A rise in the number of daily Covid-19 cases and mortality has been observed in Assam, West Bengal, Odisha, Bihar and Jharkhand, indicating the pandemic is moving eastwards, the Union Health Ministry said on Wednesday. To review arrangements for containment and management of the Covid-19 infection, a high-level meeting was held by Union Health Secretary Rajesh Bhushan and Member (Health), NITI Aayog Dr. Vinod K Paul with these five states.
"Evidence suggests that the pandemic is moving eastwards and a rise has been observed in the number of daily cases in these states along with rising mortality," the ministry said in its statement. Five critical areas of action were discussed for addressing the needs and challenges of the recent phase of the Covid-19 pandemic in these states, which have seen an unprecedented surge in the number of daily cases and increased mortality.
Underscoring the critical importance of human resources in providing health services and clinical management of the severe Covid patients in the hospitals, the states were advised to ensure that performance-linked payments of the Community Health Officers (CHOs) at the Ayushman Bharat Health and Wellness Centres (HWCs) and the incentives to the ANMs and other health workers are paid timely, the statement stated. The NHM funds to the states may be utilised for this purpose. In addition, a slew of decisions has been taken recently by the Union Government whereby the services of final year MBBS students; those students that are yet to take the NEET examination (which has been postponed); final year nursing students; and internees can be utilised for Covid related healthcare work. Starting today, the list of districts across the country where the positivity rate is above 20 percent has been displayed on the website of the Health Ministry. This list is dynamic and will be updated on a regular basis.
States are required to undertake focused efforts in these districts regarding testing, home isolation of the infected people, measures to prevent crowding and intermingling of people to curb the spread of infection, in addition to other containment activities,the ministry said. During the periods of the stringent restricted movement in the states, the time could be utilised foraugmentation of hospital infrastructure including construction of makeshift hospitals; attaching hotels to hospitals; and field hospitals, the statement said.
An oxygen audit is also required to be done by all the states, but barring a few states, others have not undertaken the exercise, it said and reminded them to carry out this process. It said that last year an advisory was shared with them enlisting the broad norms of oxygen usage in the clinical management of hospitalised patients. This was subject to state-wise customisation.
The oxygen requirement for the different categories of patients receiving clinical care in hospitals was also detailed in the advisory. With the aim of having one PSA plant in every district, 1000 PSA plants are being planned across the country. The states were advised to identify the sites for installation of the PSA plants, the statement said. The Health Ministry, DRDO and CSIR will support the state efforts in this direction. It was pointed out to the states that as part of the Liberalised Pricing and Accelerated National COVID-19 Vaccination Strategy Phase-3, every month 50 percent of the Central Drugs Laboratory (CDL) cleared vaccine doses of every manufacturer would be available for direct procurement by the state governments and private hospitals.
States were advised to clear the payment of the manufactures so that the vaccine consignments could be delivered to the states in a timely manner for Phase-3 of the nationwide vaccination drive. The Government of India would continue to procure its share of 50 percent of the monthly CDL cleared vaccines and would continue to make it available to the states free as was being done earlier.
It was pointed to the states that they should not lose sight of those who are to get the second dose of COVID vaccine. Of the supply of vaccines to the states, it was pointed out that 70 percent ought to be allocated to meet the requirement of second dose, while 30 percent ought to be reserved for the first dose, the statement said. Paul stressed that the states have to ramp up the hospital and clinical management capacities including effective operation of ambulances, enhance testing in districts witnessing higher positivity than the national average, and take timely decisions to augment HR under the new enabling provisions of the Union Government.
He also highlighted private sector participation in telemedicine services to relieve pressure on public facilities and requested the states to diligently follow the Home Ministry's order on containment measures. DG ICMR Dr Balram Bhargava cautioned the states on the revised testing guidelines drafted for efficient use of the testing apparatus like removal of RT-PCR confirmation of positive cases after end of the designated period.
He reminded them of the Home Ministry's advisory of implementing lockdown measures in districts with more than 10 percent positivity and asked them to ramp up on facilities like sites for RT-PCR testing, vaccination and the augmentation of the medical workforce. According to the statement, Director National Centre for Disease Control (NCDC) S K Singh emphasised on the early detection of cases before they deteriorate to more acute forms of COVID. The need to focus on stringent containment in districts with greater than a 10 percent positivity rate and rigorous contact tracing for those with less than 10 percent positivity rate was discussed. He also urged for augmentation of testing infrastructure, the statement added.
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