The advisory was sent by health secretary Rajesh Bhushan to all state chief secretaries and UT administrators in light of the threat posed by the Omicron variant, which has triggered a new wave of Covid-19 in South Africa, UK, Denmark and several other regions.
States and union territories need to step up scrutiny of Covid-19 infection trends and consider steps like night lockdowns and bans on large gatherings if more than 10% of all tests in a week turn positive or if the occupancy of hospital beds breaches 40% of capacity, the Union government said in an advisory on Tuesday.
Centre tells states to stay on Omicron alert
In all, India has detected 220 cases of Omicron as on Tuesday, with 51 of these confirmed in the last 24 hours, according to data shared by states with HT. Of the total, 77 people who had the new VOC have recovered.
States need to constantly review district-level data of “population affected by Covid-19, geographical spread, hospital infrastructure and its utilisation, manpower” and notify containment zones and enforce perimeter control so that “infection is contained at the local level itself before it spreads to other parts of the state”, the letter said.
The letter added that the two thresholds it mentions – 10% test positivity and 40% hospital bed occupancy – are normative templates, and local officials can take measures based on population characteristics even before these thresholds are breached.
The health secretary then specified “strategic areas of intervention” under five categories.
On containment, the official suggested “imposition of night curfew; strict regulation of large gatherings; curtailing numbers in marriages and funerals; restricting numbers in offices, industries, public transport etc”.
“ln case of all new clusters of Covid positive cases, prompt notification of containment zones, buffer zones should be done; strict perimeter control of containment zone as per extant guidelines must be ensured; and all cluster samples must be sent to INSACOG labs for genome sequencing without delay,” the letter said.
On testing and surveillance, Bhushan recommended there be “door-to-door case search, testing of all severe acute respiratory infections-influenza like illness and of vulnerable and co-morbid people; ensuring right proportion of RT- PCR tests in total tests being conducted daily; contact-tracing of all Covid-positive persons and their timely testing; utilizing access to ‘air suvidha’ portal by state surveillance officers and district surveillance officers to monitor international passengers who have arrived in their states and districts”.
For clinical management, the secretary said bed capacity and ambulance availability must be increased, and “mechanism for seamless shifting of patients, availability and operational readiness of oxygen equipment, buffer stock of drugs” should be ensured by utilizing the Emergency Covid Response Package-II funds released by the Centre, and other available resources.
The existing National Clinical Management Protocol remains unchanged for Omicron.
The Centre also recommended “stringent enforcement” of home isolation as per guidelines. “This would include, among others: customised kit for persons undergoing home isolation, their regular monitoring through call centers as well as home visits etc. This will be a very critical activity in the days to come specially to ensure that persons under home isolation do not spread the virus to others in view of its higher transmissibility,” the letter said.
The fourth focus area was identified as vaccination. “Ensure 100% coverage of left-out first- and second-dose eligible beneficiaries in an accelerated manner; with special focus to be given to those districts where the first- and second-dose coverage is less than the national average. The door-to-door vaccination campaign needs to be strengthened,” the letter added.
The letter called for improved community engagement and Covid-appropriate behavior.
“Ensure advance engagement and information so that there is no misinformation or panic; transparent communication on hospital and testing infrastructure availability etc. Participation of community backed by strict enforcement is necessary for ensuring Covid-appropriate behavior,” the letter said.
Experts said that test, track, treat and vaccination strategy will be critical. “Apart from having a good strategy, it is an important thing is to implement it well. It is important for people to understand that adhering to Covid-appropriate behaviour is an absolute must, especially wearing a mask and avoiding crowded places and maintaining physical distancing and hand hygiene irrespective of the variant in circulation,” said Dr GC Khilnani, former head of pulmonary medicine department, All India Institute of Medical Sciences, Delhi.
