79% of India’s Covid-19 cases are from 30 municipal areas

The Centre has asked officials from 30 municipal areas spread across 12 states, which contribute to 79% of India’s coronavirus disease (Covid-19) cases, to maintain high vigil and closely monitor areas of old cities, slums, migrant labourer camps and other high-density pockets.

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These areas are in Andhra Pradesh, Delhi, Gujarat, Madhya Pradesh, Maharashtra, Odisha, Punjab, Rajasthan, Tamil Nadu, Telangana, West Bengal and Uttar Pradesh. Maharashtra.

The selected municipal areas are Brihanmumbai or Greater Mumbai, Greater Chennai, Ahmedabad, Thane, Delhi, Indore, Pune, Kolkata, Jaipur, Nashik, Jodhpur, Agra, Tiruvallur, Aurangabad, Cuddalore, Greater Hyderabad, Surat, Chengalpattu, Ariyalur, Howrah, Kurnool, Bhopal, Amritsar, Villupuram, Vadodara, Udaipur, Palghar, Berhampur, Solapur and Meerut.

These areas should have the maximum restrictions under the home ministry’s lockdown 4.0 ground rules, the health ministry has told the government.

There is no word on the extent of the restrictions that would be imposed during the fourth phase of the lockdown. The ground rules for the next round would be made public on Sunday.

The third phase of the lockdown, first imposed form March 25, is due to end on Sunday night.

Preeti Sudan, Union health secretary, and Rajesh Bhushan, the officer on special duty in the health ministry, along with other senior officers, held the high-level review meeting on Saturday with the principal health secretaries, municipal commissioners, districts magistrates and other officials from these 30 municipal areas.

It was stressed during the meeting that timely tracing of patients to improve recovery percentage and influenza-like illness (ILI)/severe acute respiratory infections (SARI) surveillance is important.

A health ministry statement said 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 and they were informed about fresh guidelines on the management of the disease in urban settlements.

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 is 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 the area should be appropriately defined by the district administration or local urban body with technical inputs from the local level. Along with the containment zones, the buffer zone around the containment zone also must be demarcated to break the chain of transmission.

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.

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 emphasised that along with the containment and management of the coronavirus disease cases, the issue of continuing all essential non-Covid-19 health services in the urban localities like reproductive, maternal, newborn, child and adolescent health (RMNCH+A), cancer treatment, tuberculosis surveillance, immunisation efforts, vector control measures in view of the ensuing monsoon, etc, need to be ensured.

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 local surveillance teams to encourage cooperation from the local communities, in finding solutions, building trust, and for a positive influence on the health workers.

All health service providers need to be provided with adequate protective gear and communication must focus against the stigmatisation of these frontline workers.

(With agency inputs)