COVID-19 Update: Health Ministry informs about steps taken for containment and management

New Delhi: As the year 2022 ends, the Health Ministry has informed about the proactive steps consistently being taken to respond to the COVID-19 pandemic. The various technical bodies under various Ministries/Departments continued to maintain a close watch over the evolving nature of the causative virus and their public health implications.

The Government of India continued to closely monitor the evolving nature of the COVID-19 pandemic in India as well as globally. A close watch was also kept on improving knowledge about the virus, the disease, its long-term impacts, advancements being made in India as well as globally in terms of public health tools, diagnostics, therapeutics and vaccines.

According to the Ministry of Health and Family Welfare data, India reported 243 new Covid cases in the last 24 hours, against 268 cases reported on the previous day.

The active caseload stands at 3,609 cases, accounting for 0.01 percent of the country's total positive cases, said the Union Health Ministry on Friday.

The weekly positive rate currently stands at 0.16 percent, while the daily positive rate stands at 0.11 percent.

The recovery of 185 patients in the last 24 hours took the cumulative tally to 4,41,43,850. Consequently, India's recovery rate stands at 98.80 percent.

Also in the same period, a total of 2,13,080 tests were conducted across the country, increasing the overall tally to over 91.05 crore.

With 81,097 vaccines administered in the last 24 hours, India's Covid-19 vaccination coverage exceeded 220.09 crore as of Friday morning.

The various technical bodies under various Ministries/Departments continued to maintain a close watch over the evolving nature of the causative virus and their public health implications. India continued its graded yet pre-emptive and proactive approach towards COVID-19 management.

The COVID-19 trajectory in India experiences a sharp increase during March-May 2021, however, since May 2021, the trajectory has witnessed a considerable and sustained decline. Owing to the Government of India's five-fold strategy of test-track-treat-vaccinate and COVID-appropriate behavior through a Whole of Government & Whole of Society approach, India has been able to limit its cases and deaths per million to 32,775 cases per million and 389 deaths per million population (as on 25th November 2022) respectively, which is one of the lowest in the world as compared to similarly affected countries.

The Hon'ble Prime Minister provided the much required strong and decisive leadership and guidance for a national response to the pandemic. The Prime Minister's Office and Ministry of Health & Family Welfare has been in regular interactions with the all States and UT administrations to review the preparedness and response measures being taken and also to identify areas for further improvement and coordination.

The Committee of Secretaries under the Cabinet Secretary took regular reviews with all related Ministries of Health, Defence, Ministry of External Affairs, Civil Aviation, Home, Textiles, Pharma, Commerce and other officials including with State Chief Secretaries.

The Joint Monitoring Group (JMG) under the Chairmanship of DGHS and National Task Force on COVID-19 under ICMR continues to assess the risk, review the preparedness & response mechanisms and finalize technical guidelines.

The Government of India, based on its past experience of successfully managing pandemics and epidemics in the past and the evolving evidence-based contemporary knowledge about the disease, provided the requisite strategy, plans and procedures to the State Governments and UT administrations. This includes containment plans and guidelines on a wide range of subjects related to travel, behavioral & psycho-social health, surveillance, laboratory support, hospital infrastructure, clinical management, rational use of Personal Protective Equipment (PPE) etc.

Taking note of the evolving COVID-19 situation globally and the emergence of mutant variants of the SARS-CoV-2 virus, the guidelines for international arrivals were reviewed from time to time. The last updated guidelines were issued on 21st November 2022.

As per the updated guidelines, all international travellers to India should preferably be fully vaccinated as per the approved primary schedule of vaccination against COVID-19 in their Country. The updated guidelines also prescribe precautionary measures to be followed like preferable use of masks and adherence to physical distancing measures. There is no need to submit any details about COVID-19 vaccination status or RT-PCR testing for traveling to India.

Union Ministry of Health & FW is coordinating and collaborating with other stakeholder Ministries/departments including Ministry of Civil Aviation, Ministry of Ports, Shipping and Waterways, Ministry of Railways etc. Further Port/Airport Health Officers at International ports/ airports have been instructed to ensure strict health screening of all passengers and if passengers found to be symptomatic during screening shall be immediately isolated, taken to a designated medical facility as per health protocol.

Further, the Union Ministry of Health & Family Welfare is in regular interaction with all States/UTs through formal communication as well as through video conferencing. States/UTs have been urged to undertake the following activities:

• Strict monitoring of International travelers in the community.
• Contact tracing of positive individuals & follow-up for 14 days.
• Genome sequencing of positive samples through INSACOG Labs in a prompt manner.
• Continued monitoring of areas where clusters of positive cases emerge.
• Further strengthening of COVID-19 testing infrastructure and ensuring early identification of cases through adequate testing across the States.
• Ensure preparedness of health infrastructure (availability of ICU, Oxygen supported beds, ventilators, etc.) and upgrade health infrastructure under ECRP-II including in rural areas and for pediatric cases.
• Commissioning all PSA plants, ensuring sufficient logistics, drugs etc.
• Ensure rapid COVID-19 vaccine coverage.
• Ensuring adherence to COVID Appropriate Behaviour.

