Maharashtra: ‘Insufficient contact tracing has led to sustained transmission’

MUMBAI: The Central team that recently visited the state to investigate the surge in Covid-19 cases has questioned the contact tracing methodology currently being used and asked for reorientation of field staff. On the ground, shortage of manpower in several districts appears to be the main hurdle in the “test, treat and track” initiative, considered key to control the spread of coronavirus.

The team comprising Dr P Ravindran from the union health ministry, public health specialist Dr Sunil Khaparde and Dr Sanket Kulkarni, deputy director of National Centre for Disease Control, visited Maharashtra between March 7 and 11. Among other things, the team observed while on paper the case-contact ratio was 1:20 in the state, the field staff didn’t understand the concept of contact tracing entirely.

The volunteers are mainly listing the immediate family and neighbourhood contacts for “the sake of listing”, the team found. “The high-risk contacts in workplace settings, social settings and family settings were not investigated and listed,” the team wrote in their report submitted to the union health ministry and even shared with the state. It has prompted them to ask for training of field staff involved in contact tracing with an emphasis on interpersonal communication skills.

Significantly, they found monitoring of contacts was limited to conveying the message to high-risk ones for testing the very next day and not after five days as instructed by Indian Council of Medical Research. Worryingly, the “limited” tracing was leading to a large pool of asymptomatic and pre-symptomatic contacts not being tracked at all. They said the absence of rigorous tracing, testing and containment was leading to sustained community transmission.

A senior state government official said opening up of all sectors has led to increased movement across the state, which is proving to be a challenge in contact tracing.

“In cities like Mumbai, we don’t find people at home,” said the official. Chief minister Uddhav Thackeray also mentioned these challenges at the meeting with Prime Minister Narendra Modi on Wednesday.

Dr Pradeep Awate, state surveillance officer, said Mumbai and Pune have established health systems and trained people to carry out contact tracing. Smaller districts with limited health infrastructure and personnel are finding it challenging.

“During lockdown, we had pooled in state bus drivers and conductors for contact tracing, but such people have resumed their work,” he said. A senior official from Dhule said they are training people to take medical history more meticulously.