I am again writing based on our Web conference with Central Minister Harshwardhan ji on Medical preparation of GoI to fight against COVID-19.
As chronology of events Globally and In India I already posted in my previous post.
In This post I am going to talk about Government Plans B and Plan C as Indian Population is less than China still China could confine to Wuhan but In India it spread badly. Who are involved is well known fact to all Indians.
Till 25th April 2020 since 7th January what all happened giving crux and then will talk about Medical side.
- Hon’ble Prime Minister monitoring the situation since beginning. Reviewed regularly in cabinet meetings. Had detailed official reviews on 7th March, 18th March and 6th April 2020.
- A Group of Ministers (GOM) (Health, Aviation, Shipping, Home Affairs, External Affairs)headed by Union Health Minister met 12 times.
- 11 Empowered Groups headed by Secretaries/Member, Niti Aayog have been set up to review the situation.
- High Level committee of experts set up under Union Health Minister.
- Technical Joint Monitoring Group (JMG) under DGHS (Including WHO) held more than 10 Meetings since 8th January
- Health Minister wrote to Chief Ministers. had video Conferenceas well as tele conferences with State Health Ministers.
- Health Minister gave Suo-Moto statements in both sessions of Parliament on 7th and 10th February and 5th March
- Union Health Minister visited Airport, quarantine Centres, Hospitals to check field level implementation.
Now lets talk how they trained people across India to handle this. As preparation or Planning in Centre is not sufficient.
So they had done CAPACITY BUILDING PROGRAM
- Airport Health Officers & Immigration officials trained.
- State & District Surveillance Officers oriented through Video Conferences.
- Medical Evacuation Teams for Wuhan, Yokohama, Iran,Italy associated airline crew and other handling staff oriented.
- Quarantine Medical Teams oriented on patient management and infection prevention and control.
- State Rapid Response Teams trained for managing high risk pathogens.
- National level training of trainers on COVID-19 held on 6th March 2020. Attended by 260 health professionals from state, ESIC, Railways,Defense and other Ministries.
- 1000 Locations logged in for the training.
- The focus areas – Epidemiology, Surveillance, laboratory Support, Clinical management, Non pharmaceutical interventions, infection prevention control and risk communication.
- State level Training organised on 9th and 11th March 2020 across the country.
- District Level and Hospital level trainings -20th March 2020
- Orientation Workshop on State Nodal Officers – 18th March 2020.
- Training on usage of Ventilators -21st March 2020
- IGOT (integrated Government Online Training) courses on DIKSHA Platform commenced on 13th April 2020 on COVID-19 Pandemic.
Broadly speaking Government was focusing on CORE CAPACITIES LIKE
- HOSPITAL PREPARATION– Isolation beds, Critical care management and infection prevention
- RISK COMMUNICATION – Mainstream and Social Media and community level organizations
- CAPACITY BUILDING- Training of Airport/ Port Staff, identified Hospitals and RRTs
- SURVEILLANCE AT POINT OF ENTRY – Airports , Shipping, land Boarder- especially Nepal
- COMMUNITY SURVEILLANCE – Through integrated Disease Surveillance Network
- LOGISTICS – Personal Protection Kits, N95 Masks, Diagnostic reagents
- LABORATORY TESTING – Early and timely sample testing through lab network.
I am going to talk about health Measures like –HOSPITAL PREPARATION, COMMUNITY SURVEILLANCE, LOGISTICS, LABORATORY TESTING.
Lets start with COMMUNITY SURVEILLANCE.
- Community Surveillance was implemented since 18th January 2020
- Monitoring through State/ District Surveillance officers with Support of Rapid Response Teams (RRT).
- Advisory issued to all states/ UTs on 17th January for Severe Acute Respiratory illness (SARI).
- Online portal developed for states to ensure name based monitoring & surveillance.
- 9,58,519 travelers brought under community surveillance.
- 75,467 found symptomatic and referred
- 16,034 hospitalised.
One standard case of surveillance of 3rd patient from china which was published in social Media before lockdown began. A Male 23 Years during his journey of 2 days affected 162 people.
NOW I WISH TO TALK ABOUT MEDICAL FRONT
MAPPING OF PATIENTS TO CARE CENTERS
There were 3 categories of care centers for isolation or Quarantine of Patients by Central and State or UTs
- COVID Care Center – Patients with Mild/ Very mild Symptoms
- Dedicated COVID Health Center (DCHC) – Moderate Clinical Symptoms
- Dedicated COVID Hospitals (DHC) – Severe/ Critical Patients.
