Coronavirus in rural India: As the country is grappling with a severe second wave of coronavirus infections, the disease is now spreading in peri-urban, rural and tribal areas as well. Keeping this in mind, the Centre on Sunday issued new SOPs for containing and managing the spread of the virus in these areas. The focus has remained on active surveillance, screening, and isolation in these areas. The SOP states that active surveillance has to be carried out in every village for severe acute respiratory infections or for influenza-like illness. This surveillance has to be done periodically by ASHA along with help from Village Health Sanitation and Nutrition Committee, the SOP stated. It also stressed that in suspected cases of COVID-19 infections, testing should be done either using rapid antigen or by referring the samples to the nearest COVID-19 labs.
Apart from providing local healthcare facility workers training for conducting rapid antigen testing, the testing kits would need to be made available at all the public health facilities. Moreover, the staff would need to inform patients coming in for testing to isolate themselves till the test results are received. Along with this, people who are asymptomatic but are in the category of high-risk exposure to COVID-19 after being within a six-feet distance of a patient without a mask for over 15 minutes should also be guided regarding isolation and testing.
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It also said people suffering from mild or asymptomatic cases of COVID-19 need not be hospitalised and remain isolated either at their homes or at COVID care isolation centres. The SOPs also called for the provision of adequate pulse oximeters and thermometers in each village so that patients isolating at home are able to monitor their oxygen saturation – a key factor and one that has been causing a severe crisis in the urban areas of the country in this second wave. It is the low oxygen saturation levels of patients that requires them to undergo oxygen therapy which has brought to light an oxygen crisis that India is facing at the moment.
To patients testing positive and choosing to stay in home isolation, the health authorities would need to provide a home isolation kit, the SOP states, and this kit would consist of some important medicines like paracetamol, ivermectin, cough syrup as well as multivitamins based on the prescription of the doctors, along with instructions on how and when to take them and details of the person to contact if the health condition deteriorates.
Moreover, in terms of health infrastructure, a 3-tiered model would need to be followed in these areas for managing cases. This includes a COVID Care Centre (CCC) for mild or asymptomatic cases, a Dedicated COVID Health Centre (DCHC) for moderate cases and lastly, a Dedicated COVID Hospital (DCH) for severe cases.