The laboratory network is continuously being strengthened progressively in the last two years both in terms of testing infrastructure as well as diagnostics. As of 4th November 2022, a total of 1453 government laboratories and 1935 Private Laboratories are conducting COVID-19 Testing. At present India is testing around 2 – 2.5 lakh samples a day.

A three-tier arrangement of health facilities was created for appropriate management of COVID-19 cases, [(i) COVID Care Center with isolation beds for mild or pre-symptomatic cases; (ii) Dedicated COVID Health Centre (DCHC) with oxygen-supported isolation beds for moderate cases and (iii) Dedicated COVID Hospital (DCH) with ICU beds for severe cases] has been implemented. Tertiary care hospitals under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. have been leveraged for case management.

As on 25th November 2022, there are a total of 23988 COVID treatment facilities with 17,93,310 dedicated isolation beds (including 5,15,001oxygen supported isolation beds) and 1,45,014 ICU beds (including 63,850 ventilator beds).

Guidelines on Clinical Management of COVID-19 continue to be updated with emerging scientific evidence. The treatment protocol for adults was last updated on 17th January 2022 and has been widely circulated. The mainstay of treatment is supplemental oxygen and other supporting therapy. No specific antivirals have been proven effective. However as per National treatment guidelines, drugs like inhalational Budesonide, Dexamethasone, Methylprednisolone and Low Molecular Weight Heparin have been recommended. In addition, provisions for Investigational Therapies have also been made using Remdesivir, and Tocilizumab for defined sub-group of patients under medical supervision.

Guidelines for management of COVID-19 in children and adolescents were also updated on 20th January 2022. The guideline covers guidance on management of acute presentation of COVID-19 as well as Multisystem Inflammatory Syndrome (MIS-C) in children and adolescents found temporally related to COVID-19.

AIIMS, Delhi and similarly placed institutions of the States are designated Centers of Excellence for wider dissemination of the latest advancements in COVID management. Telemedicine services using 'e-sanjeevani' for tele-consultation is one among the best practices during COVID times.

States are being supported in terms of supply of logistics including PPE kits, N-95 masks, drugs, ventilators, oxygen cylinders, oxygen concentrators etc. States are also being supported in terms of installing Oxygen concentrator plants/ PSA (Pressure Swing Adsorption plants).

In order to extend on-ground support to the State and District Health Authorities, Central multi-disciplinary teams are also being deployed to States from where upsurge of cases has been reported.

In terms of financial support to States, During the FY 2020-21, funds to the tune of Rs.8257.88 crore have been released to States/UTs towards the India COVID-19 Emergency Response and Health System Preparedness Package.

In addition, 'India COVID-19 Emergency Response & Health System Preparedness Package: Phase-II' has also been approved by the Cabinet with Rs 23,123 crores (with Rs. 15,000 Cr as Central Component & Rs 8,123 Cr as State component) and is being implemented from 1st July 2021. This includes support to State/UT level for ramping up Health Infrastructure including those in rural, tribal and peri-urban areas closer to the community, providing support for procurement of drugs and diagnostics to enhance service delivery at district and sub district levels for management of COVID-19 cases (including paediatric care) and for maintaining a buffer of drugs, support for IT Interventions such as implementation of Hospital Management Information System and expanding access to tele-consultations in all districts, and support for capacity building and training for all aspects of management of COVID-19.

Government of India through National Disaster Management Authority (NDMA) has issued 'Guidelines to provide for ex-gratia assistance to kin of the deceased by COVID-19'. NDMA has recommended an amount of Rs. 50,000/- per deceased person including those involved in relief operations or associated in preparedness activities, subject to cause of death being certified as COVID-19. States shall provide the ex-gratia assistance from State Disaster Response Funds.

With the intent to develop long-term capacities in preparedness for future surges of COVID-19 and other public health emergencies, PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) has been approved with an outlay of Rs. 64,180 crores over 6 years. The PM-ABHIM envisages increased investments in public health and other health reforms to safeguard against future resurgences of COVID-19, if any, and future public health emergencies by:

• Strengthening of Health and Wellness Centers in villages and cities for early detection of diseases
• Addition of new critical care-related beds at district level hospitals.
• Operationalization of Regional National Centers for Disease Control (NCDC).
• Establishment of metropolitan units in urban areas and BSL-III labs across the country to strengthen the laboratory network.
• Strengthening of existing Viral Diagnostic and Research Labs (VRDLs) and creation of new National institutes of Virology (NIVs) and a National Institute for One Health through ICMR.
• Strengthening of Public Health Units at international Points of Entry (PoEs)

The Government of India will continue to maintain a close watch over the evolving pandemic.

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