Advisor Bhatnagar reviews COVID management strategies for effective containment of virus across J&K
Jammu: Advisor to Lieutenant Governor, Rajeev Rai Bhatnagar today stressed that it is important to efficiently manage the monitoring and treatment of COVID patients from home isolation through the public healthcare system right up to the tertiary care stage.
The Advisor stated this while chairing a meeting of senior officers and doctors through video conferencing to review COVID-19 Containment and treatment Management in urban, semi urban, rural and tribal populated areas of Jammu and Kashmir and future strategies for management of the Pandemic including preparation required for the future.
“There should be clear responsibility, accountability and follow up at each stage and we must improve contact tracing, identification of symptomatic patients so that there is targeted testing and timely isolation and treatment”, Advisor Bhatnagar said.
The Advisor also emphasized on effectively enforcing the Corona curfew to reduce spread.
Advisor Bhatnagar while highlighting that door-to-door survey is being conducted in Jammu division to trace symptomatic patients, asked the Divisional Commissioner Kashmir to consider a similar exercise .
He also directed all Deputy Commissioners and Chief Medical Officers to improve the functioning of Covid control rooms in their respective districts so that home isolated COVID positive patients are contacted regularly and can be monitored and given medical care as well as teleconsultation.
Advisor Bhatnagar further directed the officers that the facilities at District Hospitals Community Health Centers (CHCs), triage centers and PHCs should be upgraded and made effective so that appropriate level of patient care is provided depending on the severity of the disease there itself and referrals to tertiary hospitals be done on need basis.
He also called upon all the Principals of GMCs, Directors of Health Services Jammu/Kashmir to ensure that treatment protocols are followed with proper delineation of responsibility and accountability so that best outcomes are achieved.
He complimented them for the outstanding work being done by them during the pandemic and said that the second wave has presented new challenges.
Earlier, Financial Commissioner Health and Medical Education, Atal Dulloo gave a detailed presentation over COVID-19 Containment and Management in peri-urban, rural and tribal population across the Union Territory.
He informed the meeting that a gradual ingress of Covid-19 infection is now being seen in peri-urban, rural and tribal Population, so it is important to ensure that community-based services and primary level health infrastructure in these areas are well-equipped to manage the situation.
He proposed a two way strategy for the containment of the Corona Virus in these areas which include: Surveillance, screening, isolation & referral and Monitoring of Active Cases in Home Isolation.
He informed that symptomatic cases could be triaged at village level by tele-consultation with Medical officer in charge or Mid Level Health Provider ( MLHP) besides MLHPs and ANMs to be trained in performing RAT. It was given out that RAT should be made available at all public health facilities including Sub-Centres (SCs)/ Health & Wellness Centres (HWCs) and Primary Health Centres (PHCs).
He said that contact tracing of cases in community settings should be done while all those persons who have a travel history should be followed up after 5 days for any symptoms and tested if suspected.
Mobile Testing Vans can be utilized for covering 3-4 villages a day; active monitoring of Home isolation cases in rural areas; home Isolation kit including required medicines (as prescribed) and detailed pamphlet should be provided along with oximeter to all COVID Positive cases.
He said that a regular follow-up of home isolation patients through visits and telephone by frontline worker/ volunteers/ teachers duly following IPC practices should be done with immediate referral of patients to higher centers if there is difficulty in breathing, SpO2 < 90%, chest pain or mental confusion.
FC also informed that rural areas may plan a minimum of 30-bedded Covid Care Center (CCC) with makeshift facilities under supervision of PHC’s/CHC’s in schools, community halls or Panchayat buildings.
With regard to training of staff, he informed that training of the nodal officers, support staff and volunteers on basics of COVID, infection prevention control, use of PPE’s, Medical waste management, use of infrared thermo-meters etc should be imparted on regular basis for better management of Covid.
On Clinical Management front, Dulloo said that people at CCC should be given basic advice of management of fever, cough and running nose besides warm gargle and steam inhalation should also be advised twice a day and consult PHC doctor for treatment with low dose oral steroid if symptoms persist beyond 7 days.
“In case of oxygen saturation level less than 90% or shortness of breath, patient should be put on oxygen support immediately and transport for referral should be arranged”, he maintained in the meeting.
The FC further said that Telemedicine services may also be utilized for providing post-covid follow-up care and mental health support.
On Community mobilization and Behavior Change communication, he added that the key stakeholders within the village community be mobilized for COVID-19 management and a checklist for community preparedness for COVID-19 response can be referred to, which is shared by MOHFW, GOI and health department.
He added that Block Development Officers (BDO) will identify mentors from health, ICDS to mentor the team at Gram Panchayat level, mobilization and involvement of SHGs for creating awareness for COVID appropriate behaviors and for providing essential services in their respective blocks.
Preparations for rapid COVID vaccination were also discussed during the meeting and it was highlighted that high coverage of vaccination is a pivotal strategy for preventing future surge. It was also said that appropriate strategies for achieving high coverage with COVID vaccination in rural areas need to be devised.
The meeting was informed that ASHA / AWW along with community leaders can mobilize beneficiaries for vaccination and proper IEC efforts to be made to address vaccine hesitancy of public.
Besides, it was given out that it is important to ensure continuity of other (non-COVID) essential health services, which include reproductive, maternal, new-born & child health, prevention of communicable diseases, treatment of prevalent non-communicable diseases and addressing emergencies.
The meeting also discussed the COVID care strategies for tribal Population for the integration of COVID-care with Mobile Medical Units (MMUs) to be done under NHM in tribal population
Mucormycosis and its complications were also discussed during the meeting and the types and symptoms of the disease and the treatment and prevention in COVID patients was also discussed.
All the districts have been asked to make PICU and SNICU functional and to have Pediatrics Oxygen masks, nasal Cannulas and pediatric ventilators besides the districts to get medical officers and staff trained for management of PICU and other equipments.
Director SKIMS, Soura, Principal Govt Medical Colleges, Srinagar, Jammu, Kathua, Doda, Rajouri, Baramulla and Anantnag; Commissioner Secretary FCS&CA, who is also Nodal Officer for covid management for Kashmir, Divisional Commissioners Jammu/Kashmir, Director Health Services Jammu/Kashmir, all Deputy Commissioners and other concerned attended the meeting in person and through virtual mode.