After onions and milk, now cooking oil to get costlier

New Delhi, Jul 19: India's Covid-19 case fatality rate is "progressively falling" and is currently at 2.49 per cent, which is one of the lowest in the world, the Union Health Ministry said on Sunday, crediting efficient clinical management of hospitalised cases for it.

There are 29 states and union territories with a case fatality rate (CFR) lower than India's average, with five of them having a CFR of zero and 14 having fatality rate of less than 1 per cent.

The focused efforts of the Centre and state and UT governments on efficient clinical management of hospitalised cases have ensured that India's case fatality rate has fallen below 2.5 per cent, the ministry said.

With effective containment strategy, aggressive testing and standardized clinical management protocols based on holistic standard of care approach, the CFR has significantly dipped, it said.

"The CFR is progressively falling and currently, it is 2.49 per cent. India has one of the lowest fatality rates in the world," the ministry said.

From 2.82 per cent over a month earlier, India's Covid-19 case fatality rate declined to 2.72 per cent on July 10 and has further reduced to 2.49 per cent presently.

Under the guidance of the Centre, the state and UT governments have ramped up testing and hospital infrastructure by combining public and private sector efforts, the ministry said.

Many states have conducted the population surveys to map and identify the vulnerable population like the elderly, pregnant women and those with co-morbidities.

This, with the help of technological solutions like mobile apps, has ensured keeping the high-risk population under continuous observation, thus aiding early identification, timely clinical treatment and reducing fatalities, the ministry said.

"At the ground level, frontline health workers like ASHAs (Accredited Social Health Activists) and ANMs (Auxiliary Nursing Midwives) have done a commendable job of managing the migrant population and to enhance awareness at the community level.

"As a result, there are 29 States and UTs with CFR lower than India's average. This shows commendable work done by public health apparatus of the country," the ministry said.

Manipur, Nagaland, Sikkim, Mizoram, Andaman and Nicobar Islands have zero case fatality rate.

States and UTs having a CFR below the national average include Tripura (0.19 pc),  Assam (0.23 pc), Kerala (0.34 pc), Odisha (0.51 pc), Goa (0.60 pc), Himachal Pradesh (0.75 pc), Bihar (0.83 pc), Telangana (0.93 pc), Andhra Pradesh (1.31 pc), Tamil Nadu (1.45 pc), Chandigarh (1.71 pc), Rajasthan (1.94 pc), Karnataka (2.08 pc) and Uttar Pradesh (2.36 pc).

India saw a record single-day jump of 38,902 Covid-19 cases pushing its tally to 10,77,618 on Sunday, while the total number of recoveries increased to 6,77,422.

A total of 23, 672 patients have recuperated in the past 24 hours, the highest so far in a day, according to the health ministry data updated at 8 AM.

According to the Indian Council of Medical Research (ICMR), a cumulative total of 1,37,91,869 samples have been tested up to July 18 with 3,58,127 samples being tested on Saturday. 

Feb 9: The Electronic Voting Machines (EVMs) used in Delhi Assembly polls are kept under tight security, in the 'Strong Room' located at Atal Adarsh Bengali Balika Vidyalaya in Gol Market.

Voting for Delhi Assembly elections took place on Saturday with voters turnout well short of the 2015 election mark.

Counting of the votes will be on February 11.

Earlier, Deputy Election Commissioner Sudip Jain had said the Delhi elections took place peacefully and smoothly.

New Delhi, May 23: The nationwide lockdown will no longer help India in its fight against COVID-19, and in its place community-driven containment, isolation and quarantine strategies have to be brought into play, leading virologist Shahid Jameel said.

The recipient of Shanti Swarup Bhatnagar Prize for Science and Technology also stressed that testing should be carried out vigorously to identify coronavirus hotspots and isolate those areas.

"Our current testing rate at 1,744 tests per million population is one of the lowest in the world. We should deploy both antibody tests and confirmatory PCR tests. This will tell us about pockets of ongoing infection and past (recovered) infection. This will provide data to open up gradually and let economic activity resume," Jameel told PTI in an interview.

