Support More Testing for Covid
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Dear Chief Minister Sir,
This is to seek your intervention and orders for increasing testing for Corona Virus cases in Tamil Nadu. As you will be well aware Tamil Nadu, especially Chennai has seen a huge number of cases over the last one month. Over the last 3-4 weeks the case positivity rate in Chennai has almost trebled. Yet there has been no significant increase in testing across the State. Both the expert committee appointed by your Government as well as experts from ICMR and also various other doctors have been repeatedly speaking of the need to drastically increasing testing. This is the only way we can identify Covid positive patients, isolate them and avoid further spread of infection. You will also be aware of the increasing case fatality rate due to Covid. Only if infection spread is controlled can more deaths be prevented. This has been proven to be the case across the World.
All symptomatic patients need to be tested. Right now many are being turned away and told to isolate themselves and return if their symptoms persist for more than 3-4 days. Many of them continue to spread the infection. On paper the policy is to test all symptomatic persons. However from innumerable media and social media reports we know that large numbers of symptomatic patients are not being able to get tests done. They must be tested even if they have symptoms for a day.
Also it is stated that as per policy all immediate and high risk contacts of a positive case must be tested. This again is not being done as per numerous media reports. This needs to be strictly ensured.
There seems to be a concerted attempt to keep case numbers in control by not increasing tests. This can lead to huge spread of the infection leading to a large number of deaths that could have been prevented had cases been detected early and isolated.
We request your kind attention to issue orders for the following
1.Drastically increase testing in Chennai and the rest of the State to the levels recommended by the medical experts.This initially must at least be by a magnitude of 4-5 times the current testing levels in Chennai. Sample collection centers in Chennai can be drastically increased to help boost testing. Pooled testing can be started. Some states are already doing this.
2.ALL symptomatic patients IRRESPECTIVE of duration of symptoms to be tested.
3.Test ALL immediate contacts and high risk contacts of positive cases.
4.Test all high risk staff like healthcare staff,police, media, those working in containment zones,etc. once every 2 weeks.
5.Kindly ensure that the Police enforce the wearing of face masks in public. Please arrange to distribute cloth masks free through PDS. Also ensure standardized cloth masks are widely available to others at a reasonable cost.
6. Kindly publish the number of patients in ICU and those on Ventilator in the daily reports issued by Health Department.
7.Daily District wise testing data will help us understand this problem further and needs to be added to the daily health bulletin.
8. Kindly issue strict orders that the WHO definition of Covid death is to be followed when certifying death. That will help us get accurate data on the number of Covid deaths and for research. There are reports of patients dying of breathlessness before reaching hospital. They must also be tested after death and their contacts traced.
9.Go beyond ICMR guidelines and do testing for asymptomatic persons in the cluster dense zones for source location. This is something even members of the Medical Advisory Committee working under your leadership would agree.
10. Pulse Oximeter and Portable Oxygen Canisters may help old people who develop sudden breathlessness at home. Timely oxygen will be crucial till they reach a hospital. Please order that these 2 life saving products are available to people on demand and at reasonable costs.
11. The report of Tamilnadu Dr.MGR University on the Corona situation in TN was reported in parts by press. We request you to place the whole report in public domain. Scientific studies of this nature are undertaken by several Universities and institutions across the world and available freely in public domain. These reports can be further examined by experts across the world and they may come up with several useful suggestions.
12.As advised by ICMR kindly in parallel start the surveillance testing for disease prevalence using the rapid antibody tests.
We are deeply appreciative of all the efforts being made by the Govt. to contain Covid and to provide assistance to those in need. But we feel that the measures outlined above are needed immediately.
Tamil Nadu looks up to you for taking the right decisions and doing the right thing. The lives of thousands of people depend on your decision. And the entire State will certainly extend full support and cooperation to you at this critical moment.
Institute of Vascular Surgery,
Madras Medical College,
Chennai 600 003. India
Former Member Secretary,
Transplant Authority of Tamilnadu
Dr.Sumanth C Raman
Medical Consultant (Internal Medicine)
Television Anchor and Political Analyst
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