Most of the states lack both – their coffers are empty, and they may not have sufficient expertise to handle the emerging situation. The Centre’s suggestions are akin to suggesting that a person with a broken leg run a marathon.
The Centre, therefore, must come out with sufficient finance to support the states along with all help required to successfully handle the situation. For one, the Rural Health Mission should be immediately strengthened not only by suggestions but with funds and expertise.
The Centre, in its guidelines, has advised that peri-urban and rural areas plan a minimum 30-bed COVID Care Centre (CCC) for asymptomatic cases with co-morbidities or mild cases where home isolation is not feasible. It suggested providing Rapid Antigen Test (RAT) kits at all public health facilities including sub-centres, health and wellness centres, and primary health centres.
It has also suggested that CCCs can admit a suspect or confirmed case but should have separate areas for suspected and confirmed cases with preferably separate entry and exit for each.
Even if the suggestions are carried out on the ground level, these would prove too little, given the faster spread of infection. The government therefore must be ready with other supporting plans to augment the facilities in a very short period of time if required.
In every village, there should be surveillance mechanism in place, not only for tracking, identifying, and treating the patients but also for other public health and administrative issues. The guidelines have suggested that active surveillance should be done for influenza-like illness and severe acute respiratory infections periodically by ASHA and Anganwadi workers with the help of Village Health Sanitation and Nutrition Committees, but it is only the health aspect of the issue.
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