Updated: September 8, 2020 7:20:56 am
The Center has received detailed feedback from district-level officials, identifying gaps in the implementation of containment, surveillance, and clinical management strategies for Covid-19 in various states. These lapses, the sources said, were one of the key reasons for the massive increase in cases in recent weeks.
Upon detection of almost 6 lakh of new infections In the week that began on August 31, the Center has in recent days made a significant change in the orientation of its messages to address the new coronavirus.
He has moved away from addressing the states at the level of their health secretaries and has instead begun communicating directly with administrative officials and medical directors (CMOs) fighting the pandemic at the district level.
Taking the message to the ground
Many months after the pandemic, and with well-known containment and surveillance strategies, continued high numbers indicate blockages in the leakage of the message to those on the ground. That is why the Center now speaks to you directly.
India on Sunday recorded 90,802 new infections, the second day in a row of more than 90,000 numbers, indicating an extraordinary increase in which daily detections increased dramatically during the previous week.
On Saturday, central officials held a lengthy video conference with officials from 17 districts in Maharashtra, Andhra Pradesh and Karnataka, which currently contribute 46 percent of India’s national number of cases.
A meeting was also held with officials from Delhi, which has reported a second increase in cases.
“It cannot be denied that the infection is spreading in specific states. It goes to newer areas, but these are also densely populated; it will not go to the villages to that extent. The outbreak is still restricted to semi-urban areas because that is where the virus thrives, ”said a leading source.
While increasing case numbers in Maharashtra, Karnataka and Andhra Pradesh has been incremental and not exponential, “since its base in terms of population is greater, the incremental increase is also greater,” said the source.
Saturday’s meeting was attended by district officials from Pune, Nagpur, Kolhapur, Sangli, Nashik, Ahmednagar, Raigad, Jalgaon, Solapur, Satara and Palghar in Maharashtra; Prakasam and Chittoor in Andhra Pradesh; and Koppal, Mysuru, Davangere and Ballari in Karnataka.
“The challenge for us is this: Now that the states know how the virus spreads and they know the containment, surveillance, contact tracing and treatment strategies, why do these states continue to report such high numbers?” Top government sources, who are part of the team monitoring the pandemic, told the Indian Express.
“That is why we have had long meetings with district collectors and medical directors to discuss these issues,” they said.
In the course of several lengthy meetings with officials, the Center found glaring discrepancies in containment and surveillance strategies, the sources said.
“We realized in these meetings that at the district level, they have between 200 and 800 physical teams of ASHA workers, volunteers to do surveillance, containment and house-to-house searches of active cases. They also have a large number of supervisors to monitor these teams. But a lot of the members of these teams don’t really know what they are expected to do when they go into a containment zone. They have not been trained, ”said a source.
“For example, in the case of contact tracing, these districts have not been told the average number of contacts per positive that should be traced. That is important. Therefore, surveillance officers are losing a large number of infected people, the source said.
“We found that city commissioners and district magistrates have the knowledge, but people in the future, who should actually be trained, have not been trained,” the source said.
The Center has now prepared two separate manuals: one for field surveillance officers and the other for supervisors who monitor the team. “The manuals address more subtle points and have been distributed to these districts. We also asked them to translate them into local languages, ”said an official.
The CMOs were asked about reducing the mortality rate to below 1%. “We realized that even at the medical director level, there was a feeling that morality cannot be lowered below 1 percent. We asked them about CFR. Their answer was that most of the patients had comorbidities and were elderly. “
CMOs were asked to make detailed presentations on steps taken to address issues related to vulnerable groups, the sources said. “We asked whether CMOs had sought the help of AIIMS, New Delhi, in treating comorbid and elderly patients. District officials were silent, ”the sources said.
CMOs have been directed to take advantage of the services of the AIIMS team that has been holding meetings with ICU leading physicians in all states on effective clinical case management.
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