Lockdown 4.0: Amid spike in COVID-19 cases, Centre plans tougher curbs for 30 zones

New Delhi, May 16: Over 30 municipal areas have been identified in 12 states where maximum restrictions are likely to be imposed as India enters phase four of coronavirus lockdown. The development comes a day after the country surpassed China's rally with over 85,000 cases.

Health ministry held a meeting with senior officers and district magistrates from 30 municipal areas which are contributing almost 80 per cent of the country's COVID-19 cases during which monitoring of old city areas, urban slums, migrant labourer camps and other high density pockets was emphasised.

Timely tracing of patients to improve recovery percentage and influenza like illness (ILI)/severe acute respiratory infections (SARI) surveillance was also stressed during the meeting. Health Secretary Preeti Sudan and Rajesh Bhushan, OSD, health ministry, along with other senior officers held the high-level review meeting with the Principal Health Secretaries, Municipal Commissioners, DMs and other officials from the 30 municipal areas.

These 30 municipal areas are from the states of Tamil Nadu, Gujarat, Delhi, Madhya Pradesh, West Bengal, Rajasthan, Uttar Pradesh, Telangana, Andhra Pradesh, Punjab and Odisha.

The measures taken by the officials and the staff of the municipal corporations for the management of COVID-19 cases were reviewed during the meeting which was also informed that fresh guidelines on management of COVID-19 in urban settlements are being shared, a health ministry statement said.

A total of 30,150 people have been cured till now across the country and in the last 24 hours, 2,233 patients have recovered -- the highest number of recoveries in a day. This takes the total recovery rate to 35.09 per cent, the health ministry said.

The total number of confirmed cases stands at 85,940, registering an increase of 3,970 in the last 24 hours. During the meeting, a presentation was made on the present status of COVID-19 infections in the districts while highlighting the high risk factors, indices such as confirmation rate, fatality rate, doubling rate, tests per million etc.

The municipal officials were briefed about the factors to be considered while mapping the containment and buffer zones, the activities mandated in containment zone like perimeter control, active search for cases through house to house surveillance, contact tracing, testing protocol, clinical management of the active cases, surveillance activities in the buffer zone like monitoring of SARI/ILI cases, ensuring social distancing and promoting hand hygiene etc.

It was highlighted that in general the geographic area of containment zones to be defined based on factors like mapping of cases and contacts, geographical dispersion of cases and contacts, area with well demarcated perimeter and enforceability, the statement said.

Municipal Corporations, residential colony/mohallas/municipal wards or police-station area/municipal zones/towns etc., can be designated as containment zones, as appropriate, it said.

The officials were advised that the area should be appropriately defined by the district administration or local urban body with technical inputs from local level, the statement said. Along with the containment zones, buffer zone around the containment zone also must be demarcated to break the chain of transmission, it said.

"Maintaining high vigilance and monitoring in areas of old cities, urban slums and other high density pockets along with the camps for migrant workers are important steps in COVID-19 management in the urban areas," the statement said.

Regarding management of indicators like high doubling rate, high case fatality rate and high confirmation percentages seen in the containment zones, the officials were informed about the possible root causes and recommendations were offered on possible actions that could be taken.

During the meeting, it was also highlighted that especially in the densely populated urban areas further challenges need to be considered like poor socio-economic conditions, limited health infrastructure, lack of social distancing, issues faced by women, among other factors.

The Health Secretary emphasized that along with the containment and management of COVID-19 cases, the issue of continuing all essential non-COVID health services in the urban localities like RMNCHA+N care, cancer treatment, TB surveillance, immunization efforts, vector control measures in view of the ensuing monsoon, etc., need to be ensured, the statement said.

The municipal areas were asked to focus on effective risk communication in order to build trust and confidence. The officials were requested to engage with community leaders and local opinion leaders who could accompany the local surveillance teams to encourage cooperation from the local communities.

At the meeting, Mumbai shared its experience of "Containment leaders", who were local community elders and leaders working with the Ward Officers to support the government efforts in encouraging the people particularly in the slum clusters.

The role of community leadership was highlighted in finding local solutions, building trust, and for a positive influence on the health workers.

It was also emphasized that added attention needs to be accorded to timely tracing of patients to improve recovery percentage, SARI/ILI Surveillance, and more effective human resource management, the statement said.

It was advised that all health service providers need to be provided with adequate protective gear and communication must focus against the stigmatization of these frontline health workers.

OneIndia News (with PTI inputs)