Passengers wait for their turn to be tested for COVID-19 at a bus terminal in New Delhi.
Centre on Saturday advised a 5-fold covid containment strategy to states witnessing rise in daily covid cases. The strategy directs these states to increase testing and vaccination, effective tracing, prompt isolation, efficient clinical treatment, and adherence to COVID Appropriate Behaviour.
The development has come after Union Health Secretary Rajesh Bhushan chaired a high-level review meeting with Additional Chief Secretaries, Principal Secretaries and Secretaries (H&FW) of 12 States and Municipal Commissioners and District Collectors of 46 districts that are the most affected by rising cases and rising mortality because of COVID-19.
These states are Maharashtra, Gujarat, Haryana, Tamil Nadu, Chhattisgarh, Madhya Pradesh, West Bengal, Delhi, Jammu & Kashmir, Karnataka, Punjab and Bihar. Dr VK Paul, Member (Health), NITI Aayog was also present during the review meeting.
Through a detailed presentation, the States were informed that the country has seen the sharpest rise in weekly COVID cases and fatalities since May 2020 (7.7% and 5.1% respectively). The focus was on 46 districts that have contributed 71% of the cases and 69% of the deaths this month. Of total 36 districts in Maharashtra, 25 are most affected that account for 59.8% of the cases reported in the country during the past one week.
A granular analysis of affected districts in these States and UTs along with some key statistics was presented. Almost 90% of the COVID-19 deaths continue to be in the category of those aged above 45 years. Findings of studies were highlighted which depicted that while 90% people are aware, only 44% actually wear face masks.
One infected person could spread COVID-19 to an average of 406 other individuals in a 30-day window without restrictions which could be reduced to just 15 by decreasing physical exposure to 50% and to a further 2.5 (average) by decreasing physical exposure to 75%.
It was also highlighted that the concept of 'second wave' reflected more the laxity among everyone regarding COVID Appropriate Behaviour and COVID containment and management strategy at the ground level. Hence stringent action including effective containment and contact tracing for at least 14 successive days in the 46 districts was strongly recommended for breaking the chain of transmission and not frittering away the gains of collaborative efforts of last year.
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5-fold strategy for States and UTs for effective Covid containment
Exponential Increase in Testing
The States were strongly advised for a significant increase of testing in all districts in line with their Positivity Rate, with increased share of RT PCR tests, to a ratio of more than 70% of total. Rapid Antigen Test (RAT) to be mostly deployed as a screening tool in flushing out cluster cases from densely populated areas.
Effective Isolation and Contact Tracing of those infected
Testing leading to detection of positive cases is to be followed with prompt tracing of the close contacted and swift isolation. It was advised that an average of 30 close contacts are to be traced, tested and isolated in the first 72 hours. Health Secretary highlighted the need for effective and strict means to be employed for effective containment, with focus on micro-containment zone approach.
Re-invigoration of Public and Private Healthcare resources
It was re-emphasised to strengthen public and private hospital infrastructure and reenergise the Healthcare workers for removal of complacency and fatigue. Targeted approach to reduce mortality rate and number of deaths to be implemented. In this regard, states to strictly follow the Standard National Treatment Protocol for effective clinical management of the severe cases in ICUs. In this regard, it was pointed out that Punjab and Chhattisgarh despite being smaller in population size than Karnataka and Kerala, are reporting higher fatalities.
Ensuring of COVID Appropriate Behaviour (CAB)
Renewed attention to be paid to ensuring of 'COVID appropriate behaviour' in crowded place like markets, inter-state bus stands, schools, colleges, railway stations etc. Promotion COVID-appropriate behaviour through sensitization and public awareness campaigns with active participation of local community leaders, religious heads of the community and other influencers.
States also advised enforcement of CAB through penal measures like heavy fines which sends a strong exemplary message among the people.
Muted celebrations of festivals like Holi, Shab-e-baraat and Easter with emphasis on keeping the celebrations inside the confines of the house stressed. States were informed that 70% of the cases can be controlled by adherence to CAB alone.
Targeted approach to Vaccination in districts reporting large numbers
States asked to focus on universalization of vaccination in the specified priority population age groups as an aid to containment strategy in districts where maximum cases are being reported. It was reiterated that there is no shortage of vaccines.
States to optimally utilise all vaccination capacities within the public and private sectors in all districts, and make full use of the available vaccine stocks without keeping a buffer stock in anticipation of a shortage. The four GMSD depots at Chennai, Mumbai, Kolkata and Karnal have the requisite buffer stocks and all requirements of States, based on their daily consumption and available stocks, are being met.
States were also asked to make advance planning of logistics and infrastructure management for 1-1.5 months as any unchecked spread of infection among the community may overwhelm the local administration. Re-appropriation of unused vaccine stocks in a district to focus on the high burden districts was also suggested.
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