Lok Sabha Question No. 1878 (UNSTARRED), answered on 2021-07-30
Subject: COVID-19 Severity Score
Ministry: SCIENCE AND TECHNOLOGY
Asked by: T.R.V.S. Ramesh, Chinta Anuradha, Magunta Sreenivasulu Reddy

## GOVERNMENT OF INDIA

## MINISTRY OF SCIENCE AND TECHNOLOGY

## DEPARTMENT OF SCIENCE AND TECHNOLOGY

LOK SABHA

UNSTARRED QUESTION No. 1878 TO BE ANSWERED ON 30/07/2021

## COVID-19 SEVERITY SCORE

1878. SHRI T.R.V.S. RAMESH:

SHRIMATI CHINTA ANURADHA: SHRI MAGUNTA SREENIVASULU REDDY:

मंýी

Will the Minister of SCIENCE AND TECHNOLOGY िव²ान और ÿौīोिगकì be pleased to state:

- (a)  whether  the  Science  for  Equity,  Empowerment  and  Development (SEED) division of Department of Science and Technology (DST) have developed an algorithm in partnership with other agencies to measure symptoms,  vital  parameters,  test  reports  and  co-morbidities  of  the COVID-19  positive  patient  against  a  pre-set  dynamic  algorithm  to generate a Covid Severity Score (CSS);
- (b) if so, the details thereof;
- (c) whether  the  application of this  software can  help in early identification of patients who require ventilator support in an ICU and other critical care; and
- (d) if so, the details thereof?

## ANSWER

MINISTER OF STATE (INDEPENDENT CHARGE) OF SCIENCE AND TECHNOLOGY AND EARTH SCIENCES (DR. JITENDRA SINGH)

ǒव£ान और Ĥौƭोिगकȧ तथा पृØवी ǒव£ान के राÏय मंğी ( èवतंğ Ĥभार) ( डॉ . ǔजतɅġ िसंह )

- (a)  Yes, Sir, Science for Equity Empowerment & Development (SEED) Division  of  Department  of  Science  and  Technology  (DST),  under  a project supported for sustainable public health & primary care by the

Foundation  For  Innovations  In  Health,  Kolkata  has  developed  an algorithm that measures COVID Severity Score (CSS).

- (b)   The  software  application  is  suitable  for  use  by  Frontline  Health Workers and other  health personnel. The algorithm has been expanded, to  measure  different  parameters  of  a  COVID-19  positive  patient (symptoms, vital  parameters,  test  reports  and   co-morbidities)  and  it scores each patient against a pre-set dynamic algorithm and allocates a  COVID  Severity  Score  (CSS).  In  this  initiative,  the  organization has  collaborated with IIT, Guwahati, University of Edinburgh and World Health  Organisation  (WHO)  (South  East  Asia   Regional  Office).  This technology has been made available at primary care e-Health clinics in resource  poor  settings  through  the  project  supported  by  the  SEED division. Certified 'Frontline Health Workers'  received additional training  from  Healthcare Sector Skill Council as COVID Warrior.  The Hon'ble Prime Minister inaugurated the training centre at IIT Guwahati for training of "Customised Crash Course Program for COVID Warriors". The students at this course are being trained in the use of CSS, apart from specific capacity-building in various aspects of COVID management.
- (c)   Yes, Sir.
- (d)   The  software  generates  a  CSS  based  on  personal  information, symptoms, vital parameters and laboratory test reports. The software dynamically monitors the clinical status of the patient so that informed and timely decision can be taken regarding clinical management plan of COVID affected patients viz. requirement of ICU admission, ventilator support, discharge, etc. The details may be seen at Annexure I.

- A) The software is designed to enable earlier identification of COVID patients  who  will  need  admission  in  a  hospital  ward  or  ICU.  The software generates a Covid Severity Score (CSS) based on four types of variables:
- 1) Personal information: such as history of smoking, age, vaccination status, relevant medical and surgical history;
- 2) Symptoms: a total of 10 symptoms are monitored to provide a score based on the progression of symptoms. Each symptom can be entered into  the  software  as  a  score  (scale  of  1-5,  1  being  least,  5  being maximum) based on its severity;
- 3) Signs: A total of 5 vital parameters are regularly monitored and the data is entered into the software;
- 4) Laboratory test reports.
- B) The above data from a patient is an input to generate a static CSS the first time a patient is brought under care. Subsequently, a dynamic CSS  score  is  constantly  generated  based  on  data  input  by  a  health worker,  which  is  processed  by  the  software.  Any  alteration  of  the clinical status of the patient can be picked up by the dynamic CSS score trend analysis, including deterioration in the condition of the patient.
- C)  Based  on  this,  a  decision  can  be  taken  regarding  ICU/Hospital admission  of  the  patient/discharge/continuing  clinical  management plan.  This  also  allows  monitoring  of  patient's  clinical  status  during treatment being received outside the hospital setting.
- D) The 'CSS' is regularly monitored multiple times for each patient in a graphical  trend.  An  offline  module,  for  geographies  with  no  internet services, is in conceptual stage.
- E) This  allows  earlier  identification of patients  likely to  require ventilatory  support  in  an  ICU  and  reduces  hospital  referral  for  those unlikely to require critical care support, thus releasing more hospital beds in circulation. It helps in providing monitored medical support to those patients who cannot afford treatment or cannot isolate at home due to poor housing conditions.

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