As many as 20 States and Union Territories have ordered complete lockdown under their jurisdiction and six other States have put in place similar restrictions in some areas in the wake of coronavirus outbreak, officials said on Monday.

The Centre has also asked States to enforce additional restrictions, if necessary, leading to imposition of curfew in Punjab and Maharashtra.

Maharashtra Chief Minister Uddhav Thackeray, who announced the imposition of a curfew from Monday midnight, however, did not spell out the duration of the curfew. But a senior official from the Chief Minister’s office said that all District Collectors and Superintendents of Police will soon notify the time limit.

Simultaneously, to counter the spread of Covid-19, Kerala, Tamil Nadu and Andhra Pradesh announced a lockdown. In Kerala, the lockdown started on Monday and will last till March 31.

Chief Minister Pinarayi Vijayan announced the measure on Monday evening after the number of positive cases shot up to 95, with 28 new cases being reported.

In Tamil Nadu, the lockdown will kick in from 6 pm on Tuesday. Section 144 of the CrPC will be in force till March 31. The announcement comes after the total number of Covid-19 cases in the State rose to nine on Sunday. Andhra Pradesh, too, has gone for a complete lockdown till March 31 with the number of cases rising to six on Sunday.

Task Force’s prescription

On a day when the Ministry of Health and Family Welfare reported 464 confirmed cases of Covid-19, the National Task Force, to tackle the novel coronavirus, recommended using hydroxychloroquine as a preventive drug among high-risk individuals. The drug can be used by healthcare workers involved in the care of suspected or confirmed coronavirus cases and contacts of confirmed cases even if they do not display any symptoms, it said.

In its recommendations, the Task Force has clarified that the drug should not be used on children under 15, as also  patients with conditions such as retinopathy and hypersensitivity to the drug.

Balram Bhargav, Head, Indian Council of Medical Research (ICMR), told BusinessLine the anti-malarial drug is currently being repurposed for prophylactic or preventive treatment in persons exposed to high risk situations. “However, we do not know what works and what does not. We are still not sure how efficacious is the drug,” he said.

India has tried a combination of lopinavir and ritonavir, an anti-HIV drug, in a few Covid-19 confirmed cases. The latest evidence, of 199 patients from China, published in the New England Medical Journal , has suggested that there is no visible difference between those receiving the anti-HIV cocktail and those who don’t in Covid-19 cases.

To this, Bhargav said: “In the Indian context we will still continue using the anti-HIV cocktail for treatment. What do you do when no drug is working on a severely ill patient? We have to try something that is available, even if the results are not encouraging.”

Leena Menghaney from Doctors Without Borders said: “The government should shed clarity on whether hydroxychloroquine will also be used in treatment protocols, now that there is forthcoming evidence from China that lopinavir and ritonavir are not helpful in improving the situation.”

Testing by private labs

The ICMR has approved 12 private labs as of Monday to conduct Covid-19 tests, including Lal Pathlabs in Delhi, Unipath Specialty Lab in Ahmedabad, Strand Life Sciences and SRL Ltd in Gurugram, Neuberg Anand Reference Lab in Bengaluru, Thyrocare, Suburban Diagnostics, Metropolis, Sir HN Reliance Foundation Hospital and SRL in Mumbai and Navi Mumbai, Christian Medical College in Vellore and Apollo Hospitals in Chennai.

On Monday, the ICMR also stated that it has developed a fast-track mechanism for validation of test kits — including indigenous ones that do not have international approvals like those of the USFDA and European regulators.

It said the National Institute of Virology had finished validating nine companies — Altona Diagnostics, MYLAB, BGI, Krishgen Bio System, ABI, HIMEDIA, HUWEL, IIT-Delhi and KILPEST (BLACKBIO) — for diagnostic kit approval. Of the nine, only Altona and MYLAB have been approved for use by ICMR-recommended government and private labs.

“Test kits with 100 per cent concordance among true positive and true negative samples will be approved for commercial use in India. The rest of the technologies do not show 100 per cent concordance,” an ICMR official said.

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