Highlights
- Challenge Trials are ideally done where a virus causes mild disease: Expert
- Some researchers believe challenge trials can help develop vaccine fast
- Challenge trials are risky as much is still unknown about COVID-19: Experts
New Delhi: As the COVID-19 pandemic continues to rage, pharmaceutical firms and scientists all over the world have been working relentlessly and racing against time to develop a safe vaccine against coronavirus. According to the Centres for Disease Control and Prevention (CDC), the major stages of vaccine development include initial research followed by a series of pre-clinical trials which are mostly done on animals and clinical or human trials consisting of three phases and each of the steps can take two or more years to complete. Vaccine development takes years because the process involves studying and determining for how long the vaccine will provide protection and also observing volunteers for any side-effects, says Dr. KK Agarwal, President, Confederation of Medical Associations in Asia and Oceania (CMAAO). The fastest ever vaccine to be developed is the one for mumps – and even that took four years, he said. However, for countering the COVID-19 pandemic and provide a vaccine at the earliest, the steps involved in vaccine development are being rapidly accelerated. Experts say that ‘Human Challenge Trial’ or deliberately exposing volunteers to the virus during the Phase-3 clinical trials is also a way of accelerating vaccine trials. According to Dr. Chandrakant Lahariya, epidemiologist, vaccinologist, and public health and policy expert based in Delhi, the researchers across the globe are currently divided on the matter of considering this method of studying the performance of a vaccine candidate for COVID-19.
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On July 15, 153 academics, doctors, epidemiologists, and scientists wrote an open letter to health regulatory bodies in the U.S. like CDC, National Institutes of Health, the Coronavirus Task Force, the Department of Health and Human Services, the Food and Drug Administration and international bodies like the World Health Organisation (WHO) asking for human challenge trials to address the urgent need for a vaccine to curb the pandemic. They wrote in the letter,
If challenge trials can safely and effectively speed the vaccine the development process, there is a formidable presumption in favour of their use, which would require a very compelling ethical justification to overcome.
What Are Human Challenge Trials?
According to Satyajit Rath, an immunologist and specialist in infections and diseases with the Indian Institute of Science Education and Research (IISER), Pune, in human challenge trials, volunteers are deliberately infected with the virus causing disease to test whether a vaccine provides enough protection. Human challenge trials or Human infectious microbial challenge studies, also referred to as the ‘Controlled Human Infection Model” or CHIM studies, are different from the standard late-stage vaccine trials where the developers have to wait for people to be exposed to an illness naturally, he said. Mr. Rath further added,
Mostly, the challenge trials are intended to provide well-controlled human infection situations for analysis, where the type, dose, route of intake, and time of infection are well known which is not likely to be the case in actual, naturally occurring infections. So, typically, researchers will deliberately give infections to healthy people, and follow various study parameters like the course of the infection and immune responses, and/or the effects of various drugs/medications, or vaccine.
Could Human Challenge Trials Be Used To Speed Up The Process Of COVID-19 Vaccine Development?
According to Dr. Aggarwal, challenge trials have improved vaccine development for seasonal flu, cholera, among other diseases and there is now an increasing discussion that preparations should begin for COVID-19 challenge trials in case needed. He added that in July, the team behind the Oxford COVID-19 proposed to start human challenge trials by the end of the year and Professor Adrian Hill of Oxford University, that is developing a vaccine candidate with pharmaceutical company AstraZeneca, has said that challenge trials may be done in parallel with Phase-3 trials or after these trials are completed.
During an online discussion organised by Indian Council of Medical Research (ICMR) on July 30, Professor Adrian Hill of Oxford University, reiterated,
There are multiple therapies in use now to consider both challenge trials as well as randomised control trials to get quicker results, and that these had been conducted for other viruses like malaria and cholera without any issues.
During the same discussion, other experts like Dr Anthony S Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID), US, expressed concerns over conducting ‘human challenge trials’ to accelerate vaccine development for COVID-19. He said,
Purposely exposing someone to the coronavirus is unnecessary and unethical in the case of a disease for which we have no proven cure yet.
