The Health Ministry has written to the States which have some districts reporting high number of Covid-19 cases urging them to take urgent appropriate actions to bring down the cases and also share the details of the actions taken as per the Disaster Management Act.

Among the States that have received the communication sent out by Health Secretary Rajesh Bhushan on Tuesday were Arunachal Pradesh, Manipur, Kerala, Assam, Meghalaya, Tripura, Odisha and Sikkim.

“Although the trajectory of daily new cases of Covid-19 has come down substantially in the country, there is a need for continued monitoring of weekly case positivity, as well as cases trajectory in each district to identify any early warning signals of spread of infection,” Bhushan said in the letters written to State Chief Secretaries.

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For instance, the letter to Arunachal Pradesh Chief Secretary Naresh Kumar pointed out the concern that the easternmost State of India reported a weekly positivity rate of 16.2 per cent in the week from June 28-July 4. The positivity rate in the State was increasing over the last four weeks, Bhushan said adding that 19 out of 25 districts in the state are reporting a positivity rate of more than 10 per cent. Arunachal reported 12 per cent increase in weekly new cases, he said.

Similarly, Bhushan’s letter to Jishnu Bharua, Chief Secretary to the Assam government, expressed concern that 29 out of 33 districts in the State reported more than 100 new cases in the week ended on July 4.

Containment is crucial

He said containment is the most crucial strategy of flattening the current curve. It is critical to plan effective containment measures and implement them stringently, and to strengthen the efforts made for prompt contact tracing of the close contacts of positive cases and immediate quarantine or isolate all suspected and confirmed cases as per the existing guidelines.

Bhushan also called for ramping up of tests in districts which are reporting high positivity rates. A microanalysis needs to be done of area showing high positivity (>10 per cent) during the past weeks. Accordingly, all such areas should be targeted for increasing the testing exponentially while maintaining high proportion of RT-PCR tests. The States should aim at maintaining positivity rate below 5 per cent in each district, he said.

Healthcare infrastructure planning was another area that the Health Ministry wanted these States to focus on. “To ensure preparedness, the State must maintain continuous vigil regarding bed occupancy of critical beds (Oxygen supported and ICU beds) and if the occupancy is more than 40 per cent for any bed category, the States should plan for augmentation of healthcare infrastructure in those districts,” the Health Secretary’s letter said.

Trained human resources, infrastructure, logistics and procurement should be planned considering the geographical spread of the pandemic. States should also work towards ensuring timely disclosure of all infrastructure availability-based details on public portals or through media so as to avoid misinformation, he said. .

Similarly, the States were told to ensure effective clinical management in order to reduce fatalities. It is important to monitor all cases under home isolation and put processes in place to ensure smooth hospitalisation of patients, in case it is required. All facilities also should be monitored with respect to the overall fatality, including deaths being reported between 24,,48 and 72 hours of hospitalisation to identify any weak spots and to undertake required corrective action, the letter said.

Ramping up vaccination as an infection containment strategy and levying fines on violation of Covid appropriate behaviour can also be considered by the States, the Ministry said.