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The | New Delhi |
Updated: May 9, 2020 7:21:04 am
Covid-19 suspect on his way to the hospital from the Narahi area of Lucknow on Friday.
While most large cities, including all metropolitan areas, are in the red zone, the absence of field-level health workers in urban areas is becoming a major obstacle.
Meanwhile, at the daily briefing on Friday, the joint secretary of the Ministry of Health, Lav Agarwal, said that “it is important that we learn to live with the virus and that we practice behavioral changes.”
The doubling time has been reduced to 10 days, from 12 days on May 5. With 3,390 new cases and 103 deaths reported in the past 24 hours, the total count is now 56,342 (16,539 recovered) and 1,886 deaths.
“Of the 37,916 active cases, 3.2% need oxygen, 4.7% are in the ICU and 1.1% need ventilators,” said Agarwal.
Even as Commissioner of the Brihanmumbai Municipal Corporation (BMC) Praveen Pardeshi was diverted On Friday, Health Ministry sources said the high case load in Mumbai indicates the biggest problem in big cities across the country.
Kolkata MC health worker during a door-to-door survey in a residential area in northern Kolkata.
Although the National Urban Health Mission (NUHM) was approved by the Cabinet in 2013, it was no longer a priority a year later. Therefore, there is a shortage of dedicated health workers, such as ASHA (Accredited Social Health Activist) and ANM (Nurse Assistant Midwife) workers on the ground. In addition, the structure of the Integrated Disease Surveillance Program (IDSP) is designed to access rural areas.
“The real problem, not only in Mumbai but in urban areas elsewhere, as we are discovering now, is the lack of surveillance infrastructure. The NUHM never took off. In the villages, we are using ASHA and ANM workers: there are enough workers at the field level, they just need to be mobilized. But where are they in the cities? Municipal agencies are not in tune with the surveillance work, “said an official.
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“The other surveillance instrument is the IDSP, with a structure of three levels: national, state and district. Never felt the need to increase its presence in urban areas, “he said.
He said that the structure of municipal agencies, in which sanitation workers and a sanitation inspector oversee the areas, is not the right model for active and active case finding and contact tracking needed for COVID-19 .
Speaking of Mumbai, a senior official from the Ministry of Health said: “We are on the edge. They needed to quarantine from the start. They did not do that. However, we are hopeful that we can still go back. ” So far, Mumbai has reported 12,142 cases and 462 deaths.
“In some states like Maharashtra, Gujarat, Delhi, Rajasthan, Madhya Pradesh and Tamil Nadu, there is an outbreak. We are coordinating with state governments to strengthen containment efforts, “said Agarwal.
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However, officials who visited Mumbai said there is still no community transmission in the city, adding that fever clinics outside the containment areas and surveillance for influenza-like illness in the buffer zones have not yielded. ” no significant positive. “
The main problem, they said, is the impossibility of maintaining social distancing in the slums there. “In some of these places, people take turns sleeping, basically four people spend eight hours each on a ‘shift’ in one room. Now all 12 are packed in the same space. How does the distancing occur? We’ve asked for gyms, community rooms, whatever is available, to turn them into quarantine centers, use makeshift cardboard beds, and move people in. It’s not much, it probably can’t even accommodate a fraction, but it’s still better than the current situation “said an official.
At the daily briefing, Agarwal said it is possible that “with compliance with the rules of social distancing and aggressive containment, India will never rise to the top.”
Praising the system implemented by the BMC, an official said: “Actually, they did better than we asked for. We said a containment zone and a buffer zone. They even established a third zone outside where they did the ILI surveillance. But they were lax in the containment zone, partly due to inexperience and partly due to the conditions of the urban slums ”.
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At the daily briefing, Agarwal said it is possible that “with compliance with the rules of social distancing and aggressive containment, India will never rise to the top.”
“When a new list of districts is drawn up in the red, green and orange zones, we will share it with the states. But as we talk about the relaxations and the return of migrants, it is important that we learn to live with the virus and that we practice behavioral changes, ”he said.
While 216 districts have reported no cases to date, 42 districts have not reported a new case in the past 28 days, 29 districts in the past 21 days, 36 districts in the past 14 days, and 46 districts in the past 7 days.
Meanwhile, the ICMR has started a multicenter clinical trial called the PLACID trial: “Phase II open label,
Randomized controlled trial, to assess the safety and efficacy of convalescent plasma in limiting complications associated with COVID-19 in moderate disease. “
The study received the approval of the National Ethics Committee COVID-19 (CONEC). The ICMR has shortlisted 21 hospitals for trial: 5 in Maharashtra; 4 in Gujarat; 2 each in Rajasthan, Tamil Nadu, Madhya Pradesh and Uttar Pradesh; and 1 each in Punjab, Karnataka, Telangana and Chandigarh.
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