To handle COVID-19 pandemic...List of suggestions highlighted
Source: The Sangai Express

Imphal, October 19 2020: Several organisations including the Peoples Task Force for COVID-19 (PTFC-19), Indian Red Cross Society (IRCS), Manipur State Branch, Association of HealthCare Providers of India (AHPI), Manipur Chapter and Indian Medical Association (IMA), Manipur State Branch submitted a number of recommendations to the Government to consider in handling the COVID-19 pandemic in the State.

The recommendations they submitted to the Chief Minister today were arrived at a one day academic discourse on COVID-19 pandemic held at IMA Auditorium, Lamphelpat on October 11, said a joint statement of the organisations listing the recommendations they submitted.

General Recommendations
1) At present the single overarching objective should be to reduce both COVID as well as non-COVID mortality.

Three broad strategies need to be emphasized to achieve this objective a) Strengthening the existing hospital facility
b) Reduction in the rate of infection (through surveillance activities and ensuring hygienic practices) and
c) Provision of non-COVID essential health care services.

2) SOPs that have been issued should be made to follow religiously.

Violators need to be punished as per law without exception as far as possible.

It should be made available in the public domain by various means - website, publication in newspapers, discussions on electronic media, etc.

SOPs should be dynamic and customized to the local context as far as possible.

3) Small sub-committees for various activities to fight against COVID-19 with subject experts may be constituted so that the Government may be better advised on all aspects of COVID-19 control activity.

4) COVID-19 control activities must be State or district specific as done in a few other States to give better results.

Area specific recommendations
1) With the expected rise in the number of COVID-19 infected persons, there is a need to prepare the hospitals to reduce mortality.

Once the number of COVID-19 infected persons goes beyond the capacity of health care facilities, deaths will increase disproportionately.

a) Increase the number of beds to meet the increasing COVID-19 infected persons (moderate to severely infected patients) .

b) Increase the number of beds in hospitals with continuous high flow oxygen facility as many of the infected persons will be in this category.

Private hospitals may be engaged for this purpose.

c) Increase the number of ICU beds so that available ventilators can be fully utilised.

Private hospitals may also be engaged for this purpose.

d) A dedicated COVID-19 Hospital with adequate equipment and facility be constructed as soon as possible.

Human resources may be mobilized accordingly; even private sectors may be invited.

2) Provision of non-COVID essential health care services as per WHO/Government of India prescription should be started soon in order to curb the excess death during COVID-19 pandemic.

3) Reducing the rate of infection thereby preventing overwhelming the health care facilities with COVID-19 infected persons, the two most important strategies - Surveillance activities and ensuring public adherence to healthy/hygienic practices need to be pursued fervently.

a) Surveillance activities
i) There should not be any compromise to the time tested strategy of and treat (quarantine or isolate).

It should be strengthened with adequate manpower and logistic support.

ii) Testing of all close and primary contacts should be done.

iii) All returnees to the State may be tested at the point of entry to ensure comprehensive testing, "as many are avoiding the test" .

iv) Since most of the tests are done with RAT, which may lead to releasing 30-40% persons carrying the virus to the community, home quarantine must be ensured.

v) SOPs for testing should be adhered to strictly.

Violators should be punished.

vi) Home isolation teams should be strengthened to enable them for proper monitoring.

Home isolation kits including IEC leaflets (Dos &Don'ts) should be supplied.

vii) Logistic support for transport of persons infected with COVID-19 from home to health facilities should be strengthened.

More ambulances should be made available.

viii) PTF (Peoples Task Force) volunteers may be engaged to support the State initiative in contact tracing, testing of suspected cases and monitoring of some Home Quarantine/Isolation by augmenting the efforts of the State Government.

b) Ensuring public adherence to hygienic practices
i) Peoples Task Force for COVID-19 in collaboration with IRCS, IMA-MSB and AHPI-Manipur Chapter had conducted about 200 programmes since August 7, while earlier IRCS on its own had conducted another 200 but the reach is still small covering only about 0.60% of the population and 3% households.

The public must participate in the combat against the disease and their contribution shall be in full understanding and following the SOPs for which awareness programs are essential.

These IEC and public engagement activities need to be supported and expanded.

ii) State Government through the Health Department should bring out regular updates to the public through press conferences, live interactions (at least fortnightly) .

4) Since RAT testing is of low sensitivity leading to false negative tested persons mixing with the general population, the Government may reconsider RT-PCR to be the main testing strategy for the State till a newer test (like FELUDA) comes up.

5) To help and enhance the COVID-19 control efforts, a sub-committee on data analysis and projection may be formed consisting of a representative from the Health Department, Dr S Shantikumar (MU), Dr H Nabakishore (AHPI) and Dr Christina Soubam from Community Medicine Department, RIMS.

They may help in analysing Manipur specific data and in projections to help the authority in making policy and planning. 6) To understand the dimension of the spread of the disease in the State, regular sero-surveillance using antibody tests may be carried out as is done in other States.

Further, based on the policy of the Centre on vaccination, once a vaccine is approved, the State may in advance work out the system for conducting vaccination based on priority.

7) To review the opening of the markets policy to ensure economic activities while controlling the transmission.

The recommendation submitted was signed by Dr Y Mohen, chairman, IRCS, Manipur State Branch; Dr Kh Palin, president AHPI, Manipur Chapter; Dr Shyamkumar Laishram, president, IMA, Manipur State Branch and BK Moirangcha, convenor PTFC-19 .

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