Behind surge in Punjab and Maharashtra: Delay in getting to hospital

Behind surge in Punjab and Maharashtra

– The Covid-19 ventilation bed occupancy rate has passed the 50% mark in at least four districts of Maharashtra, leading to an increase in deaths.
– Most deaths in Punjab are reported between 48 and 72 hours after admission, probably due to delayed hospitalization.
– Contact of positive cases is not isolated until the final test report, resulting in the spread of infection.

These are some of the red flags raised by the Center on Saturday during the high-level meeting with 12 states and Union Territories that reported an increase in cases.

On Saturday, Maharashtra continued to report the highest number of new cases daily with 36,902; followed by Punjab with 3,122. Alarmingly, in just the last 24 hours, Maharashtra reported the highest number of victims (112) in the country; followed by Punjab (59).

Union Health Secretary Rajesh Bhushan chaired a high-level meeting with state health secretaries, municipal commissioners, and district collectors from 46 districts, the hardest hit in terms of increased cases and increased mortality. At the meeting, the Center highlighted that 90 percent of deaths from Covid-19 continue in the category of those over 45 years of age.

It is significant that of the total of 36 districts in Maharashtra, the 25 most-affected represent 59.8% of the total cases reported in the country in the last week.

At the meeting, the Center detailed a multi-point strategy, on effective containment and contact tracing for at least 14 consecutive days, for the 46 districts, which together account for 71 percent of cases and 69 percent of cases. deaths this month.

He also focused critically on the alarming death rate being reported in Punjab and Maharashtra, the sources said.

Top government sources, who were present at the meeting, told The Indian Express that a detailed discussion was held specifically with the district magistrates of Pune, Aurangabad, Nagpur, and Yavatmal.

“In Pune, 70 percent of the ventilation beds are already occupied. This is a sign that patients are late. The same happened with Nagpur. This number was around 50 percent in Aurangabad; and about 40 percent in Yavatmal. The issue of rapid identification of cases and prompt hospitalization still remains, at least in these four districts, ”they told the DMs, according to the sources.

The sources said that a similar granular analysis was conducted on the deaths in Punjab during the meeting. “For the past three days, Punjab is reporting deaths, which in absolute numbers, are higher than the deaths reported by Kerala and Karnataka. This is unimaginable. These states, which have a higher population than Punjab, are reporting fewer deaths, ”sources told the state.

The sources said that the increase in deaths in Punjab was due to patients not arriving at hospitals on time according to the clinical management protocol. “Because of this, most deaths occur immediately upon entering hospitals,” sources told the state.

Sources said the Center shared data on ventilator and ICU patients with Punjab, revealing a high percentage of patients arriving at hospitals in serious condition. “We share data on people on ventilators and in the ICU, which shows that when the patient is admitted to the Punjab hospital, they immediately go to the ICU or are put on a ventilator. Which means they come when the situation has deteriorated. That is why deaths occur in the first 48 or 72 hours of admission, ”said the sources.

“The second thing that is happening, both in Punjab and Maharashtra, is that people in the field do not have a clear understanding of containment and contact tracing,” the sources said. Both states were reported to have told the Center that they tested close contacts on the fourth day. “This is very good. However, when we asked them what the contacts do during these four days, they answered that they stay at home,” said the sources.

“We told them that the SoPs require that they also be isolated. We have also ordered that if they cannot isolate themselves at home, they must be transferred to Covid-19 care centers. We have to make sure that the contact, which can be positive, is withdrawn from circulation, ”said the sources.

The sources said that inadequate surveillance of contact “micro-containment” areas in Maharashtra was also raised during the meeting. “Maharashtra has opted for micro-containment zones. In this type, if in a high-rise building, there are three cases, those floors become containment zones. However, once the floors become a containment zone, someone needs to check if people are following the rules. This is not happening, ”the sources told the state.

He also emphasized peer-reviewed studies on transmission. “The results of studies that showed that while 90 percent of people know this, only 44 percent actually wear face masks were highlighted. An infected person could spread Covid-19 to an average of 406 more people in an unrestricted 30-day period, which could be reduced to just 15 by reducing physical exposure to 50 percent and an additional 2.5 (average) by decreasing physical exposure. 75 percent, ”the Health Ministry said in a statement.