plans to procure ‘Tableau’, a data visualisation software which costs Rs 2 crore. Read more here

Analysis

Effective communication: Perhaps the most important factor in the battle against the pandemic is precautionary measures being adopted by the masses. However, to get people to make little changes in their daily lives is often the most difficult task for lawmakers. Effective communication that doesn’t resort to fear mongering, is culturally relevant and and accessible to the population  is therefore incredibly important. The columnists analyse campaigns by MyGov and state governments to study the efficacy of their communication strategies. While most MyGov campaigns have been effective, a problem noticed is that some of the information (like distance to be maintained) is at odds with scientific data. They also noticed deviations from best practices being included in the campaigns. More worryingly, some posters rely on folk wisdom (drink juices to boost immunity) which are not evidence-based. Some state government campaigns, on the other hand, lack accessibility. Read more here

How Pune topped the chart: On Monday, the number of Covid-19 cases in Pune crossed 200,000. This more than any other city, including Mumbai and Delhi, but is more than most states except for the top 5. This is despite the city being less densely populate than Mumbai or Delhi and having lesser number of migrants as well. While officials say that higher testing is the main driver behind the surge in cases in Pune, it should be noted that Delhi conducts even higher number of tests. Among the reasons for the higher number of cases is greater spread of the virus as shown by the sero-survey compared to Delhi or Mumbai. Pune was the first place in Maharashtra to report a Covid-19 case but it was Mumbai that took over at one point. However, experts now point out that Mumbai adopted effective isolation measures which were lacking in Pune. For example, the state capital had many large makeshift hospitals with ventilators and oxygenated beds. Others point towards the fact that the lockdown was not as effectively imposed on Pune as in other places. Read more here

Understanding Covid-19

Can the virus spread by air? Even after all this time, aerosol transmission remains a topic of hot debate among medical experts. It seems logical that the coronavirus can spread in the aerosol particles. However, the writers point out that the bulk of scientific evidence fully rules out this possibility. Aerosols are just a small fraction of all respiratory particles — most of which are larger droplets that settle on the ground quickly. Secondly, most aerosol particles are empty and do not carry any germs. Further, most studies on aerosols are performed in indoor settings and their findings cannot be extrapolate to the outdoors. Also, most aerosol particles originate from the front of the mouth but the virus is mostly located deep in the lungs. Read more here