Keep toll low, suppress Covid transmission: Centre to states
States also told to ensure 72-hr surveillance of 80% of close contacts of patients
NEWDELHI: With cases of the coronavirus disease (Covid-19) spiralling to nearly 700,000, the Centre has asked state governments to adopt a two-pronged strategy to slow the spread of the pandemic, people aware of the development said. Key elements of the new strategy include keeping the mortality rate at less than 1% and suppressing transmission of the disease by following the guidelines of World Health Organization (WHO).
The strategies were discussed at meetings last week in an interaction between cabinet secretary Rajiv Gauba and state officials, the people said on condition of anonymity.
The Centre’s revised strategy to tackle Covid-19 comes at a time when India has overtaken Russia to the third position in the tally of cases, behind only the US and Brazil, and after a careful assessment of the experiences of states such as Karnataka, Tamil Nadu, Kerala and Haryana and the urban centre of Hyderabad, capital of Telangana.
The Centre has also pointed out that Delhi, which had a positivity rate—or number of positive cases per 100 tests—of 40% a month ago, has reduced to just 10% now. The Centre underlined that Delhi has also doubled its testing from 11,000 per day a month ago to daily 22,000 tests.
The states have been told to ensure 72-hour surveillance of at least 80% of close contacts of Covid-19 patients, a measure that can go a long way in reducing the transmission and possibility of spread of the virus. From proper quarantine of suspected Covid-19 patients to setting a target of ensuring a positivity rate of less than 10%, the centre has set a series of doable tasks for the states. Gauba has also said that once the positivity rate declines to less than 5%, the states can feel they are in a comfort zone.
All states have been told to conduct minimum of a 14 tests per 100,000 people.
While Delhi’s Covid-19 management has improved after the Union home ministry stepped in last month, working out collaborative strategies at joint meetings with the state, a few other states have emerged as a big headache for the Centre.
“Karnataka, Tamil Nadu and the city of Hyderabad had seen transmission slowing down but again the outbreak gained pace. We have told the states that they initially did a good job but then lost some momentum,” said a senior official involved in the management of the outbreak.
In two meeting with the cabinet secretary, lasting two hours each, examples of Kerala, Haryana and Tamil Nadu were given to other states to show how these states were able to keep the death rate around 1% or below. To improve the death rate, the Centre has asked states to improve the “speed to care”.
“We had asked states to do an assessment of how many people called for ambulances, how many were rejected and what time it took for the patient to reach hospital in an ambulance,” said another official, “and also ensure that when a patient reaches the hospital he/she should not spend more than 45 minutes in triage.”
The states were also told it is critical to “smoothen transition points” which includes test confirmation to hospitalization to ambulance coordination.
For suppressing transmissions, the Centre is referring to the detailed guidelines issued by the WHO such as the need for more effective contact tracing, better sealing of hotspots and antibody testing.
The states were also encouraged to hold teleconferences for local doctors with specialists or senior doctors of the All India Institute of Medical Sciences and other top hospitals.