Health Ministry issues SOPs on COVID-19 containment; management in rural & tribal areas

The Health Ministry on Sunday issued detailed guidelines on COVID-19 containment and management in peri-urban, rural and tribal areas amid rising cases of Coronavirus in rural pockets. In its SOP, the Ministry has placed special emphasis on active surveillance, screening, isolation and referral in such areas stating that testing needed to be expanded by training CHOs, ANMs and ASHA workers who can be roped in for surveillance with the help of Village Health Sanitation and Nutrition Committee (VHSNC).

"In every village, active surveillance should be done for influenza-like illness/severe acute respiratory infections(ILI/SARI) periodically by ASHA with help of Village Health Sanitation and Nutrition Committee (VHSNC)," said the Health Ministry.

CHOs have been asked to determine the seriousness of the infection by teleconsultation and recommend cases with comorbidities and low oxygen saturation to higher centres. The guidelines also talk about focusing on contact tracing as per Integrated Disease Surveillance Programme’s (IDSP) guidelines. 

Infrastructure 

A three-tier system has been planned for health infrastructure for managing COVID at a rural area. These include- 

• COVID Care Centre (CCC) to manage mild/asymptomatic cases
• Dedicated COVID Health Centre (DCHC) to manage moderate cases 
• Dedicated COVID Hospital (DCH) to manage severe cases 

The Health Ministry has advised a minimum of 30-bedded CCC in peri-urban and rural areas under the supervision of the nearest PHC/CHC. These may be set up in schools, community halls, panchayat buildings etc. The nodal officers have been asked to get trained in performing Rapid Antigen Detection Kit and volunteers from the VHNSC (school teachers, staff) have also been asked to undergo training in the basics of COVID, infection prevention control, medical waste management etc. 

Advisory for home-isolated patients

The Health Ministry has also advised home and community-based isolation for rural pockets, as per the ICMR guidelines stating that nearly 80-85% of cases are asymptomatic or mildly symptomatic. 

"A home isolation kit shall be provided to all such cases which should include required medicines such as Paracetamol 500 mg, Tab. Ivermectin, cough syrup, multivitamins (as prescribed by the treating doctor) besides a detailed pamphlet indicating the precautions to be taken, medication details, monitoring proforma for patient condition during the home isolation, contact details in case of any major symptoms or deterioration of health condition and the discharge criteria," the ministry said in the guidelines.

One of the major challenges that has emerged in the second COIVD-19 wave is the fast spread of the virus in rural areas. According to the data compiled by How India Lives, as of May 2021, rural areas have reported 1.3 times more cases of COVID-19 than urban areas, an alarming trend that was not witnessed in the first wave of the pandemic. The progression of COVID from urban to rural areas can be seen as a storm in the making since the areas are not as well-equipped with health infrastructure as urban areas which themselves have been crumbling under the spiking infections. 

India reported 3,11,170 new cases of COVID-19 on Sunday taking the total case tally to 2,46,84,077. The country currently has 36,18,458 active cases. In the last 24 hours, 3,62,437 recoveries and 4,077 deaths have been registered.