With the COVID-19 cases considerably reducing in this devastating second wave, public health experts want the governments to continue to restrict mass gathering of people for any activity, be it political, religious or social, till the end of the year. Only a small number of people should be allowed at a time for events that cannot be postponed, they suggest.
Further, all international travellers should be subjected to quarantine for 14 days and at the end of this period, all members of the household and neighbouring houses should be tested, advocates Indian Institute of Public Health (IIPH)-Hyderabad director G.V.S. Murthy, in an exclusive interaction.
“A global systematic review conducted recently showed that early initiation of quarantine, large scale screening, strong contact tracing systems and isolation of cases as a combined strategy is the most effective in combating COVID. If the screening coverage is low and isolation facilities are scarce, 75% of asymptomatic cases and mild symptomatic cases will be missed. This will be catastrophic,” he warns, urging the governments and citizens not to let their guard down.
Fever and severe acute respiratory infections surveys can help along with testing in early detection. Here again, community volunteers can be trained to support health staff. Nursing, pharmacy, medical social work, physiotherapy students and dental students can also be provided a brief orientation to conduct these services. Instead of physical forms, each team conducting a fever survey can be provided a tablet for uploading data to a cloud server, he suggested.
The director, had worked with World Health Organisation-Geneva, on the ‘Childhood Blindness Program’ and was a UNAIDS Consultant with National Aids Control Organization where he guided and monitored the first ‘Behavioural Surveillance Survey’ facilitating the development of the first ‘Computerised Monitoring Information System’ for the National AIDS Control Program.
“Speed is of essence in reducing the transmission. Contact tracing is critical. Residential Welfare Associations and colony committees should be roped in to help in contact tracing of their colonies so that there is less pressure on the already stressed health human resource,” he said.
Dr. Murthy affirmed that virus transmission can only be reduced by healthy behaviour in the hands of the people and vaccination by the government. “There is no other mantra to reduce transmission at this stage. These measures have been successful for respiratory infections like flu in the past and are equally relevant today,” he said.
Testing/isolation
The public health expert also called for increasing testing facilities at the primary health care centres, community health care centres and the district hospitals supported by mobile testing units so that there is a penetration of testing into the rural areas to control the virus spread.
Testing rate per million population has dropped from 100,900 during the first wave to 95,212 in the second wave from March 2021 till date. “Early detection at the sub-district levels is critical. Medical officers at PHC and CHC should be trained and provided adequate support including personal protection kits to function effectively,” he said, adding that isolation facilities should be created and teams for responding timely needs to be trained.
“Infrastructure needs to be ramped up at this level, including oxygen beds and assured oxygen supplies. At this level, oxygen cylinders and at least two BIPAP machines per CHC should be provided. This will also reduce pressure on Hyderabad,” he stated.
