Mobile collection of samples with online booking of slots to arrest the trend of serpentine queues of people awaiting testing, a designated officer from Directorate of Public Health to monitor daily admissions, discharge, billing issues, etc., in all hospitals and a central dashboard with bed availability linked through these liaison officers providing real-time data and solutions are the need of the hour, say public health experts.
The government should also reinforce the 5Ts — Tracing, Tracking, Testing, Treating supported by adequate Training, and skilling of health staff.
“The 5Ts cannot be sacrificed even if it increases the work load on the public health system. Even if three contacts can be traced out of five possible, it will significantly reduce further spread,” asserted Indian Institute of Public Health (IIPH)-Hyderabad director G.V.S. Murthy on Tuesday.
Hospitalisation risks
Mobile collection of samples will prevent “intermixing of infected and non-infected patients for more than 15 minutes in close proximity” as this can spread transmission, he said, adding that unnecessary hospitalisation should be avoided. It is because hospital stay itself increases risk of other infections by 10-20%. Mild cases should go for home isolation with a dedicated tele-consultation portal and a 24/7 helpline to support.
Mobile team of doctors and nurses should visit such people at least twice a week, keep an eye on worsening symptoms and decide when they should be provided priority admission by referral through the team, advised Dr. Murthy.
He pointed out that the case load in Telangana, especially Hyderabad, continues to rise with ‘real time production’ (Rt) being >1 till August 2 and dropping to <1 from August 5. “If Rt is consistently < 1 for 7 days, it will indicate the peak infection load in the present wave has passed. Hence, government will need to see that no big new influx of cases occurs as that may alter the situation once again,” he cautioned.
Despite the increasing case load, COVID related mortality seems to be on the lower side with 2.71 average daily new deaths in the week ending May 24 May to 11.5 in the week ending Aug.1 (4.2 times increase compared to a 16 times increase in cases) and to 12.5 by August 5 with dramatic reduction of cases in GHMC area.
From 80% till July first week, it is only 27.3% new cases this month. Average daily new cases computed at weekly intervals reached a peak of 1,159 till July 5 and has steadily decreased thereafter to 765 till July 19, 650 till July 26 and 540 till August 1 to 532 on August 5.
Dip in cases
“Positive news is the dip in new infections in GHMC area which could be due to either a large number of people infected so that the virus is not finding enough susceptible people to pounce on. Or else, it could be that people are not being ‘naughty’ and not gathering in large groups clandestinely. Only means of knowing is by sero-surveillance of random testing of people for presence of circulating anti-bodies,” he said.
The worrisome part, however, is that the pandemic has spread to other districts which needs urgent attention. A two-pronged attack with community-led efforts of residential welfare associations and village panchayats can augment the success of a government-led initiative. The 5Ps — protective gear use, personal hygiene, prevent ‘naughty behaviour’, physical distance and peer support — instead of stigma should be diligently pursued, he added.