This story is from August 7, 2020

Testing and mask-use: How Tamil Nadu keeps Covid-19 spread in check

The first Covid-19 case was tested in the state on March 7. Five months on, the state has managed to bring down the rate of infection through aggressive testing and by spreading messages on importance of wearing masks. Yet, the increasing number of deaths remains a concern.
Testing and mask-use: How Tamil Nadu keeps Covid-19 spread in check
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CHENNAI: The first Covid-19 case was tested in the state on March 7. Five months on, the state has managed to bring down the rate of infection through aggressive testing and by spreading messages on importance of wearing masks. Yet, the increasing number of deaths remains a concern.
Fresh cases dropped from 5,881 on July 31, when there were 58,350 RT-PCR tests, to 5,684 on Thursday when 65,062 tests were done.
But the number of deaths is growing. In one week, TN reported 733 deaths – nearly 16% of the state’s total.
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Health secretary J Radhakrishnan announced on July 22 that the death of a Covid positive person will be added to the Covid toll if it occurs within a fortnight of the test or before being discharged from hospital. “This means even if Covid is an incidental finding in a person with chronic diseases like end stage cancer or organ failure, we will record it as Covid deaths,” he said.
Deaths among people with no co-morbidities have also gone up as many young and asymptomatic patients testing positive don’t come for early review.
“Health officials visit their homes to ask them to come for tests. Sometimes, even that is too late. We are now aggressively campaigning for all patients to consult doctors as soon as they get test results,” he said.
Over the past five months, the number coming into hospitals with breathlessness and other complications has increased.

Until early June, only 20% of patients had symptoms. Today, 40% have symptoms. This means more people require oxygen and intensive therapy.
“We don’t yet know if the virus is behaving differently. But we know one of the reasons is because we are now carefully looking for markers in blood instead of changes in X-rays or CT scan. If we see certain markers in early blood tests, we advise hospitalisation and aggressive therapy,” said Rajiv Gandhi Government General Hospital dean Dr Therani Rajan.
Public health experts like WHO chief scientist Dr Soumya Swaminathan recommend a registry to monitor patients admitted with Covid symptoms despite testing negative for the infection. Directorate of public health data shows nearly 5,000 of the 14,500 patients with Severe Acute Respiratory Infections admitted to hospitals currently remain in hospitals.
“Sensitivity of RT-PCR is around 70%. In some cases, when the virus multiplication period is over they may test negative for the infection but their condition may deteriorate. These patients should be registered as clinical Covid. Their health status should be monitored,” Swaminathan said.
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