All districts reporting a positivity rate of more than 10 per cent in the last few weeks need to consider strict restrictions to prevent/curtail movement of people, formation of crowds and intermingling of people to prevent spread of infection, said the union health secretary
Union health secretary Rajesh Bhushan on Saturday chaired a high-level meeting to review the COVID-19 situation in Manipur and nine other states, which are either reporting a rise in new daily COVID cases or a rise in positivity. The other states are Kerala, Maharashtra, Karnataka, Tamil Nadu, Odisha, Assam, Mizoram, Meghalaya and Andhra Pradesh.
According to official source, the public health measures taken for surveillance, containment and management of COVID-19 by the health authorities in these states were also reviewed.
In the meeting, DG ICMR and Secretary (DHR), Dr Balram Bhargava was also present. The principal secretary (Health), mission director (NHM), state surveillance officer of all these states participated in the review meeting.
The States were advised to:
· Undertake intensive containment and active surveillance in clusters reporting higher cases.
· Define containment zones, based on mapping of cases and contacts traced.
· Undertake regular reviews and follow-up for implementation of ECRP-II with a focus on augmentation of existing health infrastructure particularly in rural areas and paediatric cases.
· Report death count as per ICMR guidelines.
Critical COVID control and management strategies
The union secretary for Health and Family Welfare underlined the critical COVID control and management strategies:
· All districts reporting a positivity rate of more than 10 per cent in the last few weeks need to consider strict restrictions to prevent/curtail movement of people, formation of crowds and intermingling of people to prevent spread of infection. It was “forcefully underlined” that any laxity at this stage will result in deterioration of the situation in these districts.
· More than 80 per cent active cases in these states are reported to be in home isolation. The secretary highlighted the need to effectively and strictly monitor these cases so that they are not intermingling and circulating in their neighborhoods, community, village, mohalla, ward etc, and spreading the infection.
· It was also stressed that people in home isolation should be effectively monitored in such a manner to ensure that those who require hospitalization are seamlessly transferred for timely clinical treatment. Detailed SOPs covering various facets of effective clinical management of COVID19 patients in hospitals have been earlier shared with the states for prompt shifting and effective hospital management, it added.
The secretary also stressed that states also need to focus on those districts where the positivity rate is less than 10 per cent, so as to protect these districts and the populations by focusing on saturation of vaccination in these districts. Union Health Ministry provides advance visibility on a fortnightly basis to enable the states to plan their vaccination schedules in an effective manner. States were again informed that this quantum of vaccine doses indicates the minimum possible allocation by the union government to the states; quantum more than this is usually delivered by the Union Health Ministry to states based on their consumption.
In the last two months, the union government has been supporting states by providing oxygen concentrators, oxygen cylinders and PSA plants. In addition to this, the secretary said that states are using their own resources to put up PSA plants in government hospitals. States were advised to direct private hospitals to put up hospital-based PSA plants. States have been advised earlier regarding this in the past two months. Provisions under the Clinical Establishment Act enable states to issue such directions to the private hospitals. For states which have already issued such directions, they were advised to review the status and facilitate the private hospitals further.
Warning against any complacency
On the other hand, the DG of ICMR warned against any complacency with around 40,000 cases being reported daily since the preceding weeks.
Highlighting the fact that 46 districts are showing more than 10 per cent positivity while another 53 districts are showing a positivity between 5-10 per cent, he urged the states to ramp up their testing.
States were advised to conduct their own state level sero-surveys for district-wise disease prevalence data, as the national level sero-prevalence survey was heterogeneous in nature, in collaboration with ICMR to ensure the same sturdy protocols of survey.
He advised the states to ramp up vaccination in the 60+ and 45-60 age categories as evidence shows nearly 80 per cent of the mortality is from these vulnerable age-groups. Regarding enforcement measures, he advised the state authorities for avoiding all non-essential travel and to discourage all large gatherings of crowds.
Through a detailed presentation, a granular analysis of the highly affected districts (Districts of Concern) in these states, COVID-19 Vaccination Coverage, Status of Ventilators, PSA Plants, Oxygen Cylinders and Concentrators along with some key statistics was presented.
States were asked to use the INSACOG laboratory network for genomic surveillance to screen international travelers (for the entry of new variants/mutants in India from other countries), monitor ongoing surveillance through Sentinel Sites (RT-PCR labs or secondary & tertiary care hospitals managing COVID cases) and surge surveillance.