Karnataka's doubling rate of the COVID-19 cases is 33 days
Karnataka has 33 dedicated hospitals, 246 quarantine centres
New Delhi: Despite the initial prompt and successful response to the novel coronavirus, Karnataka has been struggling to control the crisis at present. The state has become the fourth worst hit in India, after Maharashtra, Andhra Pradesh and Tamil Nadu, with over 5 lakh (5,19,537) confirmed cases. The first case of the COVID-19 pandemic in Karnataka was detected on March 8, as an international traveller returned to state’s capital, Bengaluru. Two days later, the state became the first in India to invoke the provisions of the Epidemic Diseases Act, 1897, to curb the spread of the disease. The law, meant for containing the epidemics by providing special powers that are required for the implementation of containment measures, later imposed across the nation.
Karnataka’s coronavirus status was neutral as the state entered Unlock 1 on June 8.
However, by the end of June, the infection started spreading in the state and there has been no stopping since. The rapid increase in the number of COVID-19 cases also forced the government to impose another lockdown there.
As on September 22, Karnataka has 98,062 active cases of COVID-19 and 8,023 people have lost their lives to the virus. Over 4 lakh (4,13,452 ) people have reportedly recovered.
The state has been recording about 8,000 new cases daily over the past few days, a health department official told NDTV.
While at 35.29 per cent, Karnataka had one of the worst recovery rates among the states until July 20; at present, it has shot up to 80 per cent. The mortality rate in the state has dipped to 1.54 per cent, as on September 22, which is lower than the country’s mortality rate of 1.84 per cent.
As per the data, the state’s doubling rate of the COVID-19 cases is 33 as compared to India’s doubling rate is 37. Public health experts say that a mortality rate of below 2 per cent is the norm to be maintained to keep deaths at the minimum.
Dr Ajay Ramnath, the lead doctor from a private COVID hospital told NDTV that the sudden spike in the number of cases can be attributed to the easing of the interstate travel restrictions. He said,
During April and May, most cases in the state were related to travel from other countries and domestic migration. Starting June 18, the nation observed relaxations in the inter-state travel restrictions as part of the first phase of the lockdown. In this phase, Karnataka saw an increase in new cases, driven by travellers from Maharashtra and the people they came in contact with. Seeing this cluster grow rapidly, the Karnataka state government enacted mandatory institutional quarantine and testing for all the travellers and the people they came in touch with. This was only possible through a strong contact tracing.
The worst-hit districts of the state are Bengaluru, Ballari, Davanagere, Koppal and Shivam ogga. Out of the total 41, 234 containment zones in the state, 28,395 remain active while 12,839 have been denotified.
Karnataka has implemented a 5Ts strategy to fight COVID19 in the state. These 5Ts include Tracing, Testing, Tracking, Treatment and Technology. The strategy was rolled out in the initial days of the pandemic.
Karnataka had the highest rate of contact tracing in the country, tracking 47.4 contacts per confirmed COVID-19 case in April, the health department official said. He further explained that the state is focusing specifically on the contract tracing as per their 5T strategy. The official explained,
Karnataka’s contact tracing exercise involves checking in with patients at multiple points to reduce errors and increases compliance with quarantine measures. Each patient’s contacts are traced at two points – first, patients are surveyed immediately upon testing positive and their details entered into the contact tracing application developed by the government. Then, a field team follows up with the patient at their home, stamps their hand and puts up a home quarantine notice in front of their house.
After the contacts are identified, their details are verified by the field team who refer symptomatic contacts for immediate testing and prescribe home quarantine for asymptomatic contacts, who are tested within the next five-to-seven days, he added.
In addition to contact tracing of infected individuals, in the early days of the pandemic, we also conducted a household survey through booth-level officers, covering 15 million households across the state. The survey identified people particularly vulnerable to the virus – the elderly, pregnant women and those with underlying health conditions. These people are now being regularly called and counselled through the helpline and their details have been shared with local health officers and Accredited Social Healthcare Activists (ASHA workers), who check on their health status and connect them with health resources for both COVID-19 and non-COVID ailments, the state government claims, the government official told NDTV.
Over 10,000 government employees have been working as contact tracers in Karnataka, the said.
He further said that more than 3.5 lakh (3,64,381) primary contacts and nearly 3 lakh (2,97,168) secondary contacts have been traced in the state and 3,62,984 people are under home quarantine, as on September 22.
When it comes to the status of testing in the state, Karnataka 108 labs of which 52 are government while 86 are private labs, the health department official said. The state has conducted nearly 43 lakh tests till date (42,82,735 tests) of which nearly 15 lakh are rapid antigen tests and nearly 28 lakh are RT-PCR tests.
For the tracking part of their strategy, all the people returning or travelling to Karnataka are required to register on the “Seva Sindhu” portal, which enables the state to follow them for the next few days when they are at home or in institutional quarantine, the official explained.