The WHO has also acknowledged that challenge trials will accelerate the process and help in increasing the likelihood that the most effective candidate vaccines will ultimately become available, validate tests of immunity, and improve knowledge about SARS-CoV-2 infection and transmission. In its guidance document on criteria for conducting challenge clinical trials and providing clinical care for the participants, WHO says,
Well designed human challenge studies provide one of the most efficient and scientifically powerful means for testing vaccines, especially because animal models are not adequately generalizable to humans. SARS-CoV-2 challenge studies could add value to other types of vaccine research by enabling (a) accurate assessment of asymptomatic infection, (b) more rapid and standardized testing of multiple vaccine candidates, and (c) testing vaccines in contexts where there is little continuing transmission (for example, due to public health measures or during inter-epidemic periods).
Also Read: Three COVID-19 Vaccines At Clinical Trial Stage In India: Indian Council of Medical Research
WHO further says that SARS-CoV-2 challenge studies should be conducted in specialized facilities, with especially close monitoring and ready access to early supportive treatment for participants, including critical care if required.
Dr. Paul Offit, an American Pediatrician and specialist in infectious diseases, vaccine, immunology and virology, however, said that challenge trials are not needed in case of COVID-19 as the natural infection is already widely present across the globe. He further added,
Human challenge trials don’t exactly mimic the real infection because when you are out there in the real world, you may get exposed to different quantities of virus. Sometimes you may get exposed to a large quantity of virus that may make you sicker as compared to a smaller quantity of virus.
Ethical Concerns Regarding The Use Of Human Challenge Trials For COVID-19 Vaccine Development
According to Mr. Rath, there are major ethical difficulties in any SARS-CoV-2 human challenge trial study. This is because challenge studies are ideally done in situations where the disease caused is expected to be mild and where the infection can be quickly treated and eliminated if the need arises. However, in the case of COVID-19, there is no definitive cure which means that even the young and healthy people who are considered low-risk can become very ill and some could even die. Along with this, as much is still unknown about the SARS-CoV-2, there is not much clarity about the long-term effect of the infection on humans and so deliberately infecting anyone would pose an ethical difficulty, said Mr. Rath.
Dr. Lahariya said that it will be upto the countries to decide whether they would take this route and device regulations regarding it.
WHO’s guidance document says that an important principle in human challenge studies is that subjects must give their informed consent in order to take part. This means they should be provided with all the relevant information about the risk they are considering. However, Mr. Rath says,
As of now, informed consent is not possible because there is a lot to be learnt about the disease like potential long-term implications of it since it is such a new disease. This means that no volunteer is able to give true informed consent.
Also Read: Scientists Predict That COVID-19 Will Become A Seasonal Virus – But Not Yet
According to an official of the Ministry of Health and Family Welfare human challenge trials are not being considered for any of the vaccine candidate being developed in the country. He said,
Sure, there are scientists debating the usefulness and the risks involved in challenge trials but India is not considering it as of now. All of our vaccine candidates are currently undergoing Phase 1 or Phase 2 of clinical trials while human challenge trials take place in Phase 3. Also, there is already enough infection out there and many volunteers who are ready to participate. It is highly unlikely that we take the challenge trial route.
Talking about if there is any risk of using monetary rewards as motivation to bring in participation for trials, the official said,
We have highly elaborate regulations for vaccines trials. While volunteers can be given a little compensation for the time that they divert from their daily work/routine to the trials and thus helping in vaccine development but it is never given as a way for earning money.
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.
