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Mrunal Manmay Dash

New Delhi/Bhubaneswar: The Union Government on Wednesday expressed concerns over a higher Test Positivity Rate (TPR) in three districts of Odisha- Balasore, Dhenkanal and Nuapada- and advised the State government to take measures to bring the graph down apart from ensuring stringent containment measures.

Rajesh Bhushan, Secretary to the Union Ministry of Health and Family Welfare shot a letter in this connection to the Odisha Chief Secretary Suresh Chandra Mohapatra stating that although the trajectory of daily new cases of COVID-19 has fallen down substantially in the country, there is a need for continued monitoring of weekly case positivity as well as cases trajectory in each district to identify any early warning signals of spread of infection.

"It is a point of concern that presently, 3 districts of Odisha are reporting weekly positivity of more than 10% (28th June to 4th July). Though the State positivity is consistently decreasing and has reported positivity of 5.36% for the week ending 4th July, the district of Nuapada has shown significant increase in positivity over the last week," Bhushan said.

Cases:

Although the cases have shown continuous decline since past 4 weeks, the State has five districts (Balaswar, Cuttack. Jagatsinghapur, Kendrapara and Khordha) that have shown an increase in the week ending 4th July when compared with previous week.

Deaths:

The State has a low Case fatality rate (CFR) of less than 0.46%, however continuous monitoring of daily new deaths needs to be done. There has been increase in the number of deaths reported by the state over the past two weeks Khordha district has reported 58 deaths over the last week, highest in the state. Total deaths reported by the state for the same period is 309.

Testing & Positivity:

The district of Nuapada reported the weekly positivity at 11% for the week ending on 27th June while it reported 27% positivity for the week ending 4th July. Three districts namely Balasore, Dhenkanal and Nuapada have reported weekly positivity for the week ending 4th July of more 10%.

The above-mentioned points are a cause for concern, and in order to not let the situation slip out of control, Bhushan urged to focus on the following points and take necessary action at the earliest.

Strict containment measures:

It is imperative to note that containment is the most crucial strategy of flattening this current curve. It is critical to plan effective containment measures and implement them stringently, and to strengthen all our efforts made for prompt contact tracing of the close contacts of positive cases and immediate quarantine /isolation of all suspected and confirmed cases as per MoHFW guidelines.

Ramp up testing:

Several districts are reporting high positivity rates, which reflect the level of widespread infection. A microanalysis needs to be done of area showing high positivity (>10%) during the past weeks. Accordingly. all such areas should be targeted for increasing the testing exponentially while maintaining high proportion of RT-PCR tests. The state should aim at maintaining positivity rate below 5% in each district duly focusing on increasing number of tests so as to aid early identification.

Healthcare Infrastructure planning:

To ensure preparedness, the State must maintain continuous vigil regarding bed occupancy of critical beds (Oxygen supported and ICU beds) and if the occupancy is more than 40% for any bed category, the States should plan for augmentation of healthcare infrastructure in those districts. Trained human resources, infrastructure logistics and procurement should be planned considering the geographical spread of the pandemic. State should also work towards ensuring timely disclosure of all infrastructure availability based details on public portals or via media so as to avoid misinformation.

Effective clinical management:

With a rise in fatalities clinical management protocol may be followed effectively & promptly. It is important to monitor all cases under home isolation and put processes in place to ensure smooth hospitalization of patients in case the same is required. All facilities also should be monitored with respect to the overall fatality, including deaths being reported between 24, 48 and 72 hours of hospitalization to identify any weak spots and to undertake required corrective action.

Ramping up vaccination:

Vaccination must be used as an aid to the infection containment strategy. Ramping up vaccination sites, improving the efficiency and utilisation of vaccination deploying strategic vaccination centers near the containment zones, and now ensuring speedier vaccination of all citizens aged 18+ should be undertaken on a priority basis.

COVID Appropriate Behavior:

Levying effective fines on violation of social distancing or mask usage in public as well as stringent enforcement is critical to control the spread of infection further in the community.

"The State is requested to share the action taken so far as per the directions issued under Disaster Management Act by MHA as mentioned above so as to ensure effective containment," Bhushan added.

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