Modify ICMR's SOPs to our needs: Go8Ds
Source: The Sangai Express
Imphal, October 22 2020:
The COVID-19 SOPs issued by the ICMR should be modified according to "our need" and strategised to effectively control the COVID-19 pandemic, said the Group of Eights Doctors (Go8Ds) and health experts, who have been vocal on the COVID-19 issues in the State.
Calling on Chief Minister's Advisor, MLA Dr S Ranjan Singh yesterday at his residence, representatives of the group of doctors discussed the prevailing COVID-19 situation and presented their suggestions for consideration.
The representatives namely, Dr Th Suresh Singh, ex-Director Health, Dr Sh Shurchandra Sharma, ex-Director Health, Dr Ibochou Singh, retired State Malaria Officer and Dr AK Khamba, retired State TB Officer apprised the MLA on the need of the hour and suggested action plans to effectively control the disease, said a statement the group of doctors released today.
The health experts said they sought the attention of the CM's advisor to the point that the major cause of the spread of the virus is home isolation for the poor.
Home isolation and treatment of the poor is a major cause of corona spread presently as they lack facilities like separate bathroom, tap water with sink, proper sanitary dustbin etc.
In the absence of these facilities, the patient goes on to spread the virus to his/her family members, and family members to the local community and afterwards to the general public.
Hence, this practice must be stopped forthwith and these mild cases be isolated and treated in a separate designated QCs, said the experts.
Regarding contact survey, they explained it was effective in the early stage.
However, they asserted that it is not being followed properly now as it takes days for testing and results to come back.
This further led to spread of the disease to the locality and then to the community.
They claimed this (contact tracing) is an outdated model now.
In any +ve area, the area should be clearly demarcated and declared as a containment zone for 14 days.
During the 14 days period, 2 times "total population survey" and testing should be done one week apart.
The ICMR also has approved this in its latest advisory it released on September 4, however it doesn't mention 2 times testing, they said.
Regarding 2 times testing and 2 times survey, they explained to the CM's advisor that the RT-PCR test gives 100% +ve result during 5-7 days of 1st appearance of symptoms, then declines gradually as time lapses.
For Rapid Antigen test, it gives false -ve test in 20-30% of cases.
Hence, there is a need for 2 times testing and survey in QCs & QZs to avoid this false -ve result and prevent cross infection and infection from asymptomatic carriers.
For all health workers and frontline workers including police and media personnel, 3 times testing, 10 days apart in a month should be done free of costs by the Government to prevent further community spread.
It is becoming urgent now in view of increasing number of +ve cases among the health staff, police and voluntary workers engaged in COVID care.
Further, Randomised Sero-Surveillance (Active Community Survey) consisting 10% of sample population of Imphal West, Imphal East, Thoubal & Kangpokpi districts should be done to find out the extent of community spread.
Regarding institutional facilities, they explained that the State has "enough" facilities and "there is no need for new construction.
It is a simple wastage of money and time now," they said.
"What is lacking is proper planning and mapping.
We should convert 100 bedded TB Hospital at Keirao Wangkhem to an exclusive corona hospital.
Besides this, we have 400 beds at City Convention Centre, Palace Compound, 100 or so each at UNNACO School and Khuman Lampak Sports Complex.
Besides this, � strength of RIMS (1176 beds) & JNIMS (657 beds) may be reserved for corona patients.
The 2 colleges should have corona OPD and a non-corona OPD with these exclusive beds as done in AIIMS and many hospitals of other States," they presented to the advisor.
Similarly, there are 200 beds at CCpur and Thoubal District Hospital and 50 beds in other districts and about 30 beds each in about 20 CHCs and some in about 85 PHCs.
Half of these beds can be reserved for COVID, they said.
In addition, there are QCs - Government and voluntary.
The private hospitals may be asked to reserve 30% of their beds.
This can be increased as situation demands.
If further beds are required, facilities at Khuman Lampak Sports Complex may be used and avoid overstretching other institutions/hospitals.
This way, normal functioning of OPDs in all hospitals, including the two medical colleges may also be started soon, they said.
"There is no need for new construction.
It will be a simple wastage of time and money," they said.
"..our institutions are overstretched.
Instead, we should spend our scarce resources for purchase of necessary equipment-ventilators, testing kits, PPEs and medicines etc.
Lack of testing kits is another area which needs immediate solution," they told Dr Ranjan.
Regarding basic preventive measures of mask use, 6 feet physical distancing, frequent hand washing, avoiding crowded places etc, they urged Dr Ranjan to implement the SOPs vigorously along with a strict penalty of maximum Rs 10,000 "as public is neglecting it now with casual care".
"We have to enforce it at any cost.
TV channels and newspapers may also be requested to contribute to this, daily free of cost, in public interest," they said.
"The ICMR/GOI releases the COVID-19 advisory, but the States are given free hands to modify as per their needs.
We should take good ones and formulate our own.
It is here that we have completely failed to strategise our own.
We also feel there is some lack of expertise in the Medical Department regarding devising the strategy.
"A complete lockdown is not required at all and is not the solution.
Instead, effective lockdown of the containment zones and effective implementation of the preventive measures as suggested is the solution," they said urging Dr Ranjan to bring their suggestions to the Chief Minister for consideration.
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