Rope in AIIMS docs, suggest group of doctors
Source: The Sangai Express

Imphal, November 14 2020: With mounting COVID-19 deaths, it is time for the Government to call AIIMS specialists for at least 2 days orientation course of State doctors, said a group of eight doctors today.

In a statement today, the doctors lauded Chief Minister N Biren for taking up three commendable works-keeping Health portfolio under him, appointing Dr Ranjan as Advisor (Health) to CM and appointing one doctor as State Mission Director, National Health Mission.

This, the doctors said, will bring cohesiveness and long overdue policy changes.

"We are of the view that the Secretariat Health Department and Medical Directorate require an overhauling to bring an effective strategy specially in our fight against COVID-19," they said: As far as COVID-19 is concerned, on the negative side, the tiny State (Manipur) is having average 200-350 new cases (almost all community transmission) during the last one month, the doctors said adding they expect more infections in the coming days as a result of the by-elections, Ningol Chakkouba festival and winter season.

Like in European countries, the virus strives in winter and in Delhi because of the pollution which is an additional factor.

Manipur also continues to have the highest active ratio case (percentage of active case out of total caseload) competing with Kerala, Himachal Pradesh and Mizoram for first 4 spots in the range of 15-18.50% .

National average is 5.63% .

Imphal West and Imphal East may be grouped as 1 st category and Thoubal, Bishnupur and Tamenglong may be grouped as 2nd category and identified as problematic areas.

2-5 deaths per day (highest 9) is also a cause for much concern and worry; hence, the need to call AIIMS specialists for a 2 day orientation course of State doctors, they said.

On the positive side, the recovery rate is good as it is in the range of 80-85% .

However, this is below the National average of 92-93% .

"Also, luckily, we are in the early or mild stage of community transmission and not yet down to moderate and severe form of community transmission.

With around 2,900 active cases, we should not be panicky, rather we should strategise our own, strengthen monitoring and evaluation exercise and re-strategise again and again," they said.

They repeated their recommendations, that the 'control strategy' should ensure that the CC observation centres shall have separate wings for COVID-19 +ve and -ve persons and 2 times testing shall be done one week apart.

Containment zones should be declared with strict follow up measures and total survey and two times testing of all persons in the area.

There should be no home isolation and home treatment for those not having proper facilities-separate room, separate bathroom, hand washing facility, 24 hr water supply, proper dustbin/disposal, temperature/BP recording, 24 hr medical staff supervision etc.

"We are of the view that this home isolation and treatment is the major cause of spread of coronavirus here, hence, it be discarded soon.

Home isolation & treatment without these facilities and not doing total population surveys in containment zones are also against ICMR guidelines," they said.

The doctors reiterated that there is no need for constructing a separate hospital and instead the funds should be utilised in revamping existing infrastructure and aid fight the pandemic.

Instead of constructing a separate hospital, the 100-bedded TB Hospital at Keirao Wangkhem may be converted as a Covid hospital and strengthen other hospitals whenever required.

Covid beds reserved at the two medical colleges and private hospitals should be increased.

With around 3,000 active cases, only 20% require hospitalisation and about 5% severe cases require ventilation support.

This means only 600 beds are required presently, out of these, only 1:50 beds are required in ICU with ventilators and other critical supports.

Remaining 80% mild cases may be kept at Covid care treatment centres.

The CCCs should be divided as mild/asymptomatic treatment centres and observation centres category-wise.

Enough beds are available for this.

This should be planned for district-wise implementation, the doctors said.

On preventive measures, they said information, education and communication (IEC) are the 3 pillars of disease prevention.

Mask use, physical distancing of 6 feet apart, frequent hand washing and avoiding crowded places, regular orientation of medical staff along with local NGOs at hospitals, CHCs, PHCs & Sub-centres and strict implementation of SOPs with heavy fines are necessary.

The State requires more and more testing to know the extent of +ve cases in the population.

Sero-surveillance should be done by random method consisting 10% of population as sample size.

All India finding and other independent State-wise surveys have shown that one in every four persons is +ve meaning 25% of population are asymptomatic carriers of COVID-19.JNIMS and RIMS may be opened forthwith without any hitch with Covid & non-Covid OPDs separately.

The same is done in AIIMS and other medical colleges of India.

"We see no rationale in restricting OPDs.

In fact, by doing so, we are doing a favour to private hospitals," the doctors said.

The group of eight doctors include, Dr Th Suresh Singh, ex-Director Health, Dr Sh Shurchandra Sharma, Pathologist & ex-Director Health, Dr L Shantikumar Singh, retired Professor, Community Medicine, JNIMS, Dr S Sukumar Singh, retired CMO, Dr Ibochou Singh, retired State Malaria Officer, Dr Ak Khamba, retired State TB Officer, Dr H Priyokumar Singh, retired District AIDS Officer and Dr AS Felix Khating, retired District AIDS Officer.

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