Updated: April 3, 2021 7:46:58 am
On the day the Centre categorised 11 States/UTs as “States of grave concern” on account of their high and rising daily cases and deaths, several states moved Friday to take measures and impose curbs on movement to contain the surge in Covid-19 cases.
Stating that these States/UTs — Maharashtra, Punjab, Karnataka, Kerala, Chhattisgarh, Chandigarh, Gujarat, Madhya Pradesh, Tamil Nadu, Delhi and Haryana — have contributed 90% of Covid cases and 90.5% of deaths (as on March 31) in the last 14 days, and have crossed or are close to crossing their peaks reported last year, the Centre said the situation was particularly worrying in Maharashtra.
In Mumbai, Chief Minister Uddhav Thackeray, in an address to the state, stopped short of announcing a lockdown, but warned that a decision may have to be taken in the next two days after consultations with experts and political leaders.
On Friday, Maharashtra counted 47,827 new Covid-19 cases, the highest since the pandemic began last year. The Maharashtra caseload now stands at 29.04 lakh, of which 3.89 lakh cases are active.
Thackeray warned that if cases continue to increase at the present rate, the state will fall short of medical personnel even if the health infrastructure is expanded.
He said restrictions have to be imposed to prevent crowding. He attacked political opponents for threatening protests against a lockdown, saying they should be helping the administration tackle the crisis instead.
“Today I am warning about the complete lockdown, but not announcing it. I will speak to the experts and political leaders in the next two days. If there is no other option to lockdown, then we will have to accept it as it is,” he said.
The question before the government, he said, was how to break the chain of infection.
The worry: Rural and semi-rural
What is of particular concern is that Tier 2 and Tier 3 cities and towns, along with peri-urban areas, are reporting a surge in Covid-19 cases. Health officials are warning that the spread of infection to rural areas with weak health infrastructure could overwhelm the entire health system.
In New Delhi, at a meeting chaired by Cabinet Secretary Rajiv Gauba – it was attended by Chief Secretaries, DGPs and senior health officials of states – the Centre told the states that Tier 2 and Tier 3 cities, along with peri-urban areas, are reporting a surge that is worrisome, and the spread of infection to rural areas with weak health infrastructure could overwhelm the health system.
On Friday, the country reported a record 81,466 new cases and 469 deaths in the last 24 hours. The Centre told the states that the country has now reached the “critical figure” of 81,000 daily new Covid cases – it was 97,000 daily new Covid cases at the peak of the pandemic in September 2020.
The country’s total active caseload has now reached 6,14,696 cases and five states — Maharashtra, Karnataka, Chhattisgarh, Kerala, and Punjab — cumulatively account for 77.91 per cent of the total active cases.
During the meeting, Health Secretary Rajesh Bhushan made a detailed presentation on the deterioration situation, specifically flagging the situation in Maharashtra – the state alone accounts for nearly 60 per cent of the total active caseload of the country.
The Centre underlined that 11 states showing a surge have not displayed a proportional increase in containment activities. It directed them to set up micro-containment zones and to ensure tracing and isolation of 30 close contacts of each infected person within 72 hours.
States were specifically asked to:
* Increase testing continuously to ensure that positivity comes down to 5% or less than 5%.
* Focus on ensuring RT-PCR tests comprise 70% of total tests.
* Reduce waiting time of test results with regular review with testing labs.
* Use Rapid Antigen Tests (RAT) as screening test in densely populated areas and where fresh clusters are emerging.
* All symptomatic RAT negatives be mandatorily subjected to RT-PCR tests.
* Ensure effective and prompt isolation of those infected in institutional facilities (Covid Care Centres).
* Ensure that patients isolated at home are monitored daily. Isolated infected persons be transferred immediately to health facilities, if required.
* Ensure that 25 to 30 such close contacts can be traced for each infected person. Tracing of close contacts and their isolation to be done in 72 hours. Subsequent testing and follow-up of all close contacts to be carried out.
* Setting up of Containment Zones/ Micro Containment Zones to break the chain of transmission.
States were also asked to examine Case Fatality Rate hospital-wise, devise appropriate strategy and mitigate concerns regarding late admission in hospitals and non-adherence to National Clinical Management Protocol. The need to formulate District Action Plans with a focus on mapping of cases, reviewing of ward/block wise indicators, 24×7 Emergency Operations Center, Incident Command System (Area Specific Rapid Response Team and Timely Sharing of information was stressed upon.
In order to minimise daily fatalities, the States were advised on strengthening public and private healthcare resources. They were specifically asked to:
* Increase the number of isolation beds, oxygen beds, ventilators/ICU beds as per requirement.
* Plan for adequate oxygen supply.
* Strengthen ambulance service and reduce response time and refusal rate with regular monitoring by local administration.
* Ensure adequate number of contractual staff and optimum rostering of duties.
* Plan regular tele-consultation of ICU doctors at the districts with AIIMS, New Delhi Core Team or State Core Team. Tele-consultation is being conducted by AIIMS, New Delhi twice a week on Tuesdays and Fridays.
* Strict enforcement of COVID Appropriate Behaviour (CAB) was reiterated. The following was underscored for immediate compliance by States/UTs:
* Use of Police Act, Disaster Management Act and other legal/administrative provisions for imposing penalties on defaulters.
* Use of local officials, political, cultural, sports, religious influencers to disseminate information proper wearing of masks and maintaining physical distance.
* Focus on markets, fair/melas, social and religious congregations that could become super spreader events.
To saturate vaccination for priority age groups in districting reporting surge in daily Covid cases, States and UTs were advised the following:
* Time-bound plan of 100% vaccination of eligible Health Care Workers, Front Line Workers and eligible age groups, to be made.
* Coordination with the Union Health Ministry to ensure adequate vaccine doses.
* Daily review of consumption from each Cold Chain Point at the State level, for required re-appropriation.
Meanwhile, states began moving to impose curbs on movements.
In Pune, restaurants, hotels, bars were ordered shut for a week and gatherings prohibited. The exceptions were 50 guests for a wedding and 20 people at a funeral. Night curfew will be in place from 6 pm to 6 am.
In Chhattisgarh, 22 of 28 districts have imposed night curfews from 9 pm to 6 am. A lockdown has
been announced in Durg district from April 6 to April 14 — the district has the highest number of active cases – 9883 as on April 1 – and has had more than 750 Covid-related deaths.
The Uttarakhand government has advised in-bound travellers from 12 states to carry negative RT-PCR reports to enter Uttarakhand. This restriction would be applicable on people travelling by road, air and train to Uttarakhand from 12 states: Maharashtra, Kerala, Punjab, Karnataka, Chhattisgarh, Madhya Pradesh, Tamil Nadu, Gujarat, Haryana, Uttar Pradesh, Delhi and Rajasthan. The government advisory said that the RT-PCR test should have been done 72 hours prior to arrival time.
Rajasthan decided to extend the night curfew by an hour. Night curfew is now in place between 10 pm and 5 am in 10 cities including Jaipur.
Markets and commercial establishments have to close by 9 pm. Classes 1-5 in all educational institutions are shut.
In Uttar Pradesh, schools have been told to shut classes for students up to Class 8 until April 11.
Karnataka suspended classes for students up to Class 9, and also classes for higher, professional and medical courses except for board/university examinations. Only individuals will be allowed at places of worship. Gyms and swimming pools are to be closed, and all rallies, dharnas are prohibited.
— With ENS reports
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