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State & District Details
State | Cases | Active | Recovered | Deaths |
---|---|---|---|---|
DistrictCases Mumbai45,478 Thane13,660 Pune9,920 Mumbai Suburban5,363 Aurangabad1,974 Nashik1,575 Raigad1,462 Palghar1,421 Solapur1,291 Jalgaon1,039 Akola757 Nagpur692 Kolhapur646 Satara629 Ratnagiri350 Amravati291 Dhule228 Hingoli208 Jalna201 Ahmednagar190 Nanded176 Yavatmal150 Sangli145 Latur139 Osmanabad125 Sindhudurg114 Buldhana88 Parbhani78 gondia69 Beed54 Nandurbar42 Gadchiroli42 Bhandara41 Chandrapur32 Washim13 Wardha11 | 21,61,467 6,397 | 78,825 613 | 20,30,458 5,754 | 52,184 30 |
DistrictCases Kannur357 Kasaragod333 Palakkad224 Malappuram119 Kollam118 Thrissur106 Thiruvananthapuram104 Pathanamthitta98 Kozhikode90 Alappuzha76 Kottayam73 Ernakulam60 Idukki40 Wayanad36 | 10,61,341 1,938 | 48,159 1,550 | 10,08,972 3,475 | 4,210 13 |
DistrictCases Udupi1,176 Kalaburagi669 Yadgir538 Bengaluru Urban529 Raichur369 Mandya346 Belagavi337 Bidar219 Hassan205 Davangere204 Vijayapura201 Dakshina Kannada179 Chikkaballapura149 Mysuru107 Bagalkote103 Uttara Kannada95 Shivamogga67 Dharwad61 Ballari60 Gadag45 Bengaluru Rural40 Tumakuru36 Kolar29 Haveri24 Chikkamagaluru19 Chitradurga14 Koppal5 Kodagu4 Ramanagara3 Chamarajanagara0 | 9,51,600 349 | 5,843 20 | 9,33,421 324 | 12,336 5 |
DistrictCases Kurnool795 Krishna557 Guntur511 Anantapur428 East Godavari356 Chittoor319 Sri Potti Sriramulu Nell*296 Y.S.R.205 West Godavari199 Srikakulam183 Prakasam104 Visakhapatnam103 Vizianagaram23 | 8,89,974 58 | 725 7 | 8,82,080 51 | 7,169 |
DistrictCases Chennai23,324 Chengalpattu1,314 Thiruvallur774 Villupuram509 Kanchipuram503 Tiruvannamalai496 Cuddalore477 Ariyalur444 Tirunelveli433 Tuticorin333 Kallakurichi324 Madurai322 Salem258 Coimbatore188 Virudhunagar185 Dindigul175 Perambalur133 Ranipet133 Thanjavur130 Theni129 Tiruchirappalli119 Ramanathapuram119 Tiruppur116 Kanniyakumari110 Tenkasi103 Nagapattinam99 Karur88 Namakkal83 Erode75 Vellore71 Thiruvarur67 Pudukkottai53 Sivaganga46 Tirupathur45 Krishnagiri43 The Nilgiris17 Dharmapuri15 | 8,52,016 474 | 4,009 13 | 8,35,506 482 | 12,501 5 |
DistrictCases North West5,463 Central4,817 West4,768 New Delhi3,405 North3,059 East2,472 South East2,446 South West2,391 South2,329 North East1,914 Shahdara1,580 | 6,39,464 175 | 1,404 69 | 6,27,149 105 | 10,911 1 |
