COVID’s ingress is now being seen in peri-urban, rural and tribal areas as well, the Health Ministry admitted on Sunday, weeks after a rising number of cases have been reported from rural areas of Uttar Pradesh, Bihar and Gujarat among other States.
The Ministry in its document “SOP on COVID-19 Containment and Management in Peri-urban, Rural and Tribal areas” said there is a need to enable communities, strengthen primary level healthcare infrastructure at all levels to intensify COVID-19 response in these new areas, while continuing to provide other essential health services.
The Ministry said with the larger spread of COVID-19 cases, it is important to ensure that these areas are equipped and oriented to manage COVID-19 cases.
“In every village, active surveillance should be done for influenza-like illness/ severe acute respiratory infections(ILI/SARI) periodically by health workers,” noted the Ministry in its latest SOP.
The Ministry said that depending upon the intensity of surge and number of cases, as far as feasible, contact tracing should be done as per Integrated Disease Surveillance Programme’s (IDSP’s) guidelines for contact tracing of COVID-19 cases in community settings amid reports of several bodies of suspected COVID-19 victims having been found abandoned and floating in the Ganga.
It added that symptomatic cases can be triaged at village level by tele-consultation with Community Health Officer (CHO), and cases with comorbidity/low oxygen saturation should be sent to higher centres.
Also every sub-centre should run an ILI/SARI OPD for a dedicated time slots/days and identified suspected COVID cases should link for testing to the health facilities either through COVID-19 rapid antigen testing or by referral of samples to nearest COVID-19 testing laboratory, in accordance with ICMR guidelines.
The Ministry has also directed that staff should be trained in performing Rapid Antigen Testing (RAT) and that provision for RAT kits should be made at all public health facilities including sub-centres (SCs)/ Health and Wellness Centres (HWCs) and Primary Health Centres (PHCs). These patients should also be counselled to isolate themselves till test results are available.
“Those asymptomatic but having history of high-risk exposure to COVID patients (exposure of more than 15 mins without a mask within 6 feet distance) should be advised quarantine and tested as per ICMR protocol,” notes the Ministry.
The document further notes that on discharge, patients should be counselled for post-COVID management at home and leaflets regarding danger signs (e.g. breathlessness, chest pain, recurrence of fever, low oxygen saturation, etc.), precautions and various respiratory exercises.
“Patients with other co-morbidities should also be followed up and primary assessment of other co-morbidity (e.g. measuring blood pressure, blood glucose level) should be arranged and any modification treatment if necessary should be decided by a primary health centre medical officer,” says the document.
The Ministry has advocated for use of telemedicine services for providing post-COVID follow-up care.
Giving of the support pillar needed the Ministry said that major tasks will include preventive measures for the control of pandemic, help in surveillance activities, support quarantine and isolation facilities, availability of items of daily needs including food items and ensure continued provision of essential health services including referral transport.