Two years after the official start of the pandemic in Karnataka on March 8, 2020, over 39.43 lakh people have been infected by the different variants of the SARS-CoV-2 virus and over 40,000 have lost their lives.
Over 45% of the total caseload and over 42% of the total fatalities are from Bengaluru Urban. The country’s first death was reported from Kalaburagi on March 12. The pandemic that shook the health authorities also made them realise that combating the disease meant strengthening the overall surveillance system.
The three waves
While hospitals saw an acute shortage of testing and diagnosis infrastructure through the first wave (March-October 2020), the second wave (December 2020-November 2021), largely driven by Delta variant of SARS-CoV-2, caught the health authorities unawares. The State’s health infrastructure was overwhelmed as the rise in caseload resulted in huge demand for hospital beds. Several patients died at home due to the non-availability of ICU beds and timely care. With many healthcare staff getting infected, lack of manpower also became a major issue.
However, the Omicron-driven third wave (January-March 2022 onwards) was milder. Although the surge in cases was huge, the severity was low and the demand for hospital beds and oxygen was negligible. The situation was under control as a major chunk of the population had been vaccinated with at least one dose of COVID-19 vaccine.
Preparedness
Karnataka started its combat against the pandemic by converting the government-run Victoria Hospital into a dedicated COVID facility. However, when the disease started spreading, the Health Department roped in private hospitals, most of whom were reluctant to turn into dedicated facilities initially. Almost all secondary and tertiary care public health facilities were turned into COVID hospitals.
A centralised bed-allotment system was worked out only after patients lost their lives waiting for beds. Now, with the third wave subsiding, all health facilities have resumed full-fledged non-COVID services.
Role of TAC
One of the few States to have taken the assistance of a Technical Advisory Committee (TAC) and an expert committee in pandemic management, Karnataka strengthened surveillance for early detection and isolation. Logistics for contact tracing and control measures were put in place. A war room was set up and eight in-house applications, including Coronawatch, Quarantine Watch, Daily Analytics and Reports Software, and Contact Tracing were developed for better management.
State Health Commissioner D. Randeep said the State was better prepared now. “Testing labs and critical care facilities, including oxygenated beds have been ramped up exponentially. The government filled thousands of vacant positions of health workers in the State, including in BBMP. The innovative Tele-ICUs in the State and better clinical management protocols helped save many lives. Although the absolute numbers were high in the third wave, death count was low as we had good treatment protocols in place after better understanding of the virus,” he said.
Long-term vision
V. Ravi, nodal officer for genomic confirmation of SARS-CoV-2 in Karnataka and head of Research and Development at TATA Medical and Diagnostics Ltd. (TATA MD), said although the State was better prepared now to handle a pandemic, a long-term vision involving a systemic regular surveillance for detection of emerging pathogens should be put in place.
“This surveillance can be done by monitoring all acute fevers in sentinel sites. Samples that test negative for the known list of pathogens should be considered for next-generation sequencing. Early detection and effective management of disease outbreaks in the future will depend on this,” he said.
