'Manipur not following ICMR guidelines'
Source: The Sangai Express

Imphal, October 18 2020: Manipur is 'not following' the latest ICMR (Indian Council of Medical Research) even as it is facing rapid surge in the number of deaths and COVID-19 positive cases, said the group of eight doctors and health experts who had predicted community transmission some time back.

If the present trend of surge continues, the experts said there will be 500/600 new patients per day by the end of the year.

It may be noted that the group of eight doctors had been vocal on the COVID-19 issue and they had condemned the State about its 'faulty' policies.

Earlier, they had predicted rapid rise in the number of cases and suggested ways to flatten the virus infection/transmission curve.

Asserting the State was in the early stage of community transmission in August first week, they had urged the State to declare and make public the status of community transmission for awareness in early September.

In a statement, the doctors alleged that the State is 'not following' the latest ICMR advisory.

Stressing that everybody should know the latest ICMR advisory in order to avoid any confusion, the doctors also claimed that private hospitals are charging double the amount for Rapid Antigen Test when compared to other States.

Explaining the latest ICMR advisory, the doctors said, allowing COVID-19 test on demand means if anyone wants to test for COVID-19, it can't be denied.

The individual has, however, to bear the expenses.

"Now private hospitals are charging about Rs 800 for Rapid Antigen Test i.e.almost double the amount when compared with other States." Hence, the rate of the test in private hospitals should be regulated, they said.

As per the ICMR advisory, all persons in containment zones should be tested by Rapid Antigen Test.

There is no testing of all persons in the containment zones in Manipur.

Even containment zones are not declared properly here, the doctors said adding they have been demanding testing of all persons in the containment zones since August 9 .

Rapid Antigen Test is the first priority at both containment and non-containment zones followed by RT-PCR test.

It (ICMR advisory), however, does not clarify when to do the second test.

"It also mentions all asymptomatic health workers and frontline workers should be tested.

We have been recommending the same for weekly testing," they said.

For hospital settings, RT-PCR test should be done first, followed by Rapid Antigen Test.

Once confirmed +ve, no further test is to be done to reconfirm it.

Repeat the test again for patients exhibiting symptoms after testing –ve.

For non-emergency/selective operations, stay 15 day quarantine at home before operation.

Regarding the infection curve in Manipur, the doctors said the State had 3,542 civilian active cases from September 29 to October 15.Out of this, 3,465 (98 per cent) were community transmission cases, they claimed.

Between June and July, the daily positive cases detected was around 50 per day.

From last week of July to second week of September, there were 100-150 cases per day meaning there was a 3 fold increase.

Further, between the second week of September and October 15, there were 200-300 cases per day ie 5/6 fold increase since June.

This is a worrying sign indeed.

If the present trend continues, there will be 500/600 new patients per day by the end of the year, they said.

Urging the State to ramp up its measures and strictly follow the ICMR advisory, the doctors reiterated that their suggestions be considered by the health authority to prevent further community spread in Manipur.

Listing their suggestions, the doctors said there should be no home quarantine & no home treatment for the poor as they lack facilities.

Stating it is also against the ICMR guidelines, the doctors claimed that the major cause for spread of the disease in Manipur is home quarantine lacking proper facilities.

Further, all COVID-19 positive persons should be kept at QCs (quarantine centres) and undergo 2 (two) tests, one week apart, during the 14-day quarantine period.

Even if only one person is found COVID-19 +ve in a community, the whole community area should be declared a quarantine zone (QZ) and conduct 2 (two) times total survey and testing of all inhabitants, one week apart.

Two times survey and two times testing of all persons in QZs and QCs are a must to avoid cross infection, spread of the disease from asymptomatic patients and to avoid false –ve test results.

All health workers and frontline workers should be tested 3 times free of costs, 10 days apart in a month (better option is weekly testing) .

Mild +ve cases can be treated in QCs if hospital beds are not available.

Hydroxychloroquine (HCQ) Prophylaxis tablet in the dosage prescribed by the ICMR guidelines should be given to all frontline health workers, police personnel and other volunteers including media.

Strict enforcement of mask use, 6 feet physical distancing, frequent hand washing, avoiding crowded places etc be implemented vigorously along with strict penalty.

Randomised Sero-Surveillance (Active Community Survey) consisting 10% of sample population of Imphal West, Imphal East, Thoubal and Kangpokpi districts to find out the extent of community spread. The eight doctors and public health specialists include Dr Th Suresh Singh, former Director Health; Dr Sh Shurchandra Sharma, Pathologist & former Director Health; Dr L Shantikumar Singh, retired Professor, Community Medicine, JNIMS; Dr S Sukumar Singh, retired CMO; Dr Ibochou Singh, retired State Malaria Officer and WHO programme specialist; Dr Ak Khamba, retired State TB Officer and Public Health Specialist; Dr H Priyokumar Singh, retired District AIDS Officer & Public Health Specialist and Dr AS Felix Khating, retired District AIDS Officer & Public Health Specialist.

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