With gradual ingress of COVID-19 infection in rural and peri urban areas, the Union government on Sunday urged states to ensure community-based and primary health centre services to manage the situation while stressing on sensitisation of ground workers on containment, surveillance and use of RAT for screening, and tele-consultation.
The states were also urged to train the ground-level staff on rapid antigen test (RAT), which is the preferred test for screening of the infected cases to enable timely isolation and prompt treatment, the Union Health Ministry said. Union Health Secretary Rajesh Bhushan along with Member (Health) of NITI Aayog V K Paul chaired a high-level video conference meeting with all the states and union territories.
The focus of the meet was on COVID-19 containment and management in peri-urban, rural and tribal areas along with the effective clinical management of COVID-19, including the black Mucormycosis fungi which is being recorded in a growing number of states, the ministry said. The meeting assumes importance in the context of the rural hinterland of the country recording a very high number of cases with increasing fatality and positivity rate, combined with low reported levels of testing.
The Union Health Secretary highlighted various areas for the states which include sensitisation of ground workers, particularly medical officers and block level nodal officers on containment, surveillance and RAT for screening, the use of RT-PCR, teleconsultation and important element of the SOPs issued by the ministry.
The state health secretaries were asked to hold daily regular review meetings starting tomorrow Monday with medical officers and block level nodal officers to ensure that the SOPs and the advisories percolate to the grassroots level.
States were urged to organise a series of meetings/interactions for sensitisation of the ASHAs, ANMs, Panchayati Raj Institutions along with the Community Health Officers (CHO). States have been advised to train them to identify the early signs of SARI/ILI and COVID symptoms, the statement said.
States were advised to use the services of village-level health and sanitation committees and gram sabha as first responders.
"With gradual ingress of COVID infection in rural and peri urban areas, the importance to ensure community-based services and PHC services to manage the situation was highlighted," the statement said.
Mechanism for surveillance, screening, isolation and referral of cases from such areas, monitoring of home isolation cases and providing them with information pamphlets, ramping up of facilities in all the three subsequent levels of COVID-19 Healthcare â€” COVID Care Centres (CCCs), Dedicated COVID Health Centres and Dedicated COVID Hospitals (DCHs) â€” was discussed at length.
The states were exhorted to share their best practices, and leverage their existing capacity in tele-consultation. The need to ensure continuity of non-COVID essential healthcare delivery systems, communications and behavioural change, and renewed parallel focus on mental health support were also highlighted.
ICMR DG Balram Bhargava reiterated the importance of the Rapid Antigen Test (RAT). He reminded the states to use this among the communities for large scale screening and quick identification of the COVID infection, the statement said.
AIIMS Director Randeep Guleria highlighted the importance and need for infection control protocols. He cautioned that with the expansion of COVID in the rural hinterland, donning and doffing protocols are not being strictly followed which could infect the healthcare workers deployed. The adherence to protocol for donning and doffing areas for PPE kits was stressed.
He advised the state health administrators for triaging of critical cases to reduce mortality.
Throwing light on the COVID complications being reported from many states, he advised states to curb the excessive use of steroids, the statement said. Steroids are to be administered only to those hypoxic, in low doses and not beyond 10 days at a stretch, he said.
The changes in the CoWIN platform were notified to the states and UTs. Secretary urged the states to break the myth that the CoWIN platform is biased to those abled by technology and requested them to make good use of facilitated cohort registration, the statement.