Apart from checking infection spread, the government is now focusing on early detection among patients in the high-risk category, in order to prevent deaths.

Health workers standing by an empty bed in a COVID-19 hospitall in ThaneImage for representation/PTI
Coronavirus Coronavirus Thursday, June 18, 2020 - 18:54

The Andhra Pradesh government has consistently increased its COVID-19 testing capacity over the past few weeks, averaging between 13,000 and 15,000 tests per day. It has also set up laboratories on war-footing for quicker results. Although the state has been faced with a serious financial crisis for a long time now, and the government criticised for its lax response at the start of the pandemic, the Jagan Mohan Reddy government now claims to be prepared with the adequate infrastructure to fight COVID-19. 

As of Thursday morning, Andhra Pradesh has 3,632 COVID-19 patients. So far, 3,772 people in the state have recovered from the disease. 92 people have succumbed to the disease, of the 7,496 people infected so far. This puts the state’s mortality rate at 1.2%. 

Apart from keeping a check on the extent of infection spread, the government is now focusing on early detection among patients in the high-risk category, in order to prevent deaths.   

In conversation with TNM, Andhra Pradesh Special Chief Secretary (Health) KS Jawahar Reddy remarked that in spite of the state’s poor financial situation, the government has managed to handle the crisis by making it a priority and treating it as the public health emergency that it is. 

Jawahar Reddy shared details on the present status of Andhra Pradesh in terms of being equipped to handle the expected rise in infections, and the impending peak of the current COVID-19 wave in the state. 

Testing strategy 

So far, the Andhra Pradesh government has conducted more than 6 lakh COVID-19 tests. Around 13,000 to 15,000 samples are being tested daily, according to the state’s medical bulletins. 

Jawahar Reddy explained that nearly half the tests being done are TrueNat rapid tests and the remaining are RT PCR (reverse transcription polymerase chain reaction) tests. Speaking about the procurement of test kits, he said, “Initially there was a bit of a problem, with the Indian Council of Medical Research being unable to meet the demand. So we were trying to procure the rapid antibody test kits. But now, we have a comfortable supply of testing equipment for the coming weeks.”

On the deployment of widespread testing to reduce the mortality rate, Jawahar Reddy said that district collectors have been directed to test more people from the high-risk category, which includes people above 60 years of age, and those with comorbidities.  

“We have all the details of such people. Collectors have been asked to test people falling in this category if they are living in containment zones. If these people are outside containment zones, they will be screened for a few parameters, like blood sugar, breathlessness, blood oxygen levels, temperature, and some COVID-19-like symptoms. If they are symptomatic, they will be tested. Otherwise, treatment for diabetes or hypertension or other conditions will be given,” he said, laying out the plan for the most vulnerable in the population. 

The government plans to ramp up testing in the coming weeks for those who fall under high-risk categories. “We want to give more time to doctors to treat those who test positive, so they can be saved,” he said.

Apart from focusing on reducing mortalities, the state government has been testing people from various categories, like industrial workers who have returned to work, people visiting malls and religious places, etc. “This is to gauge the extent of the spread of infection, and to prevent sudden, large outbreaks,” said the Special Chief Secretary. 

Under its ‘Sentinel Surveillance’ testing program, the government announced that nearly 330 people in each of the 13 districts are being tested daily. The tests are performed on people from more than 15 categories, including those with comorbidities, people visiting malls, health care workers, vegetable vendors, etc. 

“We are getting details from medical stores on people buying medicines for fever-like symptoms. We are seeing some positive cases among them. Voluntary testing option is also available. In places like Vijayawada, Guntur and Kurnool, samples are being collected in centres set up in buses. There also we are getting a lot of positives,” he said. 

Preparedness of hospitals 

In the last week of March, the state government had directed all private medical colleges and private hospitals to make their premises, resources and manpower available to the district collector, as and when required. By the first week of April, the government announced that it had taken over 58 private hospitals across the state, and that a total of 19,114 beds were available in these medical colleges and hospitals. 

Out of this, 17,111 were non-Intensive Care Unit beds, 1,286 were ICU beds and 717 were isolation beds, according to a government statement. 

According to the state Health Department’s website, the state has three categories of medical care facilities for COVID-19 patients. Under Category I, there are 19 dedicated COVID-19 hospitals meant for providing comprehensive care for patients who have been clinically assigned as “severe”. Of these, 13 are private institutions, while four are state government-run hospitals and two are Central government institutions. 

Under Category II, meant for moderate cases, the state has 67 hospitals available, of which 19 are state government hospitals, and the remaining (48) are private establishments. Under Category III are COVID-19 care centres, meant for mild cases, and people suspected to have COVID-19. Under the third category are around 275 care centres, most of which are hospitals where the patients are kept under isolation and basic medical care is provided. 

Jawahar Reddy said that most of the private hospitals are ones covered under Aarogyasri, the government’s healthcare program for the poor. “The same hospitals are treating patients above the poverty line too, in case of COVID-19,” he added. 

“Government hospitals are being conservatively used, because otherwise, other services will suffer,” Jawahar Reddy said. While private medical infrastructure has been used extensively, the Special Chief Secretary for Health pointed out that the government is also investing in public hospitals with a long-term view, by adding oxygen lines and other facilities. 

Currently, the state’s hospitals are equipped with around 20,000 oxygen support beds, 5,000 ICU beds, and 1,000 ventilators, the senior bureaucrat said.

According to projections made by consultants, at the peak of the pandemic in the state, around 40,000 people are expected to be hospitalised, he added.

“We are gearing up to have 40,000 hospital beds, and another 15,000 beds in COVID-19 care centres for less serious cases. So we will be able to accommodate 55,000 patients,” he said.

COVID-19 patients categorised as ‘mild cases’ are being encouraged to remain under home isolation. “Already in West Godavari, East Godavari and in Tirupati, some patients who can afford to remain under home isolation and have sufficient space, have been advised to do so,” he said. 

Adequate medical staff 

While infrastructure needs have been met by roping in private establishments, the real shortage, Jawahar Reddy admitted, is in terms of human resources. “At present, we have around 21,000 doctors and 24,000 paramedical staff, including final year nursing students and postgraduate doctors, on our rolls. In addition, we have issued notices to recruit around 9,700 more doctors and paramedical staff,” he informed.

In certain districts which are the worst-affected, like Kurnool, Krishna and Guntur, infections are likely to peak sooner than in other districts, the government anticipates. “In such cases, we are planning to pool in human resources from other districts, if the need arises,” he said.

 

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