The Union government has adopted a special strategy to fight coronavirus, with specific instructions for the district and state authorities on how to go about with it, the Home Ministry said on Thursday.
The strategic approach for COVID-19 containment broadly involves defining the area of operation, applying perimeter control, delineating containment and buffer zones, a Ministry statement said.
Besides, there is an active search for cases, contact tracing, quarantine, clinical management and awareness generation among the public.
The strategic approach for containment includes defining the area of operation and applying perimeter control, the active search of cases, early isolation, contact listing and tracking, quarantine and follow up of contacts.
The government is also carrying out sample tests of all suspect cases, symptomatic contacts, asymptomatic direct and high-risk contacts of a confirmed case and severe acute respiratory infections (SARI) cases, the statement said.
In the (hotspots red zones) districts or cities, there is a focus following the detection of a large number of cases or higher growth rate. The highest caseload districts contribute to more than 80 per cent of cases in India.
In the hotspots of clusters and large outbreak areas, there has been a localised increase in the incidence of COVID-19 cases occurring within a defined geographic area e.g., in a village, town, or city and the cases may not be epidemiologically linked.
If there are more than 15 cases, it implies a progression of a small cluster or evolvement of multiple clusters. Less than 15 cases mean it is happening in a limited area and cases are epidemiologically linked, the Home Ministry said.
The perimeter of mapped clusters are facilitated by existing geographic boundaries like roads, rivers, etc, and established clear entry and exit points. Only one or two arterial roads into the containment zone will be kept open for essential services. All roads connecting the containment zone will be guarded by police or volunteers.
There will be no unchecked outward movement except for essential services, there will be no unchecked influx of population into the containment zone too.
All vehicular movement, public transport and personnel movement will be restricted. Details of people moving out of perimeter will be recorded and followed up with the Integrated Disease Surveillance Program (IDSP), it said.
The perimeter control operations for the clusters and large outbreaks remain the same except for the enhanced scale of arrangements for large outbreaks.
Districts with a doubling rate in less than 4 days (calculated every Monday for last 7 days), will have to be determined by the state government.
Specific activities inside the COVID-19 containment and buffer zones include active surveillance by Anganwadi workers, ANMs, NSS, Nehru Yuvak Kendra etc., through the house to house visits, increased testing etc.
As on April 14, a total of 207 districts have reported cases and could be potential hotspots.
Preemptive action for cluster containment is to be initiated in all these districts while clear delineation of containment zone and buffer zone will be done in these districts, the Ministry said.
Besides, contact tracing and surveillance, laboratory testing will be done as per protocol. The clinical management of positive cases will be undertaken and also effective community engagement will be ensured by the authorities.
The government has also adopted a cluster containment policy in non-hotspot districts. As on Tuesday, 353 districts in the country, out of about 730, have not yet been affected These districts needs to be under enhanced surveillance for Influenza-like illness (ILI) and SARI symptoms and such cases will be tested, it said.
The buffer zone is an area where new cases are more likely to appear. Thus, the health institutions, including private institutions, should be aware of the signs and symptoms, the Ministry said.
For the surveillance, active cases are being searched through the house-to-house visit, designated health workers are also visiting on an average of 50 households. ASHAs, Anganwadi workers and ANMs and additional workforce from Red Cross, NSS, NYK, and Ayush students are being engaged.
Those who will be tested include people who have all symptoms and have undertaken international travel in last 14 days, all symptomatic contacts of lab-confirmed cases, all symptomatic health care workers, all patients with SARI (fever and cough or shortness of breath).
Asymptomatic direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his or her contact. The surveillance and testing activity remains the same for clusters and large outbreaks, the statement said.