Starting early gave Chhattisgarh a head start in tackling COVID-19 outbreak: State Health Minister

Approaching each family to record travel history and symptoms bolstered efforts, says T.S. Singh Deo

Updated - April 08, 2020 12:06 pm IST

Published - April 07, 2020 04:45 pm IST - Bhopal

T.S. Singh Deo

T.S. Singh Deo

With nine of its 10 patients having recovered from COVID-19 in just 20 days, Chhattisgarh is hogging the limelight for recording one of the best recovery rates in the country. Starting early helped, State Health and Family Welfare and Panchayat and Rural Development Minister T.S. Singh Deo tells in an interview to The Hindu . In addition, approaching each family to record travel history and symptoms if any bolstered efforts to quarantine more than 77,000 suspects. The way forward, he says, is random rapid antibody testing, attuning the State’s preparedness to the disease spread projections for India and extending the lockdown by 14 days at least.

What are the strategies that have worked so far in Chhattisgarh in its continuing efforts in containing the virus spread?

We started early. The day after the Republic Day celebrations on January 26, we set up a war room in Raipur and deployed rapid response task force in districts headed by the Collector. The war room meets daily to ensure the delivery of the protocol.

Once we had the rapid response teams going, we were able to put procedures in place, right from identifying places where people could be kept to being prepared for contact tracing, the most important measure in the absence of a much wider testing protocol. We were basically, so to say, groping in the dark.

Through these procedures, 77,847 people, who had possibly come in contact or travelled from outside, were home quarantined until April 6. In addition, 146 people were placed in government quarantine facilities.

Then we set up dedicated COVID-19 facilities. Each of the 26 districts was asked to put up an independent facility of 100 beds. There, no other treatment would take place. In hostels, you could keep asymptomatic patients but identified cases need a medical establishment. Five medical colleges with 200 beds each, so 1,000 beds. The Raipur medical college has 500 beds, civil hospital there has 100 beds, the AIIMS, which has been a source of great support and committed service provider, has 500. So, we have been able to identify 4,700 beds. And we have taken over a 500-bed private medical college, as a stand-by. In case we go beyond the bed limit, we may use this facility.

We set up verticals for various activities like the command centre, medical equipment supply, quarantine in home, facility quarantine, mobility and logistics support, media, data management, contact tracing, community tracing, hospital management and treatment, volunteer doctors, testing, training, planning and management. An IAS officer has been placed in charge of each vertical with a support team comprising related experts.

What would you majorly attribute the cure of almost all the patients in Chhattisgarh to?

One, their immune systems. And certainly they were looked after well by experts. But they were not serious enough to be put on the ventilator. It also meant we were lucky that all the 10 patients who came to us were the serious and not the very serious ones. They showed reducing viral count continuously.

Have you also roped in departments other than the health and ancillary ones to identify suspects who need to be quarantined? How did you go about identifying migrant workers from your and other States and support them?

The district Collector, who heads the response teams, can utilise the services of other departments, including the Panchayat. We have asked them to get forms filled by every villager mentioning symptoms and travel history. We have requested the urban development department to similarly reach out to every citizen, ideally. We are identifying people through mass mobilisation of the government machinery. As a result, we could reach such a huge quarantine figure. Officials will visit each family to procure information and will upload it on our IT system.

We are trying to set up an app too, where an individual’s movement could be traced up to say 50 metres. If they are moving away from their homes beyond that, we would be able to track their movement. All these measures may not be 100% in place, but we have tried to push this.

This has also helped in tracing the migrant labourers, who are actually engaged in reverse migration. Those stranded from other States here, we could arrange for their stay and food. We have tried to rope in self-help groups to provide food to the needy who don’t have an alternative.

How are you ensuring the lockdown continues in force? Have you employed any innovative means to ensure this?

We are encouraging home-based activities. Self-help groups have sold more than a crore face masks. Similarly, they are making soap and sanitiser. Through the MGNREGA, we are encouraging activities within a compound, say preparation of organic manure. These activities are remunerative and are not target-based. If people want to work under the MGNREGA outdoors, while maintaining social distance, we have allowed that too. Almost everywhere, especially people within villages, people have been very forthcoming in helping enforce the lockdown. They are very proactive in not allowing people to come in or go out.

We have allowed for farming to continue with farmers keeping social distance and taking harvest to the place of sale. There hasn’t been any vegetable shortage in urban areas. The poultry supply is also in place.

Several States have asked for a continuation of the lockdown, what is your view?

I feel that people have gotten used to the lockdown now and have gotten into the habit. We should take advantage of that and deal conservatively with the question of lifting the lockdown. Certainly borders between States should remain closed though activities within districts are going on to some extent. A conservative estimate and looking at expected spikes in cases, we must go for another 14 days of lockdown at least.

How do you view the Centre’s strategy in combating the COVID-19? Since Central agencies recently conducted raids in Raipur that the Chhattisgarh government strongly objected to, how has the coordination been on containing the disease spread?

There hasn’t been any purposeful lack of support. We are doing our thing, they are doing theirs. We are paying for almost everything, but they were trying to streamline the supply. I don’t think they would have taken the attitude of being stepmotherly in providing materials.

Where I have not been in agreement with the Centre was the screening protocol they adopted. We did not go in for a much stronger protocol for testing as widely as many other countries did. If South Korea was testing 4,000-6,000 people per million, we were testing three per million owing to our protocol. There was also a situation where even the U.K. was not on the testing protocol. In Chhattisgarh, five of 10 patients had returned from the U.K.

Because of such a protocol, we couldn’t go into production of either PPE kits or testing kits or other consumable. When the need came, the production was not pushed to that level. We should have been much more proactive in screening everyone coming from abroad.

How do you view the ICMR advisory to begin rapid antibody testing? Will that help in widening our testing capability?

Yes, It will broaden the testing. We will start random testing in Chhattisgarh, which we couldn’t do until now, once we procure rapid antibody testing kits. It will be indicating that now if you had the affliction, if you are negative, you’re beyond it. Which then gives you the corona cover of its not recurring.

Are you going to continue with the strategy already in place, or ramp up/alter efforts in the future?

At this point, we are focussed entirely on providing relief in medical facilities. Projections are that 20-60% of India’s population will be affected by the disease. Today we are taking a conservative projection of 10%. Of these, symptomatic patients would probably be 10%, of which those who would be serious and very serious would be 15% and 5% respectively. We are planning for the three crore people of Chhattisgarh with that figure in mind. We are building a protocol around that.

If the situation goes beyond the structures we have, there would be a limit. After government facilities, we would take over the private ones. In case there is a larger number, there could be a point where no additional facilities are available. Then we will go in for a protocol wherein those who are very serious would be given priority even the serious ones. We would go for ventilator stage patients first. We have mapped schools and hostels where the less serious ones could be kept for an eventuality I most fervently hope does not come.

The country and Chhattisgarh could have a limit when it comes to ventilators. As for PPEs, we have not had a good experience with the HLL, with which we had placed an order for 14,000 kits until March 16, but received only 2,000 kits so far. This is a result of the conservative protocol of the Centre. The message to the government of India’s subsidiary was don’t keep so much in stock, it won’t sell. Now, you are asking even car manufacturers to make ventilators. We are working backwards rather than having an anticipatory approach.

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