DistrictCases Gautam Buddha Nagar1,119 Agra933 Ghaziabad794 Meerut504 Lucknow386 Saharanpur298 Kanpur Nagar286 Moradabad252 Varanasi243 Hapur225 Aligarh215 Basti214 Amethi206 Rampur203 Jaunpur194 Firozabad190 Barabanki168 Gorakhpur166 Bulandshahr166 Siddharth Nagar159 Ghazipur159 Bijnor157 Deoria143 Azamgarh138 Sant Kabeer Nagar132 Mathura129 Ayodhya120 Muzaffarnagar117 Sambhal116 Sultanpur97 Ambedkar Nagar92 Maharajganj85 Amroha80 Rae Bareli78 Bahraich73 Kheri72 Kannauj69 Baghpat68 Kushi Nagar67 Bhadohi60 Ballia60 Gonda59 Etah52 Hardoi49 Balrampur49 Mau48 Mainpuri46 Etawah46 Hathras43 Unnao42 Jalaun41 Jhansi41 Shamli40 Chandauli38 Auraiya37 Farrukhabad36 Sitapur32 Prayagraj30 Banda27 Shahjahanpur25 Shravasti23 Budaun23 Mirzapur22 Bareilly17 Kasganj16 Pratapgarh15 Pilibhit15 Sonbhadra10 Kaushambi6 Kanpur Dehat4 Chitrakoot4 Lalitpur3 Hamirpur3 Mahoba3 Fatehpur3 | 6,03,608 81 | 2,078 25 | 5,92,803 104 | 8,727 2 |
DistrictCases Kolkata2,777 Howrah1,435 24 Paraganas North1,031 Hooghly604 24 Paraganas South281 Maldah235 Dinajpur Uttar216 Coochbehar210 Birbhum206 Medinipur West159 Medinipur East153 Nadia139 Purba Bardhaman130 Murshidabad125 Bankura116 Darjeeling97 Jalpaiguri88 Paschim Bardhaman70 Purulia66 Dinajpur Dakshin50 Alipurduar39 Kalimpong18 Jhargram9 | 5,75,316 198 | 3,293 14 | 5,61,755 212 | 10,268 |
DistrictCases Ganjam581 Jajapur322 Khordha238 Baleshwar190 Kendrapara164 Cuttack155 Bhadrak137 Balangir129 Puri103 Sundargarh102 Jagatsinghapur91 Nayagarh86 Mayurbhanj73 Nuapada69 Gajapati61 Dhenkanal36 Boudh34 Kendujhar34 Deogarh33 Kalahandi33 Sonepur29 Kandhamal28 Anugul26 Malkangiri20 Bargarh16 Koraput16 Sambalpur16 Jharsuguda8 Nabarangpur2 Rayagada2 | 3,37,277 86 | 714 10 | 3,34,647 76 | 1,916 |
DistrictCases Jaipur2,177 Jodhpur1,748 Udaipur724 Bharatpur563 Kota503 Nagaur500 Ajmer379 Dungarpur374 Pali352 Jhalawar329 Bhilwara250 Sikar231 Chittorgarh188 Tonk171 Jalore164 Rajsamand140 Sirohi130 Bikaner112 Banswara91 Alwar90 Churu81 Jhunjhunu64 Dausa61 Dholpur60 Baran59 Jaisalmer53 Barmer34 Hanumangarh31 SawaiMadhopur26 Karauli17 Pratapgarh14 Ganganagar8 Bundi5 | 3,20,455 119 | 1,304 4 | 3,16,364 123 | 2,787 |
DistrictCases Bilaspur100 Korba100 Mungeli87 Baloda Bazar85 Jashpur77 Janjgir-Champa56 Mahasamund54 Rajnandgaon52 Kabirdham52 Raigarh47 Raipur46 Balod41 Korea39 Durg31 Bemetara21 Kanker19 Balrampur17 Surguja14 Gariyaband10 Surajpur9 Dhamtari6 Bijapur2 Bastar2 Dantewada0 Kondagaon0 Narayanpur0 Sukma0 | 3,12,816 256 | 2,880 106 | 3,06,094 143 | 3,842 7 |
DistrictCases Hyderabad2,475 Ranga Reddy183 Suryapet87 Jagitial77 Nizamabad76 MedchalMalkajgiri75 Mancherial43 YadadriBhuvanagiri40 Jogulamba Gadwal40 Vikarabad40 Nalgonda33 Warangal Urban32 Mahabubnagar30 Sangareddy26 Khammam26 Adilabad22 Nirmal21 Karimnagar17 RajannaSircilla16 Medak11 Kamareddy11 Mahabubabad10 Jayashankar Bhupalapally9 Nagarkurnool8 Kumuram Bheem Asifabad8 Jangoan8 Siddipet7 Peddapalli5 Bhadradri Kothagudem5 Warangal Rural4 Mulugu3 Narayanpet3 Wanaparthy1 | 2,99,086 163 | 1,907 5 | 2,95,544 157 | 1,635 1 |
