Household Secondary Attack Rate in Gandhinagar district of Gujarat state from Western India

Objectives: Current retrospective study aims to evaluate household Secondary Attack Rate (SAR) of COVID-19 in Gandhinagar (rural) district of Gujarat, India. Methods: Line-listing of 486 laboratory-confirmed patients, tested between 28th March to 2nd July was collected, out of them 80 (15% of overall sample) cases were randomly selected. Demographic, clinical and household details of cases were collected through telephonic interview. During interview 28 more patients were identified from the same household and were added accordingly. So, study included 74 unrelated cluster of households with 74 primary cases and 386 close contacts. Results: SAR in household contacts of COVID-19 in Gandhinagar was 8.8%. Out of 108, 8 patients expired (7.4%), where higher mortality was observed in primary cases (9.5%) as compared to secondary cases (3%). Occupational analysis showed that majority of the secondary cases (88%) were not working and hence had higher contact time with patient. No out-of-pocket expenditure occurred in 94% of the patients, in remaining 6% average expenditure of 1,49,633INR (2027 USD) was recorded. Conclusions: Key observations from the study are 1) SAR of 8.8% is relatively low and hence home isolation of the cases can be continued 2) Primary case is more susceptible to fatal outcome as compared to secondary cases 3) Government has covered huge population of the COVID-19 patients under cost protection. However, more robust studies with larger datasets are needed to further validate the findings.