Covid-19 watch: Centre plans nationwide mock drill at hospitals, issues fresh advisory

Amid rising cases of COVID-19 and seasonal influenza, the government is planning a nationwide mock drill on April 10 and 11 to take stock of hospital preparedness. According to a joint advisory issued by the Union Health Ministry and the Indian Council of Medical Research (ICMR) on Saturday, both public and private health facilities in all districts are expected to participate in the exercise aimed at taking stock of availability of medicines, hospital beds, medical equipment and medical oxygen.

The exact details of the mock drill shall be communicated to the states in the virtual meeting scheduled on March 27, the advisory stated. The joint advisory highlighted that in the past several weeks, COVID-19 testing has declined in some states and the current testing levels are insufficient as compared to the standards prescribed by the World Health Organization (WHO), i.E 140 tests per million. Testing at the levels of districts and blocks also varies, with some states heavily relying on the less sensitive rapid antigen tests.

"Hence it is critical to maintain optimum testing for COVID-19, equitably distributed (with suitable modifications to address emergence of new cluster of Covid cases) across the states. This is especially important to identify any emerging hotspots and take pre-emptive steps to curb virus transmission," it stated.

The joint advisory is in continuation of the Union Health Ministry's earlier communications dated March 10 and 16 on the issue of seasonal circulation of pan-respiratory pathogens in the country as well as public health response to COVID-19 in states and Union territories. The advisory signed by Union Health Secretary Rajesh Bhushan and Director General of ICMR Dr Rajiv Bahl stated that a gradual but sustained increase in trajectory of COVID-19 cases in the country is being witnessed since mid-February.

As on date, most of the active COVID-19 cases in the country are largely being reported by a few states like Kerala (26.4 per cent), Maharashtra (21.7 per cent), Gujarat (13.9 per cent), Karnataka (8.6 per cent) and Tamil Nadu (6.3 per cent). "While the rates of hospitalization and death due to the disease remain low, largely because of the significant coverage achieved in terms of COVID-19 vaccination rates by all states and UTS, this gradual rise in cases needs reinvigorated public health actions to contain the surge," the advisory said.

The states and UTs have been asked too keep a close watch on the evolving etiologies (causes of diseases) of Influenza Like Illness (ILI) and Severe Acute Respiratory Illness (SARI) cases, adding India usually sees a seasonal rise in Influenza cases from January to March and again from August to October. Currently, the most prominent subtypes of Influenza in circulation in the country seem to be Influenza A (H1N1) and Influenza A (H3N2).

"As you may be aware, COVID-19 and Influenza share a number of similarities in terms of mode of transmission, high risk population, clinical signs and symptoms.

"While this may present a clinical dilemma for the attending doctors in terms of diagnosis, this also renders both these diseases easily preventable by following simple public health measures like avoiding overcrowded and poorly ventilated settings, using handkerchief/tissue while sneezing or coughing, wearing a mask in crowded and closed settings, maintaining hand hygiene, avoiding spitting in public places, etc," the advisory mentioned.

The Union Ministry of Health has already issued detailed guidelines for management of co-infection of COVID-19 with other seasonal epidemic prone diseases. All states and UTs have been advised to disseminate these guidelines to all health facilities and healthcare workers within the state to help in clinical case management.

"Under Integrated Disease Surveillance Programme (IDSP), states and District IDSP units need to closely follow the trend of ILI/SARI, monitor the proportion of SARI cases among all ILI and SARI cases, and refer sufficient number of samples for testing for Influenza and SARS-CoV-2," the joint advisory stated. It would also be helpful for all states and UTS to undertake re-orientation of frontline health workers on epidemiological case definitions to help early diagnosis and prompt treatment.

The advisory stated in order to limit transmission of these diseases, it is important to raise community awareness regarding adherence to respiratory and hand hygiene particularly, avoiding overcrowded and poorly ventilated settings particularly by co-morbid, wearing of masks by doctors, paramedics and other healthcare works as well as patients and their attendants within health care facilities.

"It would also be useful to take stock of hospital preparedness including drugs, beds including ICU beds, medical equipment, medical oxygen, capacity building of human resource on existing guidelines as well as vaccination coverage. To this effect, a nationwide mock drill is being planned on 10th and 11th April, 2023, wherein health facilities (both public and private) from all districts are expected to participate," the joint advisory read.