New plan holds clues to unlocking country
Health ministry outlines how areas with large outbreaks or multiple clusters will be isolated
NEWDELHI: A Union health ministry plan has outlined how regions — cities, villages or neighbourhoods — with large outbreaks or multiple clusters of the coronavirus disease Covid-19 could be walled in, charting out what may be the first official road map to keep the disease in check by focussing curbs and surveillance on hot spots while other areas return to some degree of normalcy once the nationwide lockdown ends later this month.
The strategy is based on lessons from the 2009 outbreak of the H1N1 influenza pandemic which, according to the report, had a bigger impact on “well-connected big cities with substantive population movement” while rural areas and smaller towns with low population and poor connectivity reported only few cases.
“The current geographic distribution of Covid-19 mimics the distribution of H1N1 pandemic influenza. This suggests that while the spread of Covid-19 in our population could be high, it’s unlikely that it will be uniformly affecting all parts of the country. This calls for differential approach to different regions of the country, while mounting a strong containment effort in hot spots,” said the health ministry’s containment plan for large outbreaks.
The road map is meant to tackle the third most serious scenario of the outbreak in the country. The first, and the mildest scenario, is when cases are limited to those who have travelled. Second is when cases are spread locally. The third scenario is when there are large clusters, while the remaining two are, when there is widespread community transmission and, the most severe, when India becomes endemic for Covid-19.
Actions for mitigation phase -a scenario when focus must shift to management of cases instead of containing the outbreak -- will be dealt under a separate plan, the report added. “The large outbreak in India is still amenable to containment. All states have put in place aggressive containment measures, and we haven’t reached that stage where the outbreak is uncontrolled,” said a senior health ministry official, requesting anonymity.
At present, there are 21 clusters in nine regions that are under a close watch for outbreaks. While there are no rigid thresholds set for what defines a “large outbreak” or how many clusters make the cut, an official aware of the plan cited Delhi’s Nizamuddin neighbourhood, Rajasthan’s Bhilwara and Kerala’s Kasargod as examples of what will be considered for the containment plan.
Nizamuddin is home to the Tablighi Jamaat’s headquarters, which has contributed about two-thirds of Delhi’s 445 infections. Bhilwara accounts for 27 of Rajasthan’s 200 cases and Kasargod 136 of Kerala’s 306 infections.
“That’s what is being done at the ground level from where a large number of cases are being reported. Most of our cases still can be traced back to international travel and the percentage where contacts have not been traced yet is too small to cause panic,” the official quoted above added.
According to the plan, a hot spot will be divided into zones: the quarantine zone and a buffer zone around it.