Centre's guidelines for COVID-19 management in peri-urban, rural, tribal areas: All you need to know!

All peri-urban and rural areas should plan a minimum of 30-bedded COVID Care Centre for the care of asymptomatic cases with comorbidities or mild cases. 

Created On: May 17, 2021 19:29 ISTModified On: May 17, 2021 19:29 IST
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The central government issued guidelines for containment of COVID-19 in peri-urban, rural and tribal areas on May 16, 2021 amid reports of a rapid surge in COVID-19 cases in rural India.

The centre's guidelines aim to strengthen primary-level healthcare infrastructure at all levels. According to the Health Ministry's SOPs, active surveillance should be done periodically for influenza-like illness/ severe acute respiratory infections in every village by ASHA workers with the help of the Village Health Sanitation and Nutrition Committee (VHSNC).

The SOPs stated that all symptomatic cases can be sorted at the village level by teleconsultation with Community Health Officer (CHO) and cases with comorbidity or low oxygen saturation should be sent to higher centres. It further said that every subcentre should run an ILI/SARI OPD for dedicated time slots and days. 

Centre's SOPs for peri-urban, rural and tribal areas: Key Highlights 

•All 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.

•The CHOs and ANMs should be trained in performing Rapid Antigen Testing.

•The provision of Rapid Antigen Test (RAT) kits should be made at all public health facilities including Sub-centres (SCs)/ Health and Wellness Centres (HWCs) and Primary Health Centres (PHCs).

•The COVID-19 patients should also be counseled to isolate themselves till their test results are made available.

•Those people who are asymptomatic but have a history of high-risk exposure to COVID patients such as exposure of more than 15 mins without a mask within 6 feet distance, should be advised to quarantine and get tested as per ICMR protocol.

•Contact tracing should be done depending upon the intensity of the rise in cases, as per the Integrated Disease Surveillance Programme's guidelines for contact tracing of COVID-19 cases in community settings.

•Since nearly 80-85 percent of COVID-19 cases are asymptomatic or mildly symptomatic, these patients do not require hospitalisation and may be managed at home or in COVID care isolation facilities.

•Each village should have an adequate number of pulse oximeters and thermometers for COVID patients to monitor the health of active cases in home isolation. 

•The Village Health Sanitation and Nutrition Committee should mobilize resources to make provisions for this equipment. 

•The pulse oximeters and thermometers should be sanitised after each use with cotton or a cloth soaked in alcohol-based sanitizer.

•Follow-ups can be done for those undergoing home isolation through household visits by a frontline worker or volunteers following infection prevention practices including wearing of a medical mask and other precautions.

•Home isolation kits shall also be provided to all such cases which should include medicines including Paracetamol 500 mg, ivermectin, cough syrup and multivitamins as prescribed by the treating doctor.

•The patients or caregivers should keep monitoring their health and seek immediate medical attention if serious signs or symptoms develop such as difficulty in breathing or dip in oxygen. 

•If SpO2 goes below 94 percent, the patient should be referred to a facility with an oxygen bed.

•The patients under home isolation will be discharged after at least 10 days have passed from the onset of symptoms. No need for testing after completion of the home isolation period. 

•The health infrastructure planned for peri-urban, rural and tribal areas should be aligned to the already mentioned 3-tier structure COVID Care Centre (CCC) to manage mild or asymptomatic cases and dedicated COVID Health Centre (DCHC) to manage moderate cases and dedicated COVID Hospital (DCH) to manage severe cases.

•All peri-urban and rural areas should plan a minimum of 30-bedded COVID Care Centre for the care of asymptomatic cases with comorbidities or mild cases. 

•The COVID Care Centres should have separate areas for suspected and confirmed cases with separate entry and exit for each.

•Such centres will be made in makeshift facilities and may be set up in schools, community halls, marriage halls and panchayat buildings in close proximity of hospitals or healthcare facilities.

•Such COVID Care Centres should also have a Basic Life Support Ambulance (BLSA) equipped with sufficient oxygen support on a 24x7 basis for ensuring safe transport of patients with more severe infection. 

Source: Ministry of Health

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