Proactively finding the positive cases: How Ahmedabad hopes to defuse corona bomb

Rutam Vora | Updated on April 20, 2020 Published on April 20, 2020

Vijay Nehra, chief of the civic body, Ahmedabad Municipal Corporation

‘Chasing the virus’ and ‘surveillance of superspreaders’ are making a difference, says civic body chief

Ahmedabad city reported its first two Covid-19 cases on March 20. A month later, the tally has jumped to 1,101. Today, Ahmedabad ranks second in India after Mumbai (2,268 cases as on Sunday) in terms of maximum coronavirus patients in a city. While the emergency response is on war footing and the administration is taking several proactive measures for containment, Vijay Nehra, chief of the civic body, Ahmedabad Municipal Corporation (AMC), wants to detect as many cases as possible before the lockdown ends on May 3.

In a telephonic interview with BusinessLine, Nehra explains Ahmedabad’s own model of ‘chasing the Virus’ and ‘surveillance of superspreaders’ to combat this global pandemic. Excerpts:

The cases are rising quite rapidly. What is causing this spurt?

A few factors are responsible for this. The large size of the population, a fairly high number of (6,000 people) foreign arrivals, a large number of visitors from affected cities like Delhi, Mumbai and Indore, and the density of population in the walled-city area, where we have seen clusters emerging. But above all, the main reason for higher cases is our strategy of proactively finding the positive cases. Of the total reported cases, about 70 per cent are proactively identified through our intensive surveillance and testing.

What is the strategy behind proactive surveillance?

If a person is not identified at the early stage and not taken into isolation, then there is a possibility of his moving around in the city, infecting many others. Once he falls really sick, he is tested and on finding him positive, he is admitted to the hospital and given the treatment. This is passive surveillance. What we are focusing on is proactive surveillance, under which our teams of healthcare workers visit all mohallas, localities, societies and pols, especially in the hotspot areas.

We conduct extensive surveillance and screening of these people and then test the suspect cases. Due to this, we have seen a sharp rise in the reported cases. But the advantage of this approach is that we are able to identify such cases at a very early stage and able to isolate them from the other public and reduce the future possibility of infection spread.

Going by the test data, West Bengal has about 47 tests per million, Andhra Pradesh and Gujarat are testing about 400 each, Kerala 512, Maharashtra 551 and Delhi 1,103 tests per million. Ahmedabad has tested 2,490 per million. We have found that about 80 per cent of the reported cases were asymptomatic. This means, they were potential spreaders. The direct benefit of this exercise is that we are able to identify the potential corona bomb and are able to defuse it in time. With this, we have been able to save about 2.5 to 3 lakh people from infection. So we are satisfied with the progress of our efforts.

What is the plan for the coming days?

We have a clear strategy, to proactively detect as many cases as possible before the lockdown ends. The objective is that we should have a minimum possible number of active infectious cases in the general population after the lockdown.

From the global experience, we have seen that once the lockdown is lifted, social distancing measures become less effective and infection rates start going up again. In our approach, we are not bothered about the surge in numbers. This approach leads to an increase in reported cases and perhaps it may also lead to increase in reported deaths. However, it will significantly reduce the actual number and actual deaths. This is our own customised model — which includes approaches of ‘chasing the virus’ and ‘superspreaders’. But for aggressive testing, we are following the South Korean model.

During the lockdown, people such as vegetable vendors, grocers and chemists become a connecting chain for a possible spread of the virus. Is there a strategy to put surveillance on them to preempt a possible spread of infection?

Yes, there is a strategy. The tools that we are using are intensive surveillance and aggressive testing, as the target we are looking for mainly are — what we call — superspreaders.

In the last one week, we have more or less covered superspreaders. None the less, tomorrow (Monday), we are going to have a “superspreaders’ day” where we are deploying all our teams across all our zones in all the wards (of the city) to undertake surveillance, screening and testing of all potential such superspreaders. These include vegetable vendors, fair price shop owners, grocers, milk parlour operators, chemists, door-to-door garbage collection team — any person who comes in touch with multiple number of people because of their job and their activity.

Do you have any concerns at present such as people support or infrastructure bottlenecks?

We no longer have any major concerns right now. People are supportive and everything else is in place.

Do we see the positive cases go up further?

I don’t think so, because most of the surge in numbers has come up only from these hotspot clusters, where the outbreak has happened. We have been able to cover about 90 per cent of that area. So, maximum in the next two days, we will start seeing a drop in numbers.

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Published on April 20, 2020
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