The Health Ministry on May 16 issued detailed guidelines on COVID-19 containment and management in peri-urban, rural and tribal areas.
The ministry has suggested surveillance, screening, home and community-based isolation and boosting health infrastructure for managing COVID at the rural level.
These guidelines come a day after Prime Minister Narendra Modi chaired a high-level meeting on the COVID-19 situation and directed government officials to make a distribution plan for oxygen supply to rural areas and scale up health infrastructure to manage the disease burden in those regions.
Here are the key guidelines:
In the 35-page guidelines, the ministry said that in every village, active surveillance should be done for influenza-like illness/severe acute respiratory infections (ILI/SARI) periodically by ASHA with help of the Village Health Sanitation and Nutrition Committee (VHSNC).
"Symptomatic cases can be triaged at village level by teleconsultation with Community Health Officer (CHO), and cases with comorbidity/low oxygen saturation should be sent to higher centres. Every subcentre should run an ILI/SARI OPD for a dedicated time slots/days."
The ministry also said that identified suspected COVID cases should link for testing to the health facilities either through COVID-19 rapid antigen testing or by referral of samples to the nearest COVID-19 testing laboratory, in accordance with ICMR guidelines for the same.
"Monitoring of oxygen saturation is important for COVID patients. For this, it is desirable for each village to have an adequate number of pulse oximeters and thermometers. The VHSNC through local PRI and administration should mobilise resources to make provisions for these equipment," the ministry stated.
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The ministry also stated that a system of providing the pulse oximeters and thermometers on loan to families with a confirmed case of COVID should be developed through ASHA/ Anganwadi workers and village-level volunteers.
A home isolation kit including Paracetamol, Ivermectin, cough syrup, and multi-vitamins should be provided to the COVID patients.
Patients under home isolation will stand discharged and end isolation after at least 10 days have passed from the onset of symptoms (or from date of sampling for asymptomatic cases) and no fever for 3 days. There is no need for testing after the home isolation period is over.
Peri-urban and rural areas may plan a minimum of 30-bedded COVID Care Centres (CCC). The centres shall offer care for asymptomatic cases with comorbidities or mild cases (Upper Respiratory Tract symptoms, without breathlessness, with oxygen saturation of more than 94 percent) where home isolation is not feasible. It could admit a COVID suspect or confirmed case.
The CCCs should be mapped to one or more Dedicated COVID Health Centres (DCHC) and at least one Dedicated COVID Hospital (DCH) for referral purposes. Such COVID Care Centres should also have a Basic Life Support Ambulance (BLSA) networked among such CCCs equipped with sufficient oxygen support on 24x7 basis, for ensuring safe transport of patients to dedicated higher facilities if the symptoms progress from mild to moderate or severe.
The nodal officers will be trained in performing Rapid Antigen Detection Kit. The volunteers selected by VHNSC (School Teacher, Staff, Village Officer, etc) will be trained in basics of COVID, infection prevention control, use of personal protective equipment, medical waste management, monitoring of temperature using infrared thermometer, recording respiratory rate, use of Pulse Oximetry and identification of early warning signs and referral.
The Primary Health Centre/ Community Health Centre/ Sub District Hospital in these areas shall be the Dedicated COVID Health Centre for management of COVID-19.
Meanwhile, the country reported 3,11,170 new cases of COVID-19 on May 16 taking the total case tally to 2,46,84,077. It currently has 36,18,458 active cases. In the last 24 hours, as many as 3,62,437 recoveries and 4,077 deaths have been registered.
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