The committee has advised against allowing large gatherings. “Onam in Kerala and Ganesh Chaturthi in Maharashtra have been seen to seriously intensify the pandemic. This must not be allowed to happen in Delhi. Our emerging gains in case reduction will be reversed due to these holidays and the rush in markets and towns, ”the committee said in its report presented to the Delhi Disaster Management Authority on Tuesday. He suggested that such events should be very low-key affairs, essentially focused on family celebrations.
The committee had been asked to prepare a revised Covid-19 management plan that will now help the government fine-tune its strategy.
Why 3 months could be decisive
Before the festive period, the panel emphasizes the need to increase rt-pcr testing, renew the strategy of the containment zone
Delhi should prepare for a daily increase of 15,000 positive cases and arrange for the admissions of patients with moderate and severe disease amounting to approximately 20% of this increase, “the committee recommended. The report added that the guidelines for ICU, not ICU and Covid Care isolation beds would be made available to the government.
Underscoring that the next three months would be critical, the panel recommended renewing the strategy in the containment zones with a focus on creating micro-containment zones and prescribed limited RT-PCR testing in symptomatic individuals and limited contact tracing to fill in the gaps. . Identification of groups of workplaces for risk assessment; evidence driven by surveillance; expansion of intensive care facilities and their optimal use; launch of massive awareness campaigns in the wake of the upcoming festival season; and reducing deaths among healthcare workers are some of the other key recommendations.
Underlining that the overall fatality rate in Delhi is 1.9%, which is higher than the national average of 1.5%, the committee has advised that the focus should be on reducing mortality. Delhi had reported 5,616 deaths as of Wednesday. “Higher mortality in the comorbid (66.6%) and the elderly is unavoidable and is reported in every state and worldwide. However, (a cause for) concern is the reported mortality in children under 15 years of age.
(1.5%) and groups of 16 to 44 years (17%) … (This) could be prevented by promoting early recognition of symptoms, timely testing and greater awareness in the younger population to adopt appropriate behavior Covid, “the committee noted. It has recommended a periodic death audit and review of Covid and non-Covid deaths.
The panel has suggested that there should be a greater focus on vulnerable patients such as the elderly and those with comorbidities; a periodic review of the triage facilities should be carried out; Focused efforts should be made for timely referral of patients from lower to higher facilities or home isolation; and there should be a review of the ambulance system.
Noting the large increase in the number of Covid tests in Delhi, the committee has observed that the positivity rate is steadily decreasing. At present, more than 80% of the tests are for rapid antigens with even 90-95% in some districts. Currently, the positivity of the test is 4.3% according to RAT and 20.3% according to RTPCR (as of September 24). Containment zone testing and contact testing of positive patients and symptomatic individuals have been very limited, up to 20% of the total.
The committee has recommended testing for all high-risk contacts (regardless of symptoms), symptomatic contacts, patients with influenza-like illness, the elderly, and those with comorbidities in containment zones between the fifth and tenth day from last contact if asymptomatic or as soon as symptoms begin to appear. It has asked the authorities to use RAT for containment zones and symptomatic healthcare workers and RT-PCR for healthcare facilities and to repeat testing of all RAT negative symptomatic individuals.
Testing should not be targeted, but guided by surveillance in containment zones, the committee cautioned, adding that simply increasing the number of tests to reduce the positivity rate would not be appropriate.
Noting that contact tracing in Delhi has been very limited from the start and contacts tracked per positive case on average have remained in the range of 7 to 10, the committee has recommended tracing immediate family contacts, neighborhood contacts and close contacts. in the workplace of positive cases and evidence.
He has called for micro-containment and home isolation zones in planned colonies, large apartments and RWA-governed localities and the formation of new containment zones only in very dense areas such as resettlement colonies, JJ conglomerates or slums. He underlined the need to enlist high-risk groups and house-to-house search to detect all suspected cases within three days and a strict perimeter control in rural areas. In many of the 11 districts, authorities are already creating micro containment zones. In fact, in many places, individual houses have become buffer zones.
The committee also noted that the containment strategy adopted at the beginning (large containment zones) and the measures taken within the containment zones have been quite successful in limiting the number of cases.
The government will implement the committee’s recommendations and all districts have been asked to take the actions suggested in the report.
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