The multi-disciplinary teams that were deployed by the Centre to 50 districts across Maharashtra, Chhattisgarh and Punjab, have flagged several problems with the states’ approach to contain the spread of the coronavirus pandemic, News18 reported on Sunday.
This includes inadequate RT-PCR tests, lack of containment measures and contact tracing operations, and a general shortage of healthcare workers, even as hospitals are inundated with new patients. On the basis of the feedback, the health ministry has written to the three states, urging authorities to focus on these areas.
In the letter to the states, Union Health Secretary Rajesh Bhushan said that the Centre has taken note of matters related to vaccine availability, according to PTI. He said the action required to augment supplies will be taken based on the stocks available with the states.
The two-member high-level team consists of a clinician or an epidemiologist and a public health expert. They were deployed to 30 districts of Maharashtra, 11 districts of Chhattisgarh and nine districts of Punjab to assist the state health department and local authorities in Covid-19 surveillance, control and containment measures.
Here’s a brief summary of key performance indicators related to testing, hospital infrastructure and vaccination reported by the teams in the three states.
The central teams in Maharashtra, which is the worst-affected in the country, reported lack of Covid-appropriate behaviour, oxygen and ventilator shortage, and “sub-optimal efforts at surveillance and contact tracing in areas”, the Centre said.
Containment operations were found to be sub-optimal in Satara, Sangli and Aurangabad, with less than satisfactory perimeter control and lack of active surveillance, the team said, adding that the experts deputed in Bhandara found that most cases were being reported from outside of containment zones.
This means there is a need for the state government to either increase the areas of containment zone or notify new ones, the Centre said.
The teams also said the testing capacity in several districts, including, Satara, Bhandara, Palghar, Amravati, Jalna and Latur, was already overwhelmed. This has led to delays in reporting of test results.
ln Bhandara and Satara, a large percentage of Covid-19 patients are under home isolation, which requires rigorous follow up to minimise mortality. But such a follow up is not happening presently, the Centre said.
“Occupancy rates of available hospital bed capacity are very high in Ahmednagar, Aurangabad, Nagpur and Nandurbar,” the Centre added. “Team to Aurangabad reported dependency of the district on neighboring districts for management of critical patients and critical care infrastructure upgradation thereon.”
Medical oxygen supply was found to be an problem in Bhandara, Palghar, Osmanabad and Pune, while malfunctioning ventilators were reported by teams from Satara and Latur districts, it said.
In Punjab, the Centre flagged the need to focus more on contact tracing in Patiala and Ludhiana. “Contact tracing and surveillance efforts in SAS Nagar are being hampered due to shortage of manpower,” it said. “Additional manpower must be deployed for contact tracing on a priority basis.”
It also reported low rates of testing from Patiala, while in Rupnagar, there was not even a single RT-PCR laboratory, the experts said. The team to Patiala and Ludhiana reported slow pace of vaccination among persons older than 45 years and those above 60 years.
The team also added that there was no dedicated Covid hospital in SAS Nagar and Rupnagar districts, and that in many cases, patients were being referred to neighbouring districts or to hospitals in Chandigarh.
“Hospital bed occupancy rates in SAS Nagar, Jalandhar and Ludhiana are on the higher side and suitable arrangement for the same must be undertaken by the district health authorities with sufficient lead time to prepare for any surge in cases,” it added.
The central teams deployed to Chhattisgarh reported a lack or shortages of RT-PCR testing facilities in Korba, Durg, Balod districts, leading to increased testing turnaround time. Similarly, limited RT-PCR testing capacity was also reported from Balod, the Centre said. It asked the state government to expand RT-PCR testing by exploring the use of mobile testing labs.
“There appears to be no restriction on movement of people inside containment zones too,” the Centre added. “Hence, Containment Zone including micro Containment Zones need to be strictly implemented. Contact tracing efforts need to be reinforced in Korba.”
Additionally, the teams also flagged instances of “resistance” and “attacks on healthcare workers” in Raipur’s Dhaneli village. “This needs to be addressed on an urgent basis,” the Centre said.
Hospital bed occupancy rates are high in Balod, Raipur, Durg and Mahasamund districts, the Centre said, adding that the district administration needed to ramp up hospital infrastructure and other logistic requirement to meet any demand arising due to surge in cases.
“Similarly, shortage of Remdesivir, Low Molecular Weight Heparin needs urgent attention in Korba District,” the central government said.
The teams also reported non-adherence to Covid appropriate behaviour by the public. “Overcrowding and no physical distancing was observed in vaccination center visited by the team in Rajnandangaon,” it said.