13 Districts with High Covid-19 Mortality Told to Address Low Testing, Ensure Timely Hospitalisation

Thirteen districts in eight states and Union Territories reporting COVID-19 mortality higher than the national average were advised by the Centre on Saturday to address the issues of low testing and delay in test results, and ensure timely hospitalisation. In view of reports from some areas that patients were dying within 48 hours of being admitted to health facilities, the Union health ministry asked them to ensure timely referral and hospitalisation of people afflicted with COVID-19.

In a high-level virtual meeting chaired by Union Health Secretary Rajesh Bhushan, the eight states were directed to ensure availability of ambulances and maintain zero tolerance for their refusal, the ministry said. As part of the Centre's effort to review and handhold states and Union Territories for collaborative management of COVID-19, two high-level meetings were chaired by Bhushan — on August 7 and 8 — to engage with those reporting high number of cases and fatality rates higher than the national average in order to advise and support them on efforts to prevent and reduce fatality, it said.

On Friday, the Union health secretary held a virtual meeting with 16 other districts in four states — Gujarat, Tamil Nadu, Telangana and Karnataka — reporting COVID-19 mortality higher than the national and states' average. Saturday's meeting focused on 13 districts in eight states and UTs. These are Kamrup Metro in Assam, Patna in Bihar, Ranchi in Jharkhand, Alappuzha and Thiruvananthapuram in Kerala, Ganjam in Odisha, Lucknow in Uttar Pradesh; North 24 Paraganas, Hooghly, Howrah, Kolkata and Maldah in West Bengal, and Delhi.

"These districts account for nearly nine per cent of India's active cases and about 14 per cent of COVID-19 deaths. They also report low tests per million and high confirmation percentage. "A surge has been observed in daily new cases in four districts –Kamrup Metro in Assam; Lucknow in Uttar Pradesh; and Thiruvananthapuram and Alappuzha in Kerala," the health ministry said.

Principal secretaries (health) and managing directors (NHM) from the eight states along with district surveillance officers, district collectors, commissioners of the municipal corporation, Chief Medical Officers, and Medical Superintendent of Medical Colleges participated in the virtual meeting. Several issues critical to reducing case fatality rate were discussed at the meeting.

The states and Union Territories were advised to address the issues of low laboratory utilisation, that is less than 100 tests per day for RT-PCR and 10 for others, low tests per million population, decrease in absolute tests from last week, delay in test results, and high confirmation percentage among the health care workers, the health ministry said. The need to ensure monitoring asymptomatic cases under home isolation with special focus on physical visits, phone consultation on a daily basis was underscored.

They were asked to ensure timely assessment and make advance preparedness for infrastructure like ICU beds, oxygen supply and others based on the prevailing caseload and estimated growth rate, the ministry said. It was reiterated that AIIMS, New Delhi, is holding virtual sessions on Tuesdays and Fridays every week where a specialist team of doctors provides guidance on effective clinical management of COVID-19 patients in the ICUs of different state hospitals through tele/video consultation, to reduce the case fatality rate.

The state authorities were advised to ensure that State Centers of Excellence other hospitals participate in these video consultations regularly to improve clinical practices. "They were advised to follow all ministry protocols for effective management of containment and buffer zones along with seamless patient and clinical management of patients with special focus on critical cases.

"Another major area highlighted in the meeting was that of preventable deaths by strict surveillance among high-risk population like people with co-morbidities, pregnant women, the elderly and children," the ministry said.