Covid-19: “Hospitalisation May Increase Rapidly:” Centre to States/UTs
Manas Dasgupta
NEW DELHI, Jan 10: As India logged over 1.79 lakh new Covid cases on Monday and continued to show an upward trend, the centre asked the states and union territories to keep close watch on the cases both in home isolation and in hospitals with a caution that considering the present “dynamic” situation the number of cases needing hospitalization could start increasing rapidly.
The centre, however, said the contacts of COVID-19 patients, unless identified as high-risk, don’t need to be tested. The government’s top medical body the Indian Council of Medical Research (ICMR) also said in a new advisory that asymptomatic individuals in community settings, patients who stand discharged as per home isolation guidelines, also patients discharged from a COVID-19 facility and individuals undertaking inter-state domestic travel need not be tested. It said Genome Sequencing is done for surveillance purposes and is not required to be undertaken for treatment purposes adding that genome sequencing is to be performed only in a subset of positive samples as per recommendations of INSACOG (Indian SARS-CoV-2 Genomic Surveillance Consortium).
Cautioning the states and UTs, the union health secretary Rajesh Bhushan in a letter on Monday said only 5 to 10 per cent of the active Covid cases this time needed hospitalisation so far. However, the situation was dynamic and might change rapidly, it added. During the second wave, the percentage of active cases requiring hospital care was in the range of 20-23 per cent, he reminded.
The rise in COVID-19 cases in various parts of the country appears to be driven by the Omicron variant as well as by the continued presence of Delta, he said and stressed on augmenting human resources, particularly healthcare workers, for Covid management. “The rise, it appears, is being driven by the Variant of Concern (VOC) “Omicron” and the continued presence of another VoC “Delta” in large geographies across the country. In the present surge, five to 10 per cent of active cases needed hospitalisation so far. The situation is dynamic and evolving. Therefore, the need for hospitalization may also change rapidly,” Bhushan said.
All States and Union Territories are advised to keep a daily watch on the situation of the total number of active cases, cases under home isolation, the number of hospitalized cases, cases on oxygen beds, ICU beds and on ventilatory support, he wrote.
“Based on this monitoring, the requirement of healthcare workers and their availability health facility wise must also be reviewed daily as was done during the second surge,” the health secretary said.
Appreciating that while various States and Union Territories initiated steps for the establishment of jumbo health facilities, field hospitals, temporary hospitals among others, Bhushan said both infrastructure and human resources have their limitations.
“Therefore, it is important to conserve healthcare workers by initiating staggering wherever possible and by restricting elective procedures in the hospitals,” he advised. It is also important to manage healthcare workers in Covid and non-Covid areas of healthcare facilities, he said.
The ministry has suggested states and Union Territories to earmark different categories of beds in private clinical establishments for Covid care. “It must also be ensured that charges levied by such health facilities are reasonable and there is a mechanism to monitor and initiate action in cases of over-charging if any,” Bhushan said in the letter. He also suggested engaging retired medical professionals or MBBS students for tele-consultation services and providing skill training of community volunteers in basic care and management at Covid Care Centres.
The health secretary also suggested requisition of additional ambulances or private vehicles to improve referral transport and facilitate seamless transfer of COVID-19 cases from home isolation or from Covid Care Centres to Covid Dedicated Hospitals. All district hospitals and medical college hospitals should be used as eSanjeevani tele-consultation hubs. Requisite financial resources for this have already been provided under ECRP-II to States and Union Territories, Bhushan said in the letter.
Meanwhile, with a spate of COVID cases both within and outside Parliament, the Rajya Sabha Chairman Venkaiah Naidu and the Lok Sabha Speaker Om Birla have directed officials to frame a protocol for the Budget session, which is less than three-weeks away. Nearly 400 staffers working at the Lok Sabha and the Rajya Sabha secretariats have tested positive between January 4 and 8. Both houses have directed their staff to come on a rotational basis, allowing only 50% attendance at any given time.
In a parallel development, following the request of some members, meetings of the parliamentary standing committees have been temporarily stopped. In the last couple of days, according to sources, at least half a dozen meetings have been cancelled.
The cancellation of these meetings has reignited the debate on allowing virtual meetings of the parliamentary panels. Congress leader Jairam Ramesh who heads the standing committee on science and technology, said he had to cancel a crucial meeting on Wildlife Amendment Bill, 2021. In a tweet he further said, “I requested the Chairman of the Rajya Sabha on the last day of the Winter Session to allow online meetings of Standing Committees. And yet again this was disallowed. Now, important Committee meetings are being put off. I simply cannot understand why online meetings cannot be held!”
According to sources, worried by the rising cases, Naidu spoke to Om Birla. Following their conversation, secretary generals of both Houses have been asked to review the adequacy of the COVID protocol followed during the winter session in the context of the present scenario of rapidly spreading infections.
The monsoon session in August 2020 was the first full session held under COVID protocols with Rajya Sabha meeting in the first half of the day and Lok Sabha during second half. The same was followed for the first part of the Budget session during February 2021. For the second part of the Budget session, and the monsoon and winter sessions last year, Rajya Sabha and Lok Sabha reverted to normal timings but members were seated in the chambers and galleries of respective Houses.
The Secretary Generals have been asked to come up with a detailed plan, especially in view of the high transmission rate of the Omicron strain.
The country on Monday also began administering the third ‘precautionary dose’ to priority groups — health care and frontline workers and those aged over 60 years with comorbidities. According to the Centre’s directions, the third dose will be of the same vaccine as the first two jabs and will be given to those who were vaccinated at least nine months ago.
Meanwhile, India on Monday recorded 1,79,723 fresh Covid-19 cases, pushing the active caseload to 7,23,619. The daily positivity rate stood at 13.29 per cent, while 146 deaths were recorded in the last 24 hours. The Omicron tally, meanwhile, stood at 4,033, with Maharashtra (1,216) continuing to top the count.
Among the top leaders to have attracted Covid were the union defence minister Rajnath Singh and the Bihar chief minister Nitish Kumar. Restaurants and bars in Delhi will be shut from tomorrow onward. Only ‘take away’ and home delivery to be allowed. The Delhi Disaster Management Authority (DDMA) on Monday decided not to impose lockdown to contain the spread of Covid and discussed further restrictions such as closing dine-in facility in restaurants and scaling down seating capacity in Metro trains and buses, officials said.
Amid the alarming surge, Delhi, Maharashtra, and other states have been insisting they are prepared to handle the rise in infections with enough hospital beds, highlighting the low hospitalisations so far. Lessons have been learned from the second wave, some top officials have pointed out, when a majority of big cities in the country buckled under the pressure of an increase in the demand for hospital beds and medical oxygen.
Prime Minister Narendra Modi on Sunday reviewed the Covid situation in the country. The virus is evolving rapidly and genome sequencing is important, he said, pointing out that there is a need to speed up the vaccination of teens, which began last week.
