The 11 municipal areas are from the following States/UTs: Maharashtra, Tamil Nadu, Gujarat, Delhi, Madhya Pradesh, West Bengal, Rajasthan and account for 70 per cent of India’s active case load
Preeti Sudan, Health Secretary and Rajesh Bhushan, OSD, MoH&FW along with senior officers of the Health Ministry held a high level review meeting (through video conference) with the health secretaries, urban development secretaries, municipal commissioners, Mission Directors (NHM) and other officials from the 11 municipal areas which have high case load of Covid-19, here in New Delhi. Kamran Rizvi, Additional Secretary, MoHUA also participated in the VC.
These 11 municipal areas are from the following States/UTs: Maharashtra, Tamil Nadu, Gujarat, Delhi, Madhya Pradesh, West Bengal, Rajasthan and account for 70 per cent of India’s active case load.
A presentation was made to highlight the trend in case trajectory with respect to total confirmed cases, case fatality rate, doubling time, tests per million and confirmation percentage. It was told that the major challenge lies in those corporations having shorter doubling time, higher mortality rate and a higher confirmation rate than the national average. They were briefed about the factors to be considered while mapping the containment and buffer zones; the activities mandated in containment zone like perimeter control, active search for cases through house to house surveillance, contact tracing, testing protocol, clinical management of the active cases; surveillance activities in the buffer zone like monitoring of SARI/ILI cases, ensuring social distancing, promoting hand hygiene etc. Maintaining high vigilance and monitoring in areas of old cities, urban slums and other high density pockets along with the camps/clusters for migrant workers are important steps in COVID-19 management in the urban areas.
It was pointed out that the focus needs to be on prevention through active screening of high risk and vulnerable population and groups, and effective and sturdy clinical management of the admitted cases to reduce fatality rate. While many have operationalised 24×7 state control rooms, others could also follow the lead and start such units which shall not only provide assistance to the people for various facilities/services regarding COVID-19 management, but also have a panel of domain experts and doctors to provide round the clock support and mentoring for clinical issues which shall effectively contribute to reducing fatality rate.
It was pointed out that testing needs to be stepped up in some municipal areas to ensure early detection of cases, timely clinical management and a reduction in fatality rate. They also need to be mindful of ramping up the health infrastructure to ensure preparedness for the next two months with special focus on isolation beds with oxygen, ventilators and ICU beds. Other issues that need focussed attention include active coordination with government and private labs to address delays in sample collection, partnership with private hospitals to augment the health/bed capacity, waste disposal and disinfection of COVID positive areas, management of camps for migrant labourers, creating awareness regarding issues such as stigmatization of patients and medical professionals in local languages, actively involving community leaders, youth groups, NGOs and SHGs in accompanying surveillance teams for awareness and confidence building measures.
The measures taken and best practices followed by the municipal corporations for the management of COVID-19 cases were also discussed. Mumbai Municipal Commissioner briefed about establishing close cooperation between private hospitals and municipal authorities to pool the health infrastructure like ICU beds/ oxygen beds etc. They shall also soon make public the online portal displaying the bed availability with unique ID numbers for each bed, and also set up a GPS backed online ambulance tracking system. Indore authorities have focussed on contact tracing, and active house-to-house survey. They have formed ‘gully patrolling teams’ which include community volunteers and retired government officials helping the special surveillance teams in containment zones to improve confidence building measures, active surveillance, and provisioning of essential items.
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