Concerned over the spread of COVID-19 the Union Health Ministry in a letter has advised states and UTs to take up testing of grocery shop workers and vegetable vendors to prevent the potential spread of the disease leading to reduced mortality rate.
The Union Health Ministry also emphasized operationalizing the ambulance transport system with oxygen facility and increasing the response mechanisms.
Secretary in Health Ministry, Rajesh Bhushan stressed monitoring the refusal rate of ambulances on a daily basis and bringing it down to zero.
With the pandemic spreading to newer areas in the country, Bhushan said “there are likely to be scattered cases, a cluster of cases or large outbreaks in districts and that the primary aim is to control outbreaks, especially in new locations”
“The focus at the same time should be to save lives at all cost,” he added
“While we have so far done better than many other countries in this respect, our aim should be to further reduce mortality and ensure that it does not cross the 1 percent mark,” Bhushan said in the letter, addressed to additional chief secretaries, principal secretaries, and secretaries (health).
He further underlined the need for aggressive testing, swift isolation in a healthcare facility, and proper management to reduce the mortality rate.
“Early detection of cases is the most crucial element to ensure that the case fatality is reduced. It helps in terms of not only identifying the case before it may become critical but also supports in terms of checking the spread of infection,” he said in the letter.
“Once a positive case is identified, a prompt contact-tracing should be undertaken and at least 80 percent of the contacts must be identified and quarantined within 72 hours”, he said.
“There can be potential hotspots for the spread of infection like industrial clusters with the closed work environment, people coming from high prevalence areas, other high-density areas such as slums, prisons, old age homes, etc.”
“In addition, grocery shops, vegetable, and other vendors, etc. can be potential spreaders of infection to a large number of people. Testing in such areas and of such people should be taken up proactively as per ICMR guidelines,” Bhushan underscored.
He also asked states and UTs to maintain weekly death audits to assess the determinants of death such as age differentials, comorbidities, late reporting to hospital and clinical protocols that were followed, which will help identify challenges to be addressed and will facilitate effective case reporting and ensure timely and required medical interventions.
In the letter, Bhushan also emphasized the frequent house-to-house search to identify the high-risk patients, i.e the elderly people with comorbidities and pregnant women among others.
Alongside this exercise, the containment zones need to properly secure and buffer zone should also be identified properly to monitor the diffusion of infection outside the containment zone, he said.
Health secretary maintained that 140 tests per million per day (although better numbers need to be encouraged) must be ensured along with strict monitoring of daily positivity rate.
Depending on the test result, those found positive should be sent to a COVID care center or under home isolation if there is requisite provision at home.
He further emphasized making COVID-19 beds in all government and private healthcare facilities available in the public domain and directed all the respective administrative officers to ensure the transparent allocation of beds.
A proper communication channel between the patients and their family members must be organized, he stated.
He urged the districts to anticipate the requirement of health infrastructure in terms of availability of ventilators, ICUs, and oxygen supported beds to meet the future caseload.