Back in May 2020, the first covid outbreak in Uttar Pradesh started in the most touristic location: the Taj Mahal district, the district of Agra.



The Agra health team evaluated ivermectin as a covid prophylaxis and treatment. Right after the team confirmed positive results, the district included ivermectin to treat covid. The early introduction of ivermectin and the strong contact tracing strategy led to very positive results. The fast improvement drew the attention of the state authorities.

On August 5, 2020, Uttar Pradesh Chief Minister announced a shift in the covid protocol. They placed ivermectin as a treatment and for prophylaxis. The success of the “Agra model” was the primary driver to change the protocol.

The Uttar Pradesh strategy in August 2020 included over 70,000 health care workers reaching out to high-risk contacts of covid-19 positive cases and treating them. The coverage was close to 90 percent. The strategy was shared by the State Surveillance Officer and published by the World Health Organization.

The strategy in Uttar Pradesh during the first wave was successful. It was much better than the second largest state (Maharashtra). Cases and deaths in Uttar Pradesh were a fraction of Maharashtra’s. Lack of testing wasn’t the explanation, as the positivity ratio in Maharashtra remained over 20 percent from May through September 2020. Uttar Pradesh’s positivity ratio was only higher than 5 percent for less than a week.