The Union Home Ministry has come up with a special strategy to check the spread of novel coronavirus and the major contours of it involves defining the area of operation, applying perimeter control, delineating containment and buffer zones.
“The strategic approach for containment include defining area of operation and applying perimeter control, active search of cases, early isolation, contact listing and tracking, quarantine and follow up of contacts,” a Home Ministry statement said.
The government is also carrying out sample tests of all suspect cases, symptomatic contacts, asymptomatic direct and high risk contacts of a confirmed case and severe acute respiratory infections (SARI) cases.
Strategy for Covid-19 hotspots
The government strategy for Covid-19 hotspots or red zones includes increased focus on highest case load districts, which contribute to more than 80 per cent of cases in India.
In the hotspots of clusters and large outbreak areas, there has been localised increase in the incidence of COVID-19 cases occurring within a defined geographic area e.g., in a village, town, or city and the cases may not be epidemiologically linked.
If there is more than 15 cases, it implies progression of a small cluster or evolving of multiple clusters. Less than 15 cases means it is happening in a limited area and cases are epidemiologically linked, the Home Ministry said.
The government stated that the perimeter of mapped clusters are facilitated by already existing boundaries like roads, rivers, etc, and established clear entry and exit points. “Only one or two arterial roads into containment zone will be kept open for essential services. All roads connecting the containment zone will be guarded by police or volunteers,” it was quoted as saying by PTI.
“There will be no unchecked outward movement except for essential services, there will be no unchecked influx of population into the containment zone too,” it added.
Also, all vehicular movement, public transport, and personnel movement will be restricted. Details of people moving out of perimeter will be recorded and followed up with the Integrated Disease Surveillance program (IDSP), the statement said.
The perimeter control operations for the clusters and large outbreaks remain the same except for the enhanced scale of arrangements for large outbreaks.
Role of state governments
The Home Ministry statement said that districts with doubling rate in less than four days (calculated every Monday for last 7 days), will have to be determined by the state government.
“Specific activities inside the COVID-19 containment and buffer zones include active surveillance by Anganwadi workers, ANMs, NSS, Nwhru Yuvak Kendra etc., through house to house visits, increased testing etc,” it said.
PTI reported that on April 14, a total of 207 districts have reported cases and could be potential hotspots.
Preemptive action for cluster containment is to be initiated in all these districts while clear delineation of containment zone and buffer zone will be done in these districts, the ministry said.
Contact tracing and surveillance
Besides these measures, the Home Ministry said that contact tracing and surveillance, laboratory testing will be done as per protocol. The clinical management of positive cases will be undertaken and also effective community engagement will be ensured by the authorities.
“The government has also adopted cluster containment policy in non-hotspot districts. As on Tuesday, 353 districts in the country, out of about 730, have not yet been affected These districts needs to be under enhanced surveillance for Influenza-like illness (ILI) and SARI symptoms and such cases will be tested,” it said.
The buffer zone is an area where new cases are more likely to appear. Thus, the health institutions, including private institutions, should be aware of the signs and symptoms, the ministry said.
According to government guidelines, asymptomatic direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his or her contact. The surveillance and testing activity remains the same for clusters and large outbreaks, the statement said.
(With inputs from PTI)
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