The Ministry of Health and Family Welfare directs the State government to take action before ‘situation slips out of control. “There is an urgent need to strengthen our collective efforts to curb the spread of infection,” said a letter to the chief secretary of Manipur.
As Manipur is unable to curb the spread of the novel coronavirus and arrest the death caused by COVID-19, even after more than two months of restrictions being imposed by the Manipur government, the Ministry of Health and Family Welfare, government of India has instructed and suggested steps to the Manipur government to manage the situation effectively.
The ministry has written a letter to the chief secretary of Manipur on Tuesday in this regard. The development came after a central team led by public health expert, Dr L Swasticharan visited the state on June 4.
“There is an urgent need to strengthen our collective efforts to curb the spread of infection,” the letter said.
The ministry said that it is a point of concern that at present, Manipur has a weekly positivity of 12.9% (June 28 to July 4) and has shown an increase from 10.9 per cent in the week of June 7 to 13. About eight out of 16 districts are reporting a positivity of more than 10 per cent, which is a cause of grave concern, it added.
The ministry also highlighted ‘critical areas of concern’ after further analysis.
Although the state has shown a decline in new cases, two out of 15 districts (Bishnupur, Kangpokpi) are showing an increase in weekly new cases over the past four weeks.
Six districts have reported more than 100 new cases in the week ending 4 July, 2021, it added.
Bishnupur district has shown an increase in the number of weekly deaths in the last four weeks (June 13 to July 4). Imphal East and Imphal West had 17 and 28 deaths respectively in the week (June 28 to July 4) which emphasis critical analysis on the district’s deaths.
Testing & Positivity
Imphal East, Imphal West and Thoubal districts have more than 100 new cases in the week ending July 4 with a weekly positivity rate of more than 10 per cent.
Stating that the above points are a “cause for concern”, the ministry instructed the Manipur Government to focus on several suggestions and take action at the earliest “in order to not let the situation slip out of control”.
Strict containment measures
Maintaining that containment is the most crucial strategy of flattening this current curve, the ministry noted that it is critical to plan effective containment measures and implement them stringently, and to strengthen all our efforts made for prompt contact tracing of the close contacts of positive cases and immediate quarantine isolation of all suspected and confirmed cases as per MoHFW guidelines.
Ramp up testing
The ministry also noted that several districts are reporting high positivity rates, which reflects the level of widespread infection. A microanalysis needs to be done of the areas showing high positivity (10 per cent) during the past weeks. Accordingly, all such areas should be targeted for increasing the testing exponentially while maintaining a high proportion of RT-PCR tests. The state should aim at maintaining a positivity rate below 5 per cent in each district duly focusing on increasing the number of tests so as to aid early identification, it added.
Healthcare Infrastructure planning
To ensure preparedness, the state must maintain continuous vigil regarding bed occupancy of critical beds (Oxygen supported and ICU beds) and if the occupancy is more than 40 per cent for any bed category, the states should plan for augmentation of healthcare infrastructure in those districts. Trained human resources, infrastructure, logistics and procurement should be planned considering the geographical spread of the pandemic. The state should also work towards ensuring timely disclosure of all infrastructure availability-based details on public portals or via media so as to avoid misinformation, the ministry instructed.
Effective clinical management
With a distressing rise in fatalities, the ministry suggested that the state government should turn to clinical management protocol and focus on making it more effective, smooth and prompt. It is important to monitor all cases under home isolation and put processes in place to ensure smooth hospitalisation of patients, in case the same is required. All facilities also should be monitored with respect to the overall fatality, including deaths being reported between 24, 48 and 72 hours of hospitalisation to identify any weak spots and to undertake required corrective action, it added.
Ramping up vaccination
The ministry also noted that vaccination must be used as an aid to the infection containment strategy. Ramping up vaccination sites, improving the efficiency and utilisation of vaccination, deploying strategic vaccination centres near the containment zones, and now, ensuring speedier vaccination of all citizens aged 18 years and above should be undertaken on a priority basis.
COVID Appropriate Behaviour
The ministry also suggested that levying effective fines on violation of social distancing of mask usage in public as well as stringent enforcement is critical to control the spread of infection further in the community.
“Although the trajectory of daily new cases of COVID-19 has fallen down substantially in the country, there is a need for continued monitoring of weekly case positivity, as well as case trajectory in each district to identify any early warning signals of spread of infection,” the letter said.
The ministry also mentioned that the implementation framework was shared with all states and UTs for intensive action and local containment in specific and well defined geographic units to break and suppress the chain of infection, as mentioned in the recent order issued by the MoHFW on June 28, 2021. This was also later reiterated by the Ministry of Home Affairs and orders regarding the same were issued under the OM Act 205 vide letter no 40-3/2020-DM-(A) dated June 29, 2021.
The ministry requested the state government to share the action taken so far as per the directions issued under Disaster Management Act by MHA as mentioned above so as to ensure effective containment.