Primary response to COVID-19 situation by Himachal Pradesh, India, during pandemic year 2019–20

Abstract

BACKGROUND: India announced its first incidence of corona virus disease-2019 (COVID-19) in the state of Kerala on January 30, 2020. The severe acute respiratory syndrome- coronavirus-2 (SARs-CoV-2) pandemic was also unavoidably pounding on the doors of the state of Himachal Pradesh (HP), with enormous regional discrepancies necessitating remarkable insight. SETTINGS: On February 5, 2020, HP’s health authority took its first reaction step and followed it with a swift, adequate, and innovative response subsequently. Assuming R0 of 2.28 at the early stages of an epidemic, the outbreak threshold (T0 = 1/Log R0) is estimated to be mere 2.7 infections. However, with the emergence of only two positive cases, the state acted conscientiously vigilant to announce a lockdown at an opportune moment. METHODS: Department of Information and Technology developed a “CORONA Mukht (free) App” for keeping a digital record of all home-quarantined persons on the administration vigil list. During the active house-to-house case-finding campaign, an exercise involving 16,000 healthcare workforces, around 10,000 individuals with influenza-like illness (ILI) were screened. The ambulances were modified innovatively as “mobile sample collection kiosks” for sample collections throughout. The state added additional categories in the sampling protocol to keep a vigil for any community transmission. The protocol included samples from Flu clinics, ILI patients from the community, and occupants with ILI from migrant relief camps. DISCUSSION: On April 20, 2020, there were 23 incident cases in the state and declined to 10 on April 27, 2020. On May 3, 2020, out of 40 positive cases reported, there was only one active case under treatment. Subsequently, with effective containment measures, the state succeeded in keeping the test positivity rate below 2% from May to August 2020. Effectively during the specified period, cumulative deaths reported were 33 only in the state, with a case fatality rate of 0.56% at the end of August 2020, lower than the national average of 2.1%. CONCLUSION: It can be concluded that HP’s initial response to SARS-CoV-2 pandemic was exceptional and emphatic.