The total number of Covid-19 cases in Punjab have crossed 55,000-mark while state has already recorded 1,500 fatalites. Amid a steady surge, a majority of the caseload was added in August. Hussan Lal, Principal Secretary, Health and Family Welfare, Punjab, tells The Indian Express how government is preparing for the challenges ahead.
At a time when both the Covid curve and the death toll is increasing, how prepared is the state?
We are well prepared to tackle the surge in cases. The required infrastructure, human resources, medicines and consumables are available in adequate quantities. These resources have been arranged keeping in mind the projections by experts regarding the number of cases likely to be reported by the time the state reaches its peak. Presently in the government sector, there are 5290 level II beds with 1330 (25%) occupancy, 320 level III beds with 162 (50%) occupancy. In the private sector there are 2231 level II beds with 1153 (51%) occupancy while level III are 693 with 466 (67%) occupancy. There are 7,088 beds for level I in government facilities with 925 (7%) occupancy. About 6,000 patients are in home isolation To check the increasing mortality due to Covid-19, a group of experts has been established, which includes experts from AIIMS, PGI and medical colleges and some international experts from Northwell Hospital and Bronx Hospital New York and UK. This group conducts regular webinars with doctors involved in management of Covid-19 cases in the state. A committee of experts has been formed from medical colleges which do real time monitoring of patients and guide regarding day to day management of patients.
The increase in death toll has become a cause of concern. Residents in containment zones in urban as well as rural areas fear giving samples.
How is the department tackling it?
To overcome resistance in containment zones, planning and implementation committees have been set up in each district which includes medical staff, district administration, elected representatives of public and NGOs. Extensive information education communication (IEC) and behavior change communication (BCC )activities are going on through electronic, print and social media. People are being informed that if they test positive for Covid-19 and are asymptomatic or mildly symptomatic they have the option of home isolation and there is no need to get admitted to a hospital. Recently people have been given the option to opt for home isolation as per protocol at the time of giving a sample only in case they test positive for Covid-19.
What major challenges are ahead and how are you going to win over them?
One of the major challenges in curbing the spread of disease is the willing support and cooperation required from the public. Government has issued advisories regarding social distancing, wearing of masks and hand hygiene with provision of challans for violations. Another challenge is mortality among Covid positive patients. For early detection and treatment of such patients, testing has been increased to around 23,000 per day. Testing is targeted in areas where a large number of persons is reported positive for Covid-19. Target is to increase testing to about 30,000 per day.
What do you think are the major reasons for the surge in Covid cases and the death rate as August numbers increased exponentially?
The major reason is increased movement of people and the public not following advisories regarding social distancing, face masks and hand hygiene. Social and religious gatherings are taking place without adherence to restrictions on the number of persons allowed. This is more common in urban areas and nearly 80% of cases are being reported from these areas. The major reason behind deaths of Covid patients is that people report to health facilities very late despite having symptoms. Another reason is the prevalence of co-morbidities among Covid positive patients.
How are you going to rebuild confidence among masses about government health care centers as people fear getting admitted to such facilities?
Facilities at government health care centers have improved significantly. Patients admitted at these facilities are randomly contacted through telephone to take their feedback regarding facilities being provided to them. More than 95% have expressed satisfaction with the facilities. Moreover videos of people who have recovered from Covid and discharged from govt. health centers giving positive messages regarding the government. health centers are being shared on social media. Over all facilities available at govt. health centers are satisfactory.
How many new staff have been recruited for Covid centers?
A total of 6,182 staff has been recruited for Covid centers including medical, paramedical and support staff.
A major complaint is about food not being good at Covid level 1,2&3 facilities. They say that the diet is not as per patient’s previous disease history but like a common langar. Frequent short meals are needed, but patients complain that this norm is not being followed?
Good quality food is being provided to the patients. In addition snacks and fruits are also made available to the patients admitted at level I, II and III facilities. Patients have been given the option to get food and other essentials from their home as well. Moreover they can order food and other items online as well.
What are your top five priorities in fighting this pandemic in Punjab.
The top priorities are preventing spread of infection by early detection and isolation and treatment of patients; increased testing; Strengthening of health care services by expanding infrastructure and recruitment of human resource; better management of patients at health facilities, and preventing spread of infection among health care workers and other frontline workers.
Neighboring Haryana and Himachal Pradesh are doing better than us. Why are we lagging behind?
We are not lagging behind. Haryana has more cases than Punjab. Most of our indicators are comparable to neighboring states.
How do comorbidities play a role in the increase in caste fatality rate ( CFR)?
Presently the CFR of the state is 2.6. Comorbidities have a significant role in CFR. About 90% of deaths happened in patients with comorbidities.
Do you think that converting hospitals into 100% Covid hospitals can be a better approach to fight with the growing number of cases in Punjab rather than allocating few beds in multiple hospitals?
You have to balance Covid care and non-Covid care at the health facilities. In view of Covid cases , we have decided to convert some of the facilities into 100% Covid care facilities at such places where a nearby health facility was available where total non-Covid care services were provided.
Any advice for masses?
Follow advisories regarding social distancing, wearing face masks, hand hygiene and cover your nose and mouth while coughing or sneezing. Avoid social and religious gatherings. Avoid going to crowded places.
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