Covid-19 in Karnataka: Poor contact tracing in 11 districts a concern

BENGALUR: The state’s Covid-19 management team is at its wit’s end as primary contacts of patients infected over the past few weeks across several districts have not been traced and screened. For instance, in Ballari, 65% of those found positive between November 17 and 23 have no primary contacts.
Trace, test and treat are cornerstones of Covid management in Karnataka, but contact tracing has taken a beating, experts admit.From an epidemiological perspective, one positive case generally has at least 2-3 primary contacts.

Of 11 districts on the radar where the pandemic situation is worsening, Ballari reported the most nil contacts, according to data tabled before the chief secretary at a recent review meeting. It was followed by Haveri (53.1%), Raichur (32.5 %), Tumakuru (31.4 %), Kolar (29 %) and Uttara Kannada (28 %). Dakshina Kannada has the least cases of zero contacts with 8.7% nil primary contacts.
Dr Giridhara R Babu, epidemiologist and member of the state’s technical advisory committee on Covid management, said in the early months of the pandemic, Karnataka was known for its contact tracing with up to 42 contacts traced for every infected person.
“If 100 positive cases are detected, there must be a minimum 300 primary contacts,” Dr Babu said. “Tracing primary contacts is an index of how active the surveillance and review system is in the district. Any district with more than 20% of patients with nil primary contacts is a problem.”
Experts say it’s possible for a few patients to have no primary contacts, but not a staggering 65% of them. Explaining possible glitches, Dr Babu said: “First, when people are tested in random locations like bus stops and worksites, their addresses may not be recorded and this can hamper contact tracing. Second, workers may not have recorded addresses correctly due to laziness and third, infected people may not have given accurate details at the time of testing.”
However, Pankaj Kumar Pandey, commissioner, health and family welfare department, put it down to timing. “Data shows the swiftness in contact tracing. Some districts may trace late or may be entering the data late,” he said.
But another expert said a delay can lead to a lag at every stage. “More test positive when contact tracing is done efficiently. A sense of lethargy has set in among workers,” the public health expert said.
Nakul, Ballari district deputy commissioner, said a recent transition in the district’s Covid management team may have led to the problem. “Earlier education department officials were doing contact tracing, but the health department was recently given the responsibility. I think the data has been obtained but has not been uploaded due to technical issues,” he said.
The issue is also raising concerns about the quality of data in the state. For instance, Haveri district authorities say only 63 cases were reported between November 17 and 23 as against 98 cases reported by the health department. Data shows 53.1% of patients in the district had nil contacts.
“The figures are incorrect,” said Dr Rajesh Doddamani, Haveri health officer. “This has been brought to the notice of senior authorities. Only in eight patients, primary contacts are still being traced. The number of patients with nil primary contacts is only about 5%.”