- COVID Care Center
- For Mild very Mild Case /Suspect cases
- Makeshift facilities to be set up in Hotels, Schools, Stadiums, Etc
- Individual rooms for suspect cases prefered
- Dedicated Basic Life Support Ambulance (BLSA) 24*7 available with Assured Oxygen Support
- Dedicated COVID Health Center (DCHC)
- For moderate cases
- Full Hospital or a Block of Hospital
- Hospital to have beds with assured oxygen support.
- Basic Life Support Ambulance (BLSA) with sufficient Oxygen Support for ensuring safe transport
- Total Centers – 1357
- Total Isolation beds – 83602
- Total ICU beds 8841
- No. of ventilators – 3104
- Dedicated COVID Hospitals (DHC)
- For Severe Cases
- Full Hospital or a Block of Hospital
- ICUs, Ventilators and Oxygen support
- Referral centers for Dedicated COVID Health Centers & COVID Care Centers.
- No. of D COVID Hospitals -729
- No. of Isolation Beds -115726
- No. of ICU beds – 16357
- No. of Ventilator – 9125
Now very important is Laboratory to test COVID-19
We had only laboratory in Pune for virology. Which is definitely not sufficient for entire India.
Apart from Laboratory Kits for Diagnosis was also very important.
- On 31st January we had only one laboratory
- 20th March we had 75 Laboratories in India
- 2nd April we created 190 Laboratories in India
- 10th April we had 220 Laboratories in India
- on 24th April When Web Conferencing was on already 260 Laboratories were approved.
- Target was on 30th government wanted to have 300 Labs.
- Apart from These Government labs 87 NABL accedited private laboratories chains, including the most extensive network like
- Lal Pathlabs
- Appollo hospitals were roped in.
Again on 24th April Dr. HarshWardhan ji had defined that country will be divided in 3 types of District. To help people and surveillance AROGYA SETU MOBILE APPLICATION was Launched for entire Indian Population.
On 24th April 2020 Total cases were 24,06, Total Recovered 5,063 and Total deaths 775
Number of districts shared by Health Minister Dr. Harsh Wardhan ji are as follows
- Hot spots District/ Red Zone –129 Districts
- Non Hot spot District / Orange Zone –297 Districts
- Non Infected Districts/ Green Zone. –307 Districts
There was a mechanism that no new case for 14 days in Red Zone will shift district to Orange Zone and
Orange Zone District will be shifted to Green Zone if No new case in last 14 Days.
It means any district can come from Red Zone to Green Zone if they follow Government instructions strictly.
Last very important thing Minister ji said is as there is no medicine for any Virus so COVID-19 is no exception.
He said that Government has made a program to boost immunity of individual using traditional therapies like Ayurveda and Homoeopathy. Vaidya Rajesh Kotecha ji had given details on 14th April 2020.
What I have to say as a medical professional is… There are many theories on COVID-19
- Some one say its Biochemical Virus
- Some Says that during experiment it spread
- Again few say its conspiracy and
- Few believe its Natural revolt.
Irrespective of it. 1st priority is to safe guard people from getting affected as we are 2nd Largest population in world.
Government planned as I described in my 1st post that this lockdown of 21 days will break chain for 1st and 2nd affected of COVID-19. Which might be in the range of 3000*5 =15,000 People.
If due to negligence of COVID-19 affected family if they spread to another 100% patients still then 30,000 patients to be taken care of in next 21 Days means up to 10th May and India would had been out of COVID-19 Pandamic.
But as politicians of India particularly opposition wanted to prove Lock down was wrong approach. They did best politics to spread of COVID-19 by Tabliqi Jamat, Sending 50,000 labors on Road by Delhi Government and finally by Maharashtra Government during lock down by not providing them food and other services sent from Central Government.
What I suggest to all India Population as Ministry of AYUSH has suggested few options any of the options one can adopt to protect self body against COVID-19. I am sharing link of it with all.
Please watch this video and follow this for June, July and August if Your district is not coming out of Red Zone or Orange Zone.
We would had been out by 10th may 2020. Still we have time till 31st May 2020.
Still as a protection this formula on Facebook post will help you issued by Madhya Pradesh Government.
Government has already planned B and C routs if entire District is getting affected then how to handle it.
But its good for us to remain healthy and follow government instructions. We all medical doctors strongly recommend usage of AROGYA SETU APPLICATION.