Health Ministry identifies 170 districts in India as hotspots

The Union Health Ministry has declared 170 districts in 25 states as COVID-19 hotspots and 207 districts in 27 states as non-hotspots, officials said on Wednesday, reiterating that there has been no community transmission of the disease in the country so far.

Addressing the daily briefing to provide updates on coronavirus situation in the country, Joint Secretary in the Ministry of Health Lav Agarwal said that states have been asked to classify districts witnessing higher number of cases as hotspots, districts where some cases have been found as non-hotspots, and those which have reported no cases as green zones.

Hotspots are those districts which are reporting more number of cases or where the rate of growth of COVID-19 cases is high, Agarwal said, adding a detailed direction has been issued to states stating consolidated efforts are required to utilise this period of lockdown to curb the spread of the virus.

"As per data till yesterday, 170 districts have been classified as hotspot districts. Non-hotspot districts where cases have been reported are 207 in number," Agarwal said. "Cluster containment plan needs to be implemented in those 207 non-hotspots as they can develop as potential hotspots," the official said.

"There is no community transmission in the country so far. What we are seeing is some local outbreaks and clusters, where cluster and outbreak containment strategies are being adopted," he said. The districts which have not reported any cases yet have also been directed to work on cluster containment plans, he said.

In order to break the chain of transmission, focus needs to be on contact tracing, monitoring and clinical management. States have been asked to uniformly implement the containment plan in every district across the country, Agarwal said. He said the cabinet secretary held a video conference on Wednesday with all chief secretaries, DGPs, health secretaries, collectors, SPs, municipal commissioners and CMOs where hot spots was discussed and orientation on field level implementation of containment strategy was given.

They were told about large outbreak containment strategies, cluster containment strategies. Delineation of buffer and containment zone, parameter mapping, defining of entry and exit points were also discussed in detail, he said. The joint secretary said movement of people will not be allowed in containment zones, except for those related with essential services, and special teams will search for new cases and samples will be collected and tested as per sampling criteria.

The officials said that health facilities in buffer zone outside the containment zone will be oriented and people facing Severe Acute Respiratory Illness (SARI) and influenza-like symptoms will be tested there. "Special teams have been formed which will work in containment zone and do contact tracing and house-to-house surveys. Cases of fever, cough and breathlessness will be identified in the survey and requisite action will be taken as per protocol," Agarwal said, adding that there has been no community transmissions so far but some local outbreaks.

"We have told states that besides the hotspots identified by the Centre, states who are fighting the battle at field level may declare additional districts as hotspot districts and take required action accordingly," he said. Besides health staff, services of local revenue and corporation staff and volunteers will also be utilized in the special teams which will do contact tracing, survey and surveillance.

Even in those districts which are not infected, community engagement needs to be undertaken to upgrade health infrastructure and dedicated COVID hospitals need to be set up, the official said, adding monitoring and testing of cases with SARI and influenza-like illness (ILI) symptoms need to be done. Districts have been told to promote proper pharmaceutical and non-pharmaceutical interventions and to orient all staff involved in infection control practices and proactively train relevant staff in clinical management.

Responding to a question on whether the novel coronavirus has originated from bats, Head of Epidemiological and Communicable Diseases at ICMR Raman R Gangakhedkar said that a recent ICMR study has found the presence of bat coronavirus (BtCoV) in two bat species in some states which are incapable of affecting humans adversely.These bat coronaviruses have no relation with SARS-CoV2 responsible for the COVID-19 pandemic, he said.

"Coronavirus is found in bats. We have come to know from the research in China so far that the virus which has affected humans either may have been because the bat virus developed such mutations that it developed the capacity to cause disease in humans or it got transmitted to pangolins from bats first and then to human beings. "This question is being asked because we started a survey on emerging infectious diseases and to see if those viruses can be found in bats. We found the presence of coronavirus in two bat species but they are not capable of affecting human beings adversely," Gangakhedkar said.

"The instances of transmission of virus from bats to humans can happen may be once in around 1000 years or so. It is a rare event," he said. He further said 73 private labs have been given approval for conducting COVID-19 tests out of which 22 labs are currently testing.