COVID-19 in Punjab, India: Epidemiological Patterns, Laboratory Surveillance and Contact Tracing of COVID-19 Cases, March-May, 2020

Abstract

Background: In Punjab, first COVID-19 case was detected on March 5 2020 followed by multiple clusters. Understanding the epidemiology of reported COVID-19 cases helps decision makers in planning future responses. We described the epidemiological patterns, laboratory surveillance and contact tracing of COVID-19 cases in Punjab.Methods: We analysed state’s COVID-19 data from March-May 2020 to describe time, place and person distribution. We analysed the laboratory surveillance and contact tracing reports to calculate frequency of testing, sample positivity rate (PR) and contacts traced per case.Findings: A total of 2,256 COVID-19 cases were reported from March-May, 2020 (attack rate 75 cases/million and case fatality rate 2%). Attack rate was higher among males (81 cases/million males) and maximum affected age group was 60-69 years (164∙5 cases/million). Five of 22 districts reported almost half cases in first week of May. Mortality rate was highest among individuals >60years (six deaths/million) and males (two deaths/million males). Of 45 deaths, 41 reported comorbidities [(hypertension (42%), diabetes (40%)]. COVID-19 testing increased from 46 samples/day (PR: 2%) in March’s first week to 4000 samples/day (PR: 2∙5%) by end of May (2752 tests/million). Amritsar conducted 2035 tests/million (highest PR: 6∙5%) while Barnala conducted 4158 tests/million (lowest PR: 1%). For 2,256 cases, 19,432 contacts were traced (nine contacts/case) with 11% positivity rate.Interpretation: COVID-19 in Punjab mostly affected males, >60 years of age and individuals with comorbid conditions. Many districts with less testing and contact tracing had higher positivity rate. We recommended to implement and ensure adequate testing and contact tracing in all the districts of Punjab.Funding Statement: This public health activity was conducted by India Epidemic Intelligence Service (EIS) program of the National Centre for Disease Control (NCDC). The NCDC receives funding support for the India EIS Program through a cooperative agreement with the U.S. Centers for Disease Control and Prevention, Center for Global Health, Division of Global Health Protection. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Declaration of Interests: None declared.Ethics Approval Statement: We received permission from the state government of Punjab and National Centre for Disease Control, New Delhi for review and analysis COVID-19 data from the surveillance records and publication of final report.