New Delhi / Mumbai, April 23, 2020

The number of COVID-19 positive cases stands at 21,393 as on date. 4,257 people have recovered, which takes the recovery rate to 19.89%. The total number of cases under active supervision is 16,454. In the last 24 hours, 1,409 new cases and 388 recoveries have been reported. This was informed by the Joint Secretary, Ministry of Health & Family Welfare, Shri Luv Aggarwal, at the daily media briefing on the actions taken, preparedness and updates on COVID-19, held at National Media Centre, PIB New Delhi today. As on today, we have 12 Districts that did not have a fresh case in the last 28 days or more.  (8 new districts have been added to the list). There are 78 districts where no case has been reported in last 14 days (33 new districts in 9 states added to the list).

The Joint Secretary informed that the President of India has promulgated an ordinance yesterday to amend the Epidemic Diseases Act, 1897 to ensure there is zero tolerance to any form of violence against healthcare service personnel and damage to property.

The Joint Secretary also presented a video of Aarogya Setu App promoted by actor Ajay Devgan.

Chairman of Empowered Group 2, Mr. C. K Mishra, who is coordinating Availability of Hospitals, Isolation & Quarantine Facilities, Disease Surveillance & Testing and Critical Care Training gave a presentation on India's strategy and preparedness in fighting COVID-19. He informed that:

• During the 30 days of lockdown, we have been able to: 1) cut transmission, minimize spread and increase the doubling time of COVID-19, 2) consistently ramp up our testing, 3) utilize our time to prepare for the future.
• One crucial weapon we employed during the 30-day lockdown period is RT-PCR testing. On March 23, 2020, we had done 14,915 tests, while on April 22, we had done more than 5 lakh tests. There has been an increase of around 33 times in 30 days.
• Post lockdown, while no. of new positive COVID-19 cases has increased by 16 times, testing has increased by 24 times.
• The growth of COVID-19 cases has been more or less linear, not exponential; this indicates that the strategies we have adopted have succeeded in containing the infection to a particular level.
• Despite a 24-fold increase in testing, percentage of positive cases is not rising. Percentage of positive cases as a ratio of testing is more or less the same as that a month back.
• India has done better than majority of developed countries, with respect to the % of test cases yielding positive results. A comparative study, held after 400 cases were reached in India and other countries, show that India's position is more advantageous than most other countries.
• The facts show that our testing strategy has been focused, targeted and continues to expand, this is an evolving strategy based on our learnings as we go along. As the challenge kept expanding, strategy too kept expanding.
• We expanded our testing base, mobilizing all possible resources - both public and private, and have decentralized the activities to manage it effectively.
• The lockdown period has been used gainfully to review, assess and expand our hospital infrastructure and preparedness; our effort has been to use resources and be over-prepared.
• Our first goal as regards hospitalization has been to ensure that the minimum no. of people need to come to hospital, using social distancing, discipline and taking care of the vulnerable such as the elderly and those with co-morbidities. The 2nd goal is to ensure enough infrastructure so that every person who needs to come to hospital is treated well, cured and sent back. Every district in the country is now working towards that.
• A 3-tier structure has been set up which will be employed to treat COVID-19 patients. No. of dedicated COVID Hospitals has increased by 3.5 times and no. of isolation beds by 3.6 times during the last one-month lockdown period. As per patient profile, the critical thing is oxygen, our entire hospital preparation is focused on ensuring oxygen support to those who need it. Our goal is to ensure that most people get cured at COVID Health Centre stage itself. We want to create a structure so that we test most people, treat them as per need and ensure we are able to cure them and save lives.

Director General, ICMR, Shri Balram Bhargava said that the nation’s philosophy has been more labs, more tests and more resources. From NIV at the beginning of the year and around 100 labs at the beginning of lockdown, we have 325 laboratories testing for COVID-19 today. “Our strategy has been to detect the virus and then save lives. The entire scientific and medical community has risen to the occasion. Private sector too has energetically risen to the occasion. A supply chain for testing has been created. The Centre has been working with states tirelessly to ensure required reagents are supplied to testing labs in timely and calibrated fashion, enabling diversion of reagents to hot spots as needed. We have also decentralized the supply chain and created 15 hubs to which materials are supplied and further distributed. The gold standard for COVID-19 testing remains and has remained the RT-PCR test, which detects the virus and thereby enables us to save lives. This has been our principle and strategy for testing.”.

