A positive report at 2 am, 1,248 teams swing into action and intensive contact tracing in pre-lockdown era covering over 1,65,000 households in Lohamandi area of Agra. As Bhilwara model gains currency as a viable model for cluster containment of coronavirus, the Agra model has emerged as an alternative way of achieving the same results.
The Centre showcased the Agra model on Saturday at the daily COVID-19 briefing, and it is also being shared with other states as best practice.
It was discussed in the meeting the Cabinet Secretary convened a few days ago with district magistrates, and also came up for discussion on Tuesday during a meeting at the highest political level, top sources in the government said.
Agra, which saw early cases after two people who had travelled to Austria along with a resident of Delhi’s Mayur Vihar — Delhi’s first confirmed coronavirus case — travelled back home to Agra in early March. Soon, six cases were reported from the city.
A senior official associated with the Integrated Disease Surveillance Programme, who oversaw the combing operations that followed, said: “The confirmation from the airport tests came at 2 am; we got into action immediately. A 3-km radius around the house was sealed and 259 teams were formed of two members each. We covered 1.63 lakh households in a few days, took about 1000 samples, used S N Medical College as our base. It was an exercise where nothing could be left to chance — a security guard was roped in to supply daily needs to the families.”
Each team covered about 100 homes per day; doctors sat at a nearby civil dispensary, and people who showed symptoms could visit them.
The Union Health Ministry said in a statement: “The State, district administration and frontline workers coordinated their efforts by utilising their existing Smart City Integrated with Command and Control Centre (ICCC) as war rooms. Under the cluster containment and outbreak containment plans, the district administration identified epicenters, delineated impact of positive confirmed cases on the map and deployed a special task force as per the micro-plan made by the district administration.
“The hotspots were managed through an active survey and containment plan. Area was identified within radius of 3-km from the epicentre while (a) 5 km buffer zone was identified as the containment zone.”
In these containment zones, urban primary health centres were roped in and 1,248 teams were deployed; each team had two workers, including ANMs/ASHA/AWW, reaching out to 9.3 lakh people through household screening. Additionally, effective and early tracking of first contact-tracing was thoroughly mapped.
Agra, incidentally, was also the earliest reference to community transmission in an official statement; experts such as AIIMS director Dr Randeep Guleria are now talking about “localised community transmission” in hotspots.
In a statement, the Health Ministry had said on March 5: “Since, in addition to COVID-19 cases related to travel, some cases of community transmission have also been observed, it has been decided to involve district collectors and States have been asked to form rapid response teams at district, block and village levels.”
The Bhilwara model also worked on similar lines but included sealing of the whole city at a much more stringent scale than Agra since it was undertaken during the three-week lockdown.
Its steps, as per a presentation that has been shared with the Centre are: “City Border Sealed immediately. District Border Sealed immediately with check posts at all entry / exit points. Neighbouring Districts DMs requested to seal their borders with Bhilwara. (Double Check System) Railways and Roadways Services Stopped. Movement of Private Vehicles Stopped.”
Among the other models that are being discussed are the Pune Central region and Kondwa region model, and the extensive use of technology in Pathanamthitta district in Kerala.
In Pune, a door-to-door survey was undertaken in a 33-sq km area, said Lav Agarwal, Joint Secretary, Health. “Persons with co-morbidities were checked, also those with travel or contact history. In Pathanamthitta, for surveillance and contact tracing there was use of technology. There was a war room and households on quarantine were monitored with the help of technology,” he said.
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