DistrictCases Gurugram2,950 Faridabad867 Sonipat404 Rohtak145 Palwal120 Jhajjar114 Karnal104 Hisar98 Ambala93 Panipat78 Nuh68 Bhiwani60 Rewari56 Kurukshetra55 Sirsa50 Kaithal48 Mahendragarh47 CharkiDadri43 Panchkula39 Fatehabad38 Jind38 Yamunanagar19 | 2,70,950 166 | 1,288 13 | 2,66,612 151 | 3,050 2 |
DistrictCases Ahmadabad17,125 Surat2,311 Vadodara1,555 Gandhinagar410 Mahesana159 Banas Kantha147 Bhavnagar146 Rajkot135 Arvalli134 Mahisagar125 Anand107 PanchMahals107 Patan105 SabarKantha101 Kachchh99 Kheda98 Jamnagar63 Bharuch56 Botad55 Surendranagar55 Valsad47 GirSomnath45 Dohad43 Chhotaudepur37 Naysari35 Junagadh31 Narmada25 DevbhumiDwarka22 Amreli16 Porbandar11 Tapi6 Dang5 Morbi4 | 2,70,316 427 | 2,431 68 | 2,63,475 359 | 4,410 |
DistrictCases Patna279 Bhagalpur266 Rohtas256 Khagaria253 Begusarai243 Madhubani199 Munger188 Jehanabad178 Katihar175 Darbhanga143 Samastipur139 Siwan139 PurbiChamparan138 Purnia135 Banka134 Buxar134 Nalanda123 Gopalganj123 Nawada122 Sheikhpura118 Gaya115 Kaimur (bhabua)105 Bhojpur103 Saran101 Muzaffarpur96 Saharsa88 Supaul87 Vaishali87 Madhepura82 Kishanganj75 Aurangabad75 Sitamarhi73 Lakhisarai72 Araria68 Pashchim Champaran57 Arwal52 Jamui47 Sheohar20 | 2,62,556 22 | 370 29 | 2,60,645 51 | 1,541 |
DistrictCases Indore3,839 Bhopal1,880 Ujjain799 Burhanpur351 Neemuch319 Jabalpur276 East Nimar266 Sagar228 Gwalior211 Khargone196 Dewas140 Dhar132 Mandsaur112 Morena109 Bhind87 Raisen71 Barwani60 Ratlam51 Rewa39 Shajapur39 Hoshangabad37 Vidisha37 Chhatarpur35 Betul35 Rajgarh31 Dindori29 Sheopur26 Damoh26 Satna24 Anuppur22 Panna20 Tikamgarh18 Sidhi17 Narsinghpur17 Chhindwara16 Agar Malwa15 Mandla15 Shivpuri15 Jhabua14 Shandol14 Singrauli13 Ashoknagar13 Datia12 Sehore12 Umaria10 Balaghat9 Guna8 Harda4 Alirajpur3 Katni3 Seoni2 Niwari0 | 2,62,102 336 | 2,901 116 | 2,55,336 219 | 3,865 1 |
DistrictCases Kamrup Metro276 Golaghat203 Nagaon143 Hojai89 Dima Hasao86 Karimganj85 Tinsukia84 Cachar80 Dibrugarh61 Hailakandi57 Lakhimpur57 Marigaon50 Dhemaji47 Kamrup42 Kokrajhar37 Dhubri30 Charaideo29 Barpeta28 Udalguri28 Sonitpur27 Jorhat24 Nalbari23 Darrang20 Sivasagar20 Goalpara19 Biswanath16 Baksa14 KarbiAnglong13 Bongaigaon12 Chirang6 West KarbiAnglong5 South SalmaraMancachar4 Majuli2 | 2,17,570 33 | 1,631 16 | 2,14,846 16 | 1,093 1 |
DistrictCases Amritsar485 Jalandhar297 Ludhiana293 Tarn Taran163 Gurdaspur154 Hoshiarpur140 S.A.S Nagar137 Patiala132 Sangrur107 Shahid Bhagat Singh Nagar (Nawanshahr)99 Pathankot86 Rupnagar (Ropar)74 Faridkot74 Sri Muktsar Sahib71 Moga65 Bathinda60 Fatehgarh Sahib57 Fazilka53 Firozepur50 Kapurthala44 Mansa31 Barnala25 | 1,82,809 633 | 4,853 221 | 1,72,106 394 | 5,850 18 |
DistrictCases Anantnag395 Srinagar300 Kulgam295 Baramulla271 Shopian255 Kupwara231 Bandipora175 Udhampur155 Ramban151 Jammu138 Budgam110 Pulwama108 Kathua53 Rajouri39 Ganderbal37 Poonch35 Doda27 Reasi26 Samba25 Kishtwar10 Mirpur0 Muzaffarabad0 | 1,26,504 63 | 829 6 | 1,23,717 56 | 1,958 1 |
