New Delhi: The Union Health Ministry has directed the government of Bihar, Odisha, West Bengal and Assam to take necessary steps to suppress COVID-19 transmission as well as to keep case fatality rate below 1 per cent.
According to the Health Ministry, a video conference was held by Union Health Secretary on July 15 to review the COVID-19 situation in these states, which are reporting a daily spike in coronavirus cases.
Expressing concerns regarding the increase in coronavirus cases in Bihar, Odisha, West Bengal and Assam, Joint Secretary at the Union Health Ministry Lav Agarwal has written a letter to the Principal Secretaries (Health) and Secretary (Health) of these states and directed them to take action points at state level to suppress the COVID-19 transmission.
"Renewed efforts are needed to suppress the transmission as well as to keep case fatality rate below 1 per cent. The state should utilise the lockdown to focus on containment, surveillance and testing in the containment and buffer zones as the key strategy for early detection of cases and fatality management," stated the letter.
"The containment plan must be implemented at the field level as per the guidelines issued by the Union Health Ministry. Containment zones and buffer zones should be suitably delineated based on the mapping of cases and contacts. The staff involved in containment operations needs to be properly oriented for undertaking implementation of the containment plan/micro plan."
It further read that the states need to ensure that at least 80 per cent of new cases have their close contacts raised and in quarantine within 72 hours of case confirmation. A list of NCC volunteers along with other available workforce is available on the COVID warriors portal which can be optimally utilised in containment and surveillance effort.
To keep case fatality rate less than 1 per cent, weekly case fatality needs to be monitored and below action points need to be taken, the letter said, adding that "The Centre of excellence for clinical management should undertake hospital wise/facility wise fatality analysis with high CFR regular VC on appropriate clinical management. Required support from 24X7 team set up by Delhi's AIIMS for clinical management consideration may also be taken in this context."
As per the directions by Aggarwal, the state should conduct a rapid audit of hospitals and facilities, create hospital grade and dashboard to monitor the real-time status of better utilisation.
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"The state should ensure adequate human resources, revamped ambulance systems and helplines to ensure resolution of problems of patients experiencing symptoms or undergoing home isolation," he said.
"In terms of testing, the status we should aim is to achieve a minimum of 14 tests per one lakh (or 140 test per million per day), while ensuring a positivity rate of less than 10 per cent," said the official.
"Necessarily test all asymptomatic high-risk contacts and mild symptomatic as per Indian Council of Medical Research (ICMR) protocol. This can be achieved by leveraging approximately 135 TrueNat machines, and one Cobas 6800 machine operational at the Rajendra Memorial Research Institute. Besides, the testing could also be ramped up by ensuring lab operations in multiple shifts," read the letter.
The state should utilise the forecasting tools made available by the Health Ministry to forecast the required COVID-19 beds and accordingly calculate the oxygen requirement. A nodal officer to keep a track on oxygen requirements and for relevant communication with the Centre is to be appointed, it said.
The state should also focus on ensuring the availability of non-COVID services such as immunisation, maternal and child health services including other emergency and critical care services.
As per the letter to the Principal Secretary (Health and Family Welfare), Bihar, cases in the state are rising with almost 450-500 cases being reported daily and 80 per cent of the total active cases in the state were reported in the last seven days.
Districts like Patna, Bhagalpur, Muzaffarpur, Nalanda, Begusarai and Munger are reporting higher number of cases while Saharsa, Gaya, Paschim Champaran, Jamui, Arwal, Saran and Khagaria are the emerging hotspots.
The overall testing is very low in the state vis-a-vis national average and an increasing trend in case positivity rate on weekly basis is also a cause of concern, the letter said.
Similarly, in a letter to the West Bengal government, Agarwal said the state is reporting almost 1,600 cases daily and 93 per cent of the total active cases in the state were reported in the last four days.
"Kolkata, Howrah, 24 North Parganas and 24 South Parganas, as well as emerging hotspots in Jhargram, Purulia, Nadia, Midnapur East, Hooghly and Nadia, need immediate attention."
Odisha is reporting an average of more than 500 cases every day since the past four weeks, the letter to the state's Principal Secretary (Health and Family Welfare) said.
"According to active caseload, Odisha is the tenth most-affected state in the country with Ganjam reporting approximately 37 per cent of the state's active caseload," the letter read, adding, there is need to focus on emerging hotspots such as Nabarangpur, Sambalpur and Kendujhar.
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"The increase in weekly fatality trend with almost 29 pc of cases above 45 years, is also a cause of concern," the letter said.
"Assam is reporting approximately 600 cases every day. About 80 pc of the current active caseload is reported in the last 14 days with Kamrup metro reporting more than 50 per cent of the state's active caseload. Nine districts including Nagaon, Goalpara, Karbi Anglong, Nalbari, Sivasagar are testing lower than India's average. High case of positivity is noted in Dima Hasao and Kamrup Metro," said the official in a letter to the Assam government.
Agarwal said that Assam is reporting approximately 600 cases every day. About 80 per cent of current active caseload is reported in the last 14 days, with Kamrup metro reporting more than 50 per cent of state's active caseload.
Nine districts including Nagaon, Goalpara, Karbi Anglong, Nalbari, Sivasagar are testing lower than India's average. High case of positivity is noted in Dima Hasao and Kamrup Metro, the letter stressed.
ANI report