Director, AIIMS New Delhi, Prof. Randeep Guleria said that the societal stigma attached with COVID-19 patients is leading many people to not come forward and get tested or treated, leading not only to huge mental agonies and problems but also higher morbidity and mortality. Instead of sympathising with the patients and their family, we have created an environment of fear and panic which is not justified. “Patients are facing a lot of challenges and stigma which is not justified. Recovered patients are symbols of victory, but we have stigmatized them, causing a huge problem. Due to the stigma we have attached, patients are not coming forward, they are coming very late when they have severe breathlessness issues, thereby increasing morbidity and mortality Many of these COVID-19 patients can be saved by just giving them oxygen; if they do not get oxygen, it can trigger various other problems, our strategy of expanding oxygen support is based on this.” He said that we need to reach out to these patients who are afraid to come out because of stigma and thereby posing a danger to their lives. “We should look at how we can support people and families who have COVID-19 and encourage people to come forward.”

The Director informed that the primary treatment for COVID-19 is supportive in more than 80% of patients, oxygen therapy in 15% of patients, with other drugs such as convalescent plasma. HCQ and other repurposed drugs, and newer drugs are being looked at, informing that there is hope as far as treatment is concerned. on behalf of the medical community, the Director expressed his gratitude to the Prime Minister and the Government of India for the ordinance amending the Epidemic Diseases Act, saying it goes a long way in boosting morale of our frontline healthcare workers and Corona Warriors.

Stating that enforcement of lockdown is satisfactory throughout the country, except for a few incidents, Joint Secretary, Ministry of Home Affairs, Ms. Punya Salila Srivastava representative stated:

• Home Secretary and Secretary- DPIT held a meeting with industry associations through video conferencing. Discussions included how to run industrial activities, which have been given permission, in an orderly manner.
• The health professionals are making a noble contribution of saving us from COVID-19 in a dedicated manner, without thinking about themselves. The Hon'ble Supreme Court has also ruled that doctors and medical staff are to be given protection. The Health Ministry has written letters to States and UTs on this issue from time to time, and advised them to provide adequate security to healthcare workers in hospitals, quarantine centres and also at fields for testing. Home Minister held a meeting with Indian Medial Association and gave assurance for safety of medical professionals. As per advice of the Home Minister, MHA has written to all states and UTs and asked them to carry out their responsibilities and take necessary action for protection of medical professionals in coordination with the local chapters of Indian Medical Association. They have also been asked to share with IMA local chapters about the measures taken to ensure safety of medical professionals. This will give assurance to the healthcare workers that they are safe. In this context, district and state level nodal officers are also to be appointed, who can resolve the healthcare workers' safety related issues. In case of any reported incidents of violence against healthcare workers, steps are to be taken against the guilty according to the provisions of Disaster Management Act 2005. Public awareness about this issue is also to be created.
• Home Ministry has written to all States and UTs on April 21, to state that care-givers of senior citizens are to be given exemption during lockdown. Prepaid mobile recharge services have also been given exemption during lockdown.
• Keeping in view the necessity of essential commodities, food processing units in urban areas, like milk processing units, Bread factories, atta and dal mills will have also been given exemption.
• By MHA order dated April 21, Government has exempted additional agricultural and forestry items, shops of educational books for students and shops of electric fans from lockdown restrictions.
• Lakhs of Indians work in merchant shipping vessels. It has been seen that Indian seafarers are stranded in ships or are not being able to join for their duties in ships because of lockdown. In such a condition, sea-farers from countries can replace them. Hence, SOPs on Sign-on/Sign-off for Indian Seafarers at Indian Ports and their movement have been issued.
• Economic activities, especially in rural sector is going on well. In the month of April, more than 1.5 crore man days have been counted in MNREGA. At places which are not hotspots or fall under containment zones, in accordance with Centre's directives, State Governments are trying to start industrial activities in an orderly manner. On basis of feedback about problems being faced by industrial units, steps are being taken to address those issues.

Replying to a query on the visit of Inter Ministerial Central Team to Maharashtra, the Joint Secretary, Health informed that a field level implementation strategy to strengthen state's strategy has been prepared for Maharashtra, based on a discussion of best-case, medium and worst-case scenarios, in coordination with the state authorities.

LIVE tweets by @PIB_India from the media briefing can be found on this thread.

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DJM/SC

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