He stressed that testing has to be dynamic to continuously monitor red, orange and green zones and change these based on that data.

About community transmission of COVID-19 in India, Jameel said the country reached that stage long ago.

"We reached community transmission a long time ago. It's just that the health authorities are not admitting it. Even ICMR's own study of SARI (severe acute respiratory illness) showed that about 40 per cent of those who tested positive for SARS-CoV-2 did not have any history of overseas travel or contact to a known case. If this is not community transmission, then what is?" he posed.

Lockdown bought India time in its fight against coronavirus, but continuing it is unlikely to yield any further dividend, Jameel said.

"Instead, community-driven local lockdowns, isolations and quarantines have to come into play. Building trust is most important so that people follow rules. A public health problem cannot be dealt with as a law-and-order problem."

The nationwide lockdown, initially imposed from March 25 to April 14, has been extended thrice and will continue at least till May 31. The virus has claimed 3,720 lives and infected over 1.25 lakh people in the country so far.

Jameel has expertise in the fields of molecular biology, infectious diseases, and biotechnology. He is the CEO of Wellcome Trust/Department of Biotechnology's India Alliance and is best known for extensive research in Hepatitis E virus and HIV.

He said COVID-19 will eventually be controlled through herd immunity, which is acquired in two ways – when a sufficient fraction of the population gets infected and recovers, and with vaccination.

"It is estimated that for SARS-CoV-2 at least 60 per cent of the population would have to be infected and recovered, or vaccinated. This will happen over the course of the next few years," Jameel said.

Herd immunity is reached when the majority of a population becomes immune to an infectious disease, either because they have become infected and recovered, or through vaccination. When that happens, the disease is less likely to spread to people who aren't immune, because there just aren't enough infectious carriers.

"India has 1.38 billion people, a population density of about 400/sq km and a healthcare system ranked at 143 in the world. If we allow 60 per cent people to get infected quickly in the hopes of herd immunity, that would mean 830 million infections," Jameel said.

"If 15 per cent need hospitalization that means about 125 million isolation beds (we have 0.3 million). If five per cent need oxygen and ventilatory support, this amounts to about 42 million oxygen support and ICU beds; we have 0.1 million oxygen support beds and 34,000 ICU beds. This would overwhelm the healthcare system causing mayhem," he said.

Jameel said if the population level mortality is 0.5 per cent that would mean 40 lakh deaths. "Are we prepared to pay this price for herd immunity in the short term? Clearly not," he said.

He said it is unlikely that a vaccine would be available by the end of the year.

"Even then, we don't know yet how long it would give protection – weeks, months, one year, a few years? I don't think we will return to pre-coronavirus days for at least the next 3-5 years. This is also a chance to evaluate if we want to return to those unsustainable, environment-damaging ways. COVID-19 is a timely warning to reform our way of living," he said.

Jameel said it is hard to predict but plausible that COVID-19 would return in second or third wave.

"Later waves come when we don't understand the disease and become lax. A comparison to Spanish Flu is not entirely valid because in 1918 no one knew what caused it. No one had seen a virus till the mid-1930s as the electron microscope needed to view those was invented in 1931," he said.

"Today we know a lot more about the pathogen, its genetic makeup, how it transmits and how to prevent it. We need to be sensible and follow expert advice," he said.

If there is any scientific evidence linking deforestation, rapid urbanisation, climate change with pandemics like COVID-19, he said zoonotic viruses -- those that jump from animals to humans -- happen so when wild animal–human contacts increase.

"Deforestation destroys animal habitats bringing them closer to humans. When you cut forests, bats come to roost on trees closer to human habitations. Their viruses in secretions/stool get transmitted to domestic animals and on to humans. This happened clearly with Nipah virus outbreak in Malaysia in 1997-98 from fruit bats to pigs to humans," he said.

"COVID-19 possibly arose in wet animal markets due to dietary habits that bring all kinds of live and dead wild animals in close contact with humans," Jameel added.