To assist the field workers in enforcing the quarantine, the ‘Quarantine Watch App’ is being used. We have also formed Mobile Squads for the enforcement of home quarantine through community participation. In case information about the violation of quarantine is received from a neighbour or some member of the public, that violator is moved to the institutional quarantine, he added.
For the treatment, the state has set up 1,316 government fever clinics and 100 private fever clinics, where those who suspect symptoms can visit. Furthermore, Karnataka has 246 quarantine centres, 323 isolation centres and 33 dedicated COVID hospitals across the state, the health department official told NDTV.
In total, the state has 84,776 beds in its districts, of which 21,728 have been reserved for COVID-19. A total of 19,639 beds were available in Bengaluru Urban and Rural districts. And of these, 3,470 were reserved for COVID-19 in the two districts. More than 86 per cent of the 21,728 beds were isolation beds — 6,695 with oxygen facilities, 2,105 ICU beds, and 1,000 with ventilators, he explained.
When it comes to the cost of the treatment, the Karnataka Government issued an order to fix the rates for COVID-19 treatment in private hospitals.
The rates for the treatment of COVID-19 in the state ranges from Rs 5,200 to Rs 25,000 depending on the category and severity of the infection and can be availed by both Ayushman Bharat – Arogya Karnataka (AB-ArK) patients and other insurance or cash-paying patients.
The State Government also directed 50 per cent of beds in private hospitals having facilities to treat COVID-19 patients, should be reserved for patients referred from public health authorities.
The official said that about 768 people among the active cases are critical and admitted in the ICU, while most remain either in institutional quarantine or home quarantine.
When asked to elaborate on the fifth and the final leg of Karnataka’s COVID strategy, Technology, the official said,
Through a team of in-house programmers, we managed to roll out a series of mobile applications in first three months on the pandemic in the country, including contact tracing application. We also introduced the ‘Quarantine Watch’, to keep a watch over and enforce quarantine of travellers who returned to Karnataka, ‘Yatri Web App’ to track international arrivals and the ‘Critical Patient Tracking System’ to track all critical patients in the state. Other applications were created like the ‘Daily Rail and Air Passenger Arrival Tracking’ to track arrivals of people coming into the state and the ‘Health Watch App’ which recorded data of the door-to-door survey done by health workers and identified vulnerable households. The data collected was transferred to other applications like the Aapthamithra (which means close friend) and was used by the health department to follow up.
Bengaluru’s COVID-19 Story
The Silicon Valley of India, Bengaluru was once making headlines for the successful response to coronavirus, where technology played a key role (hyperlink this story). But after the spike in the number of cases in the state in June, Bengaluru remains the worst-hit city in Karnataka.
The Bengaluru COVID War Room was introduced by the Bruhat Bengaluru Mahanagara Palike (BBMP) for real-time monitoring and updates of positive cases and suspected cases.
The war room also prepared heat maps of the COVID-19 cases and identified and classified hotspots based on isolation period.
Through the Corona Watch app, the city made the geographical locations of COVID-19 infected patient and their movement history in the last 14 days public, a BBMP official told NDTV.
Corona Watch also helps in identifying the nearest hospital and testing labs, he added.
However, cases in Bengaluru escalated as the cases began to rise in June-end.
While BBMP officials attribute it to the above-mentioned ease in travel restrictions, the city further strengthened their interventions, the official said,
“Our focus at present is on the containment strategy, aggressive testing and standardised clinical management protocols based on holistic care. Eight months into the pandemic, we now have a better understanding of the disease and the standard treatment protocol is being followed.”
Experts’ Take On Karnataka’s Coronavirus Pandemic
Dr Giridhara R Babu, Professor, Head – Lifecourse Epidemiology, Indian Institute of Public Health, PHFI, Bengaluru told NDTV that even though Karnataka was faring well initially with good testing rates and the control of transmission, currently, it stands in the fourth position with respect to the total number of cases.
“But, the recovery is also reasonably high,” he said and added,
In Karnataka, Bengaluru urban has the highest number of cases and least in Kodagu with 1,216 cases. A study conducted by Stanford University reported that Karnataka is one of the best in data transparency as that of COVID statistics. In Karnataka, the cases associated with the influenza-like illness (ILI) and Severe Acute Respiratory Illness (SARI) were tested because either they had symptoms or because they came in contact with symptomatic patients. The total number of people being tested on this account has been increasing as compared to the number of people being tested due to travel.
The people tested due to travel have decreased from 67 per cent to 12 per cent in the time period of the first week of June to the last week of June, while 57.6 per cent of people tested had cases with the unknown origin of infection, he added.
