At city virus tracking hub, Markaz takes centre stage

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We did not get a list of all those who had been in the Markaz but left before the operations to vacate the premises started. However, our teams are going to mosques around the city to check whether they have anyone who had been at the Markaz living with them. DELHI HEALTH DEPARTMENT OFFICIAL

nNEW DELHI: “No entry from this gate due to Covid-19”. This note is stuck on the door of the four-room office in a Delhi government building in Laxmi Nagar. The door opens to the hub from where all coronavirus disease (Covid-19) cases in the city are tracked and containment plans are charted for the infected.

So far, Covid-19 has infected 293 people in Delhi, of which four have died. An alarming 182 of these cases, including two deaths, are linked to the Tablighi Jamaat headquarters at the Markaz building in Nizamuddin Basti, which has emerged as the biggest coronavirus hot spot in the country over the past three days.

With staff from other offices assisting the Covid-19 team as numbers swell, there are around 20 people here at any given time. They type out letters, official orders, and guidelines to be sent to health authorities; they call nodal officers in Covid-19 hospitals and quarantine facilities for an update on the number of vacant beds; and they make arrangements for resources that may be needed in the wake of a possible rise in cases.

This is also where the lists of positive cases and the people they might have come in contact is generated. These lists are then sent to teams in all the 11 districts of Delhi over e-mail and Whatsapp to arrange home visits and calls or what is referred to as “community surveillance”. If the contacts have developed symptoms, they are transported to isolation facilities in dedicated Covid-19 ambulances for testing.

There are five computers in the office, several files and lists are arranged in piles, and geospatial maps of all cases are pinned up on walls to aid the officers.

The biggest task the authorities have at the moment is finding the people who might have left the Nizamuddin Markaz building before they started testing people there on March 25.

“We did not get a list of all those who had been in the Markaz but left before the operations to vacate the premises started. However, our teams are going to mosques around the city to check whether they have anyone who had been at the Markaz living with them,” said an official from Delhi’s health department who asked not to be named.

The surveillance teams also keep an eye on the amount of food being prepared at these establishment to see whether there may be several people living in the same compound.

The district surveillance officer takes down a detailed travel history of anyone infected, trying to figure out if the source was someone they came in contact with, or if they passed on the infection to someone else. The teams – comprising of staff from dispensaries -- then visit houses in the vicinity of the patients to see if any of their contacts are showing symptoms. All the contacts are asked to self-quarantine at home, and are placed on community surveillance.

Officials from the district magistrate’s office have now been roped in for surveillance. “If we find that the address provided is wrong or the people no longer live there, then we send the list of the people to the district magistrate’s office. They take the help of the police to find these people and bring them to quarantine facilities if need be,” said a second official from Delhi’s health department.

The officials also keep in touch with their counterparts from other states for tip-offs on Delhi residents who might have come in contact with positive patients from other states. Alerts from Telangana, Andhra Pradesh, Tamil Nadu, Jammu & Kashmir and Andoman & Nicobar are what prompted the state authorities to first inspect the Markaz building last week.

All the hospitals in the city with isolation facilities for Covid-19 patients also have a nodal officer who sends updates to the office in Laxmi Nagar as soon as someone tests positive.

The Delhi government has declared five of its hospitals -- Lok Nayak, Deen Dayal Upadhyay, Baba Saheb Ambedkar, Guru Teg Bahadur, and Rajiv Gandhi Super Speciality – as designated Covid-19 centres. The five hospitals, when fully converted to Covid-19 centres, will have at least 5,850 beds for the patients.

There are also 75 isolation beds in Safdarjung Hospital, at least 32 beds at Ram Manohar Lohia Hospital, and over 100 beds in the AIL India Institute of Medical Sciences (AIIMS) Jhajjar campus for Covid-19 cases. The AIIMS trauma centre, with 250 beds and 100 ventilators, has been converted into a dedicated Covid-19 facility.

Another key area the Laxmi Nagar office tracks is testing. It receives real-time updates from government centres and, most importantly, eight private labs across the city authorised to test patients. “Since these are patients who are not under our surveillance, our team is immediately sent to their home to take history and start contact tracing,” according to a third official.

Data is shared with the state health minister and the chief minister every day. The officials from the hospitals, the integrated disease surveillance programme (IDSP), and other government departments, also have regular meetings with the ministers to track the number of infections and preparedness measures.

The ministers and health secretary, in turn, are in touch with the central government for requirements such as PPE, testing kits, and viral transport medium needed to collect samples. As of now, the health department, and by extension the Laxmi Nagar anti-covid hub, is on high alert to track people people across the city who might have come in contact with those from the Nizamuddin Markaz building.

“Many more will test positive,” says a fourth official.