Union health ministry on Wednesday said that it has identified 170 districts as hotspots of novel coronavirus outbreak and 207 districts as non-hotspots while the rest have been categorised as green zones.
All districts of the country have been classified into three categories. 170 districts have been classified as hot spot districts, where i) either the number of cases is high or where ii) rate of growth of COVID-19 cases is high or in other words, the doubling time of cases is low. The number of districts in the second category – districts which are not hot spots but where cases have been reported – is 207. The third category is green zone districts. Stating this, the Joint Secretary informed that besides the hot spots identified by the Centre, states who are fighting the battle at field level may declare additional districts as hot spot districts and take required action accordingly.
The Ministry of Health has issued detailed directions to states regarding lockdown.
Key Elements of the Plan
Key elements of the plan for management of COVID-19 were outlined by the Joint Secretary.
Movement will not be allowed in containment zones except for those related with essential services.
Special teams will search for new cases and samples will be collected and tested as per sampling criteria. Health facilities in buffer zone will be oriented and people facing SARI and influenza-like symptoms will be tested there.
Special teams working in containment zone will do contact tracing and house-to-house survey. Besides health staff, services of local revenue and corporation staff and volunteers will also be utilized in the special teams which will do contact tracing, survey and surveillance. Cases of fever, cough and breathlessness will be identified in the house-to-house survey and requisite action will be taken as per protocol. Data based on field survey will be analyzed at district level and focus areas of intervention will be decided every day.
Districts have been told to set up dedicated COVID Hospitals, COVID Health Centres and COVID Care Centres. Districts have been asked to focus on clinical management of COVID-19 Positive patients. Early identification and proper clinical management is key.
Districts have been asked to use AIIMS Call Centre and perform patient clinical management as per protocol and strive to see that no COVID-19 case gets converted into fatality.
Districts have been told to promote proper pharmaceutical and non-pharmaceutical interventions and to orient all staff involved in infection control practices and proactively train relevant staff in clinical management.
Teams need to be formed in advance, without waiting for emergence of cases. Districts where cases are being reported but are not hot spots today also need to work as proactively as hotspot districts.
Even in those districts which are not infected, community engagement needs to be undertaken to upgrade health infrastructure and dedicated COVID Hospitals need to be set up. Monitoring and testing of cases with SARI and Influenza-like symptoms need to be done.
Districts have been told to formulate District-level Crisis Management Plan for COVID-19; one failure can be the reason for the whole nation’s failure. On the other hand, individual successes of districts will lead to the success of the whole nation. Containment plan has to be implemented uniformly in the whole nation and every district.
While answering a media query, the Joint Secretary reiterated that there is no community transmission in the country so far. What has been seen is some local outbreaks and clusters, where cluster and outbreak containment strategies are being adopted, he further said.
The Ministry of Home Affairs representative stated:
MHA has issued Consolidated Revised Guidelines for the Containment of COVID-19 epidemic in the Country. Additional activities have been exempted from Lockdown Measures under the Revised Guidelines, to come into effect from 20th April, 2020. This Order, issued by MHA today, makes relaxations regarding essential services in areas which are not hot spots or containment zones. However, those areas have to ensure that lockdown measures are followed and some prerequisite steps are taken to ensure social distancing.
Consolidated revised guidelines on Lockdown issued by MHA today state that:
National COVID Directions are to be followed strictly.
- SOPs for social distancing are to be followed in all work places.
- Supply chain of essential goods and services and shops selling these goods can continue to function, so that citizens do not face any problem.
- There is no restriction on functioning of any component of the health system during lockdown.
- Rural industries, which are situated outside municipal boundaries, have been allowed to function, with a focus on food processing industries.
- The Centre has asked states and UTs to decentralize procurement and marketing of farm produce to the extent possible.
- Work of MNREGA will be allowed to take place during lockdown, provided proper Social Distancing norms are followed. This has been done in order to encourage the rural economy.
Replying to a media query on guidance provided by the Government to migrant workers, the MHA representative stated that due to prohibition of movement of buses, trains and aircraft, it is clear that movement of migrant labourers is not possible till end of the nation-wide lockdown. He said that necessary facilities for migrant workers such as food and shelter camps have been made and states have been allowed to use State Disaster Relief Fund for this purpose. This arrangement will have to continue till the end of lockdown, he further stated.
Classifications within the Zones
Within the Red Zone districts, there will be areas with large outbreaks and clusters, which could see stricter restrictions than the rest of the district.
“To get some economic activity moving post-20 April, the whole district would not be locked down as severely as the areas with large outbreaks and clusters,” an official said.
According to the list, as of 14 April, the 170 hotspot districts have been divided into 123 “hotspot districts with large outbreaks” and 47 “hotspot districts with clusters”.
A district could move from the Red to the Green Zone if it does not report any case for 28 days, and vice-versa.
Districts with no new confirmed cases for 28 days will be marked as Green Zones.
According to the list, with 22 Red Zone districts, Tamil Nadu has recorded the maximum number of districts with hotspots, followed by Andhra Pradesh (16), Maharashtra (14), Uttar Pradesh (13), Rajasthan (12) and Delhi (10).
The UTs and states to not have any districts in the Red or White Zones are Dadra and Nagar Haveli and Daman and Diu, Lakshadweep, Manipur and Sikkim.
List of Hotspot Districts with Large Outbreaks
- DELHI: South, South East, Shahdara, West, North, Central, New Delhi, East and South West
- ANDHRA PRADESH: Kurnool, Guntur, Spsr Nellore, Prakasam, Krishna, Y.S.R, West Godavari, Chittoor, Vishakhapatnam, East Godavari and Anantapur
- MAHARASHTRA: Mumbai, Pune, Thane, Nagpur, Sangli, Ahmednagar, Yavatmal, Aurangabad, Buldhana, Mumbai Suburban, Nashik.
- Gujarat: Ahmadabad, Surat, Bhavnagar, Rajkot, Vadodara.
- Karnataka- Belagavi, Mysuru, Bengaluru Urban
- Kerala- Kasaragod, Ernakulam, Pathanamthitta, Thiruvananthapuram
- Madhya Pradesh- Indore, Bhopal, Ujjain
- Punjab- Jalandhar, Pathankot
- West Bengal- Kolkata, Howrah, 24 Paraganas North, Medinipur East
- Rajasthan: Jaipur, Tonk, Jodhpur, Banswara, Kota, Jhunjhunu, Jaisalmer, Bhilwara, Bikaner, Jhalawar, Bharatpur
- Tamil Nadu: Chennai, Tiruchirappalli, Coimbatore, Tirunelveli, Erode, Vellore, Dindigul, Villupuram, Tiruppur, Theni, Namakkal, Chengalpattu, Madurai, Tuticorin, Karur, Virudhunagar, Kanniyakumari, Cuddalore, Thiruvallur, Thiruvarur, Salem, Nagapattinam
- Uttar Pradesh: Agra, Gautam Buddha Nagar, Meerut, Lucknow, Ghaziabad, Saharanpur, Shamli, Firozabad, Moradabad.