The five states are Kerala, Maharashtra, Telangana ,Gujarat and Karnataka who have received the letters.

These are the few States which are reporting higher number of cases indicating possible localized display of infection and there is a need to follow a risk assessment based approach to prevent and contain the infection on without losing the gains.

It is advised the states examine the situation of COVID-19 at micro level and maintain focus on implementation of necessary measures from prompt and effective management of covid-19.

The centre also instructed States to monitor influenza like illness and severe acute respiratory illness caused in all health facility or through dedicated fever clinics on a regular basis for detective early warning signals of the spread as infection.