DistrictCases East Singhbum170 Ranchi148 Hazaribagh110 Garhwa80 Ramgarh75 Koderma58 Simdega48 Dhanbad32 Gumla28 Palamu27 West Singhbhum21 SaraikelaKharsawan20 Giridih19 Bokaro16 Latehar14 Khunti10 Lohardaga8 Deoghar5 Dumka5 Pakur4 Jamtara2 Godda2 Chatra1 Sahebganj0 | 1,19,986 37 | 485 9 | 1,18,411 46 | 1,090 |
DistrictCases Dehradun370 Nainital323 Tehri Garhwal110 Haridwar94 Udam Singh Nagar83 Almora71 Champawat45 Pithoragarh43 Chamoli36 PauriGarhwal36 Bageshwar31 Rudraprayag30 Uttar Kashi24 | 97,031 | 459 30 | 94,880 30 | 1,692 |
DistrictCases Hamirpur117 Kangra105 Una41 Solan32 Chamba29 Bilaspur21 Mandi21 Sirmaur11 Shimla10 Kullu4 Kinnaur2 Lahaul And Spiti0 | 58,777 132 | 434 116 | 57,347 15 | 996 1 |
DistrictCases South Goa69 North Goa57 | 55,026 40 | 583 23 | 53,647 62 | 796 1 |
DistrictCases Pondicherry111 Mahe4 Karaikal2 Yanam0 | 39,734 9 | 177 8 | 38,888 16 | 669 1 |
DistrictCases Dhalai196 Sepahijala174 Gomati74 South Tripura53 Unakoti49 West Tripura45 Khowai24 North Tripura14 | 33,420 3 | 42 3 | 32,987 | 391 |
DistrictCases Churachandpur32 Kangpokpi26 Imphal West21 Thoubal18 Imphal East10 Tengnoupal9 Bishnupur7 Senapati6 Chandel5 Kamjong5 Ukhrul4 Jiribam3 Pherzawl3 Kakching2 Tamenglong2 Noney1 | 29,274 1 | 30 3 | 28,871 4 | 373 |
DistrictCases Chandigarh313 | 21,839 69 | 430 49 | 21,056 19 | 353 1 |
DistrictCases Changlang31 Papum Pare8 Lohit3 Namsai2 West Siang1 East Siang1 Upper Siang1 Tawang1 PakkeKessang1 West Kameng0 Upper Subansiri0 Tirap0 Siang0 Shi Yomi0 Anjaw0 Lower Subansiri0 Lower Dibang Valley0 Longding0 Leparada0 KurungKumey0 KraDaadi0 Kamle0 East Kameng0 Dibang Valley0 Lower Siang0 | 16,837 1 | 1 1 | 16,780 | 56 |
DistrictCases East Khasi Hills22 West Garo Hills5 South West Garo Hills4 North Garo Hills1 West Jaintia Hills1 West Khasi Hills1 East Garo Hills0 East Jaintia Hills0 Ribhoi0 South Garo Hills0 South West Khasi Hills0 | 13,963 1 | 17 0 | 13,798 1 | 148 |
DistrictCases Dimapur20 Mon8 Kohima7 Kiphire3 Tuensang3 Peren2 Phek1 Longleng0 Mokokchung0 Wokha0 Zunheboto0 | 12,200 | 7 0 | 12,102 | 91 |
DistrictCases Kargil77 LehLadakh43 | 9,819 1 | 46 7 | 9,643 8 | 130 |
DistrictCases East District3 South District3 North District0 West District0 | 6,145 | 45 1 | 5,965 1 | 135 |
DistrictCases South Andamans33 Nicobars1 North And Middle Andaman1 | 5,020 | 6 0 | 4,952 | 62 |
DistrictCases Kolasib11 Aizawl10 Mamit8 Lawngtlai2 Lunglei2 Saitual1 Champhai0 Hnahthial0 Khawzawl0 Saiha0 Serchhip0 | 4,426 3 | 20 0 | 4,396 3 | 10 |
DistrictCases Dadra And Nagar Haveli20 | 3,406 | 4 0 | 3,400 | 2 |
DistrictCases Lakshadweep District0 | 397 15 | 128 8 | 268 7 | 1 |