As India battles Covid-19, the centre is placing under scanner the two western states of Maharashtra and Gujarat which have an unusually high number of infections. Health minister Dr. Harsh Vardhan has held a meeting with Nitinbhai Patel, deputy chief minister and health minister of Gujarat, and Rajesh Tope, health minister of Maharashtra to review the situation, actions being taken and preparedness for management of the pandemic.

Union minister of state for health Ashwini Kumar Choubey and senior officials from both centre and the two states joined Wednesday’s video conference.

After a brief presentation on the status of Covid-19 cases in the states and its management, expressing concern regarding the high fatality rate in some districts, Dr. Harsh Vardhan stated, “States need to focus on more effective surveillance, contact tracing and early diagnosis to reduce high fatality rate. Proper interventions, screening and testing of Severe Acute Respiratory Infections (SARI) / Influenza Like Illness (ILI) cases need adequate attention as this may prevent spread of infection in other areas. Implementation of effective containment strategy needs be on the top priority of the States to reduce the mortality rate. It is the need of the hour to take preventive, pre-emptive and comprehensive measures in a systematic manner and follow the protocols laid down by the Centre to prevent occurrence of fresh cases.”

It was pointed out that in some cases the patients either suppressed the information of their infection or reported late to the hospitals for treatment which may be indicative of some fear or stigma associated with Covid-19, Dr. Harsh Vardhan exhorted the states to focus on Behaviour Change Communication (BCC) among the people to address the stigma associated with community discrimination and ostracization in the community more effectively. This shall also lead to people reporting early for diagnosis and treatment, he stated. 
 
He also suggested that along with the surveillance teams in the containment areas, community volunteers may also be identified at the ward-level to spread awareness about the preventive measures like hand washing, physical distancing etc., and who can also play an effective role in removing the stigma prevailing in the society. Some districts such as Aurangabad and Pune have done this.

“The ministry would provide full support and handholding to the state governments through National Health Mission (NHM) for health systems strengthening as part of the immediate and long-term measures,” Dr. Harsh Vardhan stated. Appreciating the move by some districts where the high risk population, including the elderly and those with non-communicable diseases such as diabetes and hypertension, were identified and provided focused treatment, he urged the states to ensure that persons aged more than 65 years along with those having any non-communicable diseases are screened on priority in the Ayushman Bharat-Health & Wellness Centres. He also pointed out that in compliance of the Guidelines already issued by the centre, non-Covid essential health services (such as ANCs of pregnant women, immunisation drives, TB case finding and treatment, providing blood transfusion for dialysis patients, treatment of cancer patients etc.) should not be neglected. He suggested that the data available with the States on Health Management Information System (HMIS) for various diseases may be optimally utilised for risk profiling.

Dr. Harsh Vardhan also assured that additional teams comprising of officials from the centre will also deployed in the states as per their request. He also informed that the states may also take advantage from the support offered by AIIMS, Delhi for treatment guidance and clinical management of Covid-19 patients through the National Teleconsultation Centre (CoNTeC), where doctors/Specialists from AIIMS, New Delhi provide support in real time. A single mobile number (+91 9115444155) can be dialled from anywhere in the country by Covid-19 treating doctors to reach the CoNTeC, he said.

The minister also asked that states to publicise the Aarogya Setu mobile app and the Aarogya Setu Interactive Voice Response System (IVRS) by giving a missed call at 1921, which is being implemented for the people having feature phones or landlines across India. This application has been designed to keep a user informed, in case she/he crosspaths with someone who has tested positive.

He appreciated the best practices shared by the district magistrates/commissioners and other officials of various districts like ‘Corona Yodha Samitis’ set up in slum areas of Surat (Gujarat), distribution of soaps and masks to each family, installation of hand washing machines in slum areas, setting up of fever clinics etc. He stated that similar practices may be internalised, shared and adopted by other districts as well, as a cohesive and collective effort is required to combat Covid-19.