One week after relaxed closure, the Center remains on track to open

A disinfection campaign using drones in Ahmedabad, where a team of experts dispatched by Center arrived on Saturday. (Express photo: Javed Raja)

Although Covid-19 cases are doubling at a faster rate in the first week of the third phase of the blockade, overall sentiment in the government appears to be against reversing the relaxations towards gradual unlocking. The nature of the high-level meetings within the government and the new warnings issued to the Covid-19 administration in the past two weeks demonstrate this.

According to the panel of the Ministry of Health, positive cases increased from 39,980 on May 3 to 59,662 on Saturday, the number of deaths also increased in the week from 1,301 to 1,981. May 3 was the last day of the second phase of the blockade.

On Saturday, the Ministry of Health decided to deploy more core teams in 10 states that have “witnessed / are witnessing a high case load and a large increase,” including Gujarat, Tamil Nadu, Uttar Pradesh, Delhi, Rajasthan, Madhya Pradesh, Punjab. , West Bengal, Andhra Pradesh and Telangana. Previously, 20 teams of public health experts had been deployed in districts with a high case load.

At the same time, as a government source said, “Although the cases are increasing, the discussions in the system are about post-closure activities. Different ministries are planning the required action points. “Another source noted that the informal group of more than a dozen ministers, chaired by Rajnath Singh, to guide the administration on people’s issues, has practically finished its work.

“While previous meetings used to be about closure challenges and how to deal with them, high-level meetings now refer to what to do next,” said one source, referring to a series of meetings on education, power, the financial sector. , agriculture, civil aviation sector, among others, chaired by Prime Minister Narendra Modi.

This is also reflected in post-meeting announcements, whether the remaining CBSE board exams, NEET and JEE (Main) tests are taken, or the labor law relaxations announced by states like Madhya Pradesh, Uttar Pradesh and Gujarat, governed by BJP.

“The number of cases will continue to increase. Unless the disease takes a completely adverse turn, there is a general consensus within the government to continue the business of normal life, “a source confided.

However, interstate travel issues and greater flexibility in red-light districts remain undecided. The government is likely to call them closer when the third phase of the shutdown ends on May 17. A major obstacle is the fact that large urban centers such as Mumbai, Delhi, Chennai, Ahmedabad, Pune, Indore and Thane remain Hot Spots.

On Saturday, the National Disaster Management Authority (NDMA) issued guidelines on “restarting manufacturing industries after closure” to states. While most of them address safety protocols regarding restarting industrial processes, the next few days after the Visakhapatman factory disaster, the guidelines also cover disinfection, health checks, and related aspects. quarantine covering workers.

On the Covid-19 treatment front too, the warnings indicate creating additional elbow room in the long term. On Friday, the government revised the discharge guidelines for patients with Covid-19, with mild and moderate patients no longer requiring pre-discharge testing. The government, according to sources, is also seeking a better streamlining of clinical care guidelines after the data shows more people in the ICU than in oxygen support.

During a review meeting on Saturday with the Northeast states, Health Minister Dr. Harsh Vardhan said that currently 2.41% of Covid-19 patients were in the ICU, 0.38% with ventilators and 1.88% with oxygen. “This has been the trend almost constantly, more patients in the ICU than with oxygen, because hospitals leave nothing to chance. As cases increase, we have to see this because someone else may need that ICU bed more, “an official said.

In the past few days, a number of steps have been taken to free up resources, as projections indicate an increase in cases as blocking is eased:

# On Friday, May 7, the Health Ministry said that mild and moderate cases would no longer need testing before discharge. Under the above policy, patients had to be negative for discharge. “Mild / very mild / pre-symptomatic cases admitted to a COVID Care Center will undergo regular monitoring of temperature and pulse oximetry. The patient can be discharged after 10 days of appearance of symptoms and no fever for 3 days. There will be no need for pre-discharge testing. At discharge, the patient will be advised to follow the isolation at home for another 7 days according to guidelines. ” The same applies to moderate cases, classified as those whose symptoms resolve within three days and whose blood oxygen saturation was greater than 95% for the next four days.

“There is no need to test at discharge. It is a wasted kit. Anyway, they will be isolated at home. The test can be done on someone who needs it the most, ”said a senior official.
Currently, the country can conduct 95,000 tests a day, and the government has maintained that there is no shortage of test kits or facilities. So far, 15,25,631 tests have been performed.

# On April 27, the Ministry of Health modified the guidelines to allow mild or asymptomatic cases to remain in the home, observing strict quarantine rules, rather than a facility-based quarantine. The guidelines above assigned clinically assigned patients as very mild / mild, moderate, or severe to Covid Care Centers, dedicated Covid Health Centers, or dedicated Covid Hospitals accordingly. However, those in domestic quarantine have to download the Aarogya Setu app.

# On May 6, guidelines were issued regarding the use of rail cars for cases requiring minimal medical attention, to be ready at 215 stations across the country. A proposal by NITI Aayog to convert at least some of the 5,000 coaches into full oxygen hospitals, ICU facilities, and ventilators, to take them to Tier II, III cities and towns where health care infrastructure was limited, remains pending.

# A day later, the Ministry of Health issued a POE for the quarantine of the hotels they were willing to pay, especially the Indians evacuated from abroad who must complete a 14-day quarantine. “This is likely to reduce pressure on the family, provide comfort to the person and protect family members and the immediate neighborhood,” the ministry said. Sources said the ministry was not interested, but the Cabinet Secretary pressured him following a recommendation from the Empowered Group on hospitals, isolation beds, etc.

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