States scramble as pilgrims transgress ICMR plays down signs of community transmission
NIZAMUDDIN SUPER SPREAD Delhi, areas as far as the North-east, TN deluged with cases emanating from congregation CONTROLLING THE OUTBREAK
NEW DELHI: Officials across the country began a frantic search for thousands of people who had been to the headquarters of a religious group in Delhi’s Nizamuddin area that has now emerged as the single-biggest source of coronavirus disease (Covid-19) infections in the country, leading to at least eight deaths and 117 confirmed cases.
The discovery of the hot spot at the six-storey building of the Tablighi Jamaat – called a markaz – triggered alarm in several circles of the government: the Delhi Police filed an FIR against functionaries of the centre for flouting social distancing rules, roughly a dozen states sounded an alert, and the Union government began the process to blacklist 275 foreign nationals belonging to the sect who purportedly flouted visa rules by claiming to be tourists.
“So far about 2,137 people (who were at the centre) have been identified in different states. They are being medically examined and quarantined,” a senior official of the Union home ministry said on Tuesday, asking not to be named.
The people quarantined and being searched for in the states are in addition to roughly 2,000 who were evacuated from the building since Sunday night and may have been exposed to the Sars-cov-2 pathogen in the facility, where residents routinely dined and attended religious functions together.
According to a health official in the Delhi administration, who asked not to be named, at least 400 among those who have been evacuated from the building since Sunday have been taken to hospitals with symptoms of the disease. They are being tested, this official said, adding that they are preparing for at least half of these symptomatic cases to be positive for the virus.
Delhi health minister Satyender Jain said the gathering at the markaz flouted Delhi government’s orders. “The organisers have committed a grave crime. I have written a letter to LG (Lieutenant Governor) Anil Baijal to take strictest action against the organisers. We have given directions to the police to lodge an FIR as well,” Jain said, a day after the Delhi government ordered the filing of the first information report (FIR). The functionaries of the Tablighi Jamaat denied allegations of wrongdoing and said that their members routinely arrive for events that last 3-5 days, and that the people who were left behind in the facility were stranded by the lockdown announced last week.
The largest cluster of cases that is linked to the mosque complex appears to be in the southern states of Tamil Nadu, Telangana and Andhra Pradesh. In Tamil Nadu, 50 of the 57 new Covid-19 cases confirmed on Tuesday had visited the complex earlier this month. At least 500 others were at the building and are being sought out.
Andhra and Telangana together suspect nearly 2,000 may have visited the congregation in Delhi. Delhi banned on March 13 any seminar or conference having more than 200 people.
Three days later, it prohibited any form of religious, academic, political, social, cultural, personal gathering involving over 50 people, and then gradually tightened the curbs in subsequent orders.
Government officials said the attendees flouted all these orders, and also those issued on March 19 (prohibiting the gathering of not more than 20 people) and March 21 (prohibiting the gathering of four or more people).
Then on March 24, Prime Minister Narendra Modi announced a nationwide lockdown in an unprecedented move that banned gatherings, and halted commercial rail and flight services.
As the lockdown began, the police asked the organisers to close the markaz, according to government officials.
DEATHS
New Delhi The Indian Council of Medical Research (ICMR) has come under scrutiny over the past few days for its continued insistence that there is no community transmission of Covid-19 in India, and delays in approving testing kits, parameters for which have been set at absurdly high levels, according to many experts.
The National Institute of Virology (NIV) was also taking far too long to evaluate the kits — delaying the entire testing process, which was only last week opened to private laboratories. ICMR eventually opened up six more testing sites to start clearing the backlog.
On Tuesday, a day when the number of cases in India rose by 146 (and number of deaths by 3), Dr Raman R Gangakhedkar, head, division of epidemiology and communicable diseases, ICMR, defended the organisation’s stand on both. He maintained that there is no community transmission and that at the stage of the disease India is, it cannot afford to compromise on the parameters of the testing kits.
Gangakhedkar explained that a recent Union health ministry document on transporting of positive patients mentioning “limited community transmission” was actually referring to localised transmissions that have erupted in certain pockets of the country that are still manageable.
“We are nowhere close to being in community transmission. If there was community transmission then I wouldn’t be recommending healthy people to not wear a mask. There is an increase in number but it is not an alarming increase. Look at other countries that are reporting cases in thousands, that’s what community transmission is,” he said.
ICMR has already expedited the process of evaluating test kits, Gangakhedkar said in an interview. Explaining the very exacting 100/100 (sensitivity/ specificity) parameter for validating all new testing kits, he said: “This is because we don’t want to compromise on quality. At the initial stage of transmission, only foolproof testing is needed so as to pick up maximum true positive cases. We need highly sensitive and specific results; we don’t need any false negatives or false positives at this stage in the outbreak.”
Sensitivity or true positive rate is a measure of the proportion of infected people correctly identified. Specificity or true negative rate is a measure of the proportion of uninfected people identified as uninfected. ICMR has said that only kits with 100% in both will be approved. “Even false positives and false negatives samples are used to check the kit’s ability whether it is able to pick up the results accurately or not,” said Gangakhedkar.
However, ICMR has also said kits approved by the US FDA and European CE will be allowed — some of which do not follow the 100/100 parameter ICMR has set for new kits. “Even in these, we have recommended the best available ones to open up more options in case we need to scale up,” Gangakhedkar explained.