When it comes to the testing status of the state, Anushka Shah, Researcher with Observer Research Foundation, India told NDTV,
While the situation was under control during the initial spread, the sudden spike in cases can be attributed to the negligence of the Bruhat Bengaluru Mahanagara Palike (BBMP) in emulating the COVID-19 strategy. Secondly, there was a substantial increase in the mobility levels as people let their guard down with the lifting of the night and the Sunday curfew, and businesses returning to normal.
While it is difficult for Karnataka to replicate its initial strategy of testing, tracing and treating entirely, what the state can still do is intensify its testing at the community levels, Ms Shah explains.
Furthermore, Ms Shah also talked about the low testing rate of the state as compared to other badly hit states, she said,
At present, Karnataka is only conducting 36,483 tests per one million population. Whereas states like Andhra Pradesh, Assam, Delhi, Tamil Nadu are carrying out more than 55,000 tests per one million population. As of June 29, Karnataka was testing 9,146 per million population and recorded an average of 700 cases. Whereas as of August 23, Karnataka was conducting 36,483 tests per one million population and the daily cases during the week ending August 23 averaged more than 7000 cases a day.
The tests per million in Karnataka have always remained substantially low; the current figures signify that is a direct correlation between the increase in testing numbers vis-a-vis the increase in daily increase in the number of cases, she explained.
On the other hand, Ms Shah says, the gradual increase in the recovery rate indicates a better healthcare system in the state. If Karnataka’s testing leads to a higher rate of hospitalisations, healthcare systems will be stretched at capacity.
“It will then be critical for the state to maintain the recovery rate by not compromising on the treatment given to the patients. If Karnataka levels up to states like Andhra Pradesh and Delhi in testing, the present positivity rate might further increase,” Ms Shah added and said that only then will the ‘ideal picture of the COVID-19 situation in Karnataka be revealed.’
She also expressed concern on the current condition of Bengaluru, Ms Shah said,
Within Karnataka, Bengaluru is a ticking bomb and the coming weeks are going to be a critical period. The ease of restrictions on mobility during each phase of re-opening has subsequently led to an increased movement within districts. In order to contain the transmission to various other districts, there is a need to restrict non-essential movement within the state, she said.
Dr Babu says that it is not correct to determine the state’s condition by looking at the absolute numbers, he said,
Andhra Pradesh, Karnataka and Tamil Nadu are appearing to have high burden of COVID-19. This is not true; it is misleading to look at the absolute number of cases and say that these states are at high risk. The case detection is better in these states and they also have better testing rates compared to other states with higher population density and poor compliance of public health measures such as mask use and physical distancing. The deaths averted should be the only goal when we assess the progress of the states. The states that test well and detect more cases, ensure that treatment is available for those who need it. As a result, mortality will reduce in these states.
Rural Karnataka And COVID-19
Rural districts in Karnataka have reported a fresh spike in COVID-19 cases in the month of August. Shivamogga district had a total of 1,842 cases on August 1 was which jumped to 7,848 in the last on August 30. In the same period, cases in Belagavi district increased to 11,719 from 3,449; from 2,386 to 5,205 in Yadgir; from 1,364 to 3,320 in Kolar district and in Gadag from 1,480 to 4,976.
An official from the Rural Health department tells NDTV that the fresh spike can be attributed to three factors. He said,
The main reasons behind COVID-19 cases increasing in rural areas are free movement of people after the easing of lockdown restrictions, reverse migration and increase in the number of tests have been attributed to the significant increase in cases in places like Shikaripura and Bhadravathi taluks. People in these taluks, specially farmers, depend on Shivamogga city for purchase of seeds, fertilisers etc. When they visit crowded urban areas, they contract infection and bring it back to rural ares. This has led to a rapid spread of COVID-19 into rural pockets.
The government official said that in order to increase testing further, they are planning a second door-to-door survey in the rural areas. The first survey was conducted in June, he said.
We will carry out second door-to-door survey in rural districts to identify people with symptoms and get them tested, in the month of September. Subsequently, rural Karnataka can expect ramping up in testing this month. We will also convince people during the survey to not be afraid of getting tested. Primary health centres in rural districts will be converted into fever clinics with mobile testing and treatment teams allowed to each clinic, he signed off.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
Coronavirus has spread to 192 countries. The total confirmed cases worldwide are 11,71,50,768 and 25,99,869 have died; 4,82,03,864 are active cases and 6,63,47,035 have recovered as on March 9, 2021 at 3:49 am.
In India, there are 1,12,44,786 confirmed cases including 1,57,930 deaths. The number of active cases is 1,87,462 and 1,08,99,394 have recovered as on March 9, 2021 at 2:30 am.
It is important also to educate the community to dispel harmful myths on nutrition of young children, adolescent girls and pregnant and lactating women. Men’s involvement is particularly crucial as the key enabler to meeting women’s nutrition needs: World Food Programme