The expert committee on Covid-19 headed by Dr V K Paul has raised a red flag on big congregations this festival season, warning that the town should steel oneself against a daily surge of 15,000 positive cases this winter. it’s acknowledged the winter months aggravate respiratory ailments and there could even be a rise within the number of patients from outside Delhi.
The committee has advised against allowing large gatherings. “It has been seen that Onam in Kerala and Ganesh Chaturthi in Maharashtra escalated the pandemic seriously. This must not be allowed to happen in Delhi. Our emerging gains in a reduction in cases are going to be reversed due to these festivities and rush in markets and localities,” said the committee in its report submitted to the Delhi Disaster Management Authority on Tuesday. It suggested that such events should be very low-key affairs, essentially centred around family celebrations.
The committee had been asked to organize revised Covid-19 management before the festive period, panel stresses on got to build up rt-PCR testing, revamp containment zone strategy.
Delhi should steel oneself against a daily surge of 15,000 positive cases and make arrangements for in-patient admissions with moderate and severe disease amounting to roughly 20% of this surge,” the committee recommended. The report added that guidelines for ICU, non-ICU and COVID care isolation beds would be made available to the govt.
Underlining that subsequent three months would be critical, the panel has recommended revamping the strategy on containment zones with specialising in the creation of micro containment zones and prescribed limited RT-PCR tests on symptomatic individuals and limited contact tracing to fill the gaps. Identification of workplace clusters for risk assessment; surveillance driven testing; scaling from critical care facilities and their optimum utilisation; launching of massive awareness campaigns within the wake of the upcoming festival season; and reducing deaths among healthcare workers are a number of the opposite key recommendations.
Underlining that the general case death rate in Delhi is 1.9%, which is above the national average of 1.5%, the committee has advised that the main target should get on reducing mortality. Delhi had reported 5,616 deaths till Wednesday. “The higher mortality within the comorbid (66.6%) and elderly is inevitable and reported everywhere states and globally. However, (a matter of) concern is that the reported mortality in under-15.
(1.5%) and 16-44 age-groups (17%)… (This) might be prevented by promoting early recognition of symptoms, timely testing and increased awareness within the younger population to adopt COVID appropriate behaviour,” the committee has observed. it’s advised a daily death audit and review of COVID and non-COVID mortalities.
The panel has suggested that there should be greater specialise in vulnerable patients just like the elderly and people with co-morbidities; periodic review of the triage facilities should be undertaken; focused efforts should be made for timely referral of patients from lower to higher facilities or from home isolation, and a review of the ambulance system should be undertaken.
Taking note of the extensive increase within the number of COVID tests in Delhi, the committee has observed that the positivity rate is consistently declining. at the present, quite 80% of tests are the rapid antigen ones with even 90-95% during a few districts. Currently, test positivity is 4.3% by RAT and 20.3% by RTPCR (as on September 24). Testing within the containment zones and testing of contacts of positive patients and symptomatic people are very limited — up to twenty of the entire.
The committee has recommended testing for all high-risk contacts (irrespective of symptoms), symptomatic contacts, influenza-like illness patients, elderly and people affected by co-morbidities in containment zones between the 5th and 10th day since the last contact if asymptomatic or as soon as symptoms begin to seem. it’s asked authorities to use RAT for containment zones and symptomatic healthcare workers and RT-PCR for health facilities and retesting of all RATnegative symptomatic persons.
Testing shouldn’t be target driven but guided by surveillance in containment zones, the committee has advised, adding that merely increasing the number of tests to scale back the positivity rate wouldn’t be appropriate.
Observing that contact tracing in Delhi has been very limited since the start and contacts traced per positive case on a mean have remained within the range of seven to 10, the committee has advised tracing of immediate family contacts, neighbourhood contacts and shut workplace contacts of positive cases and testing.
It has involved micro containment zones and residential isolation in planned colonies, big apartments and RWA-governed localities and formation of latest containment zones only in highly dense areas like resettlement colonies, JJ clusters or slums. It underlined the necessity for enlisting of high-risk groups and house-to-house search to detect all suspected cases within three days and strict perimeter control in rural areas. In many of the 11districts, the authorities are already creating micro containment zones. In fact, in many places, single houses are converted into containment zones.
The committee also observed that the containment strategy adopted at the start (large containment zones) and therefore the measures taken inside the containment zones are fairly successful in limiting the number of cases.
The government will implement the committee’s recommendations and every one district are asked to require measures suggested within the report.plan which can now help the govt fine-tune its strategy.
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