With a bulk of COVID-19 cases coming from urban settlements, the government has suggested deploying additional manpower in these areas and roping in local political and religious leaders for communicating all aspects of coronavirus disease prevention measures as residents are "more inclined to trust them".
It has also decided to identify an "incident commander" in urban settlements, who will be tasked with planning, operation, logistics and finance to implement an Incident Response System. The commander will report to the area municipal commissioner.
In a document, the Health Ministry said these settlements in cities have poor living conditions and are often overcrowded, with many people crammed into very small living spaces. And hence physical distancing, isolation and communicating the risk of infectious respiratory diseases -- such as COVID-19 -- to the dwellers could be challenging.
So the Urban Local Bodies need to prepare for responding to any possible outbreak.
The document, a set of guidelines for preparedness and response to COVID-19 in urban settlements, outlined steps to do it and setting up an Incident Response System and engaging community leaders were part of the measures.
"Community groups are key to creating awareness on COVID among these populations. Use of local (political, religious and opinion) leaders for communicating all aspects of the COVID prevention and control is vital as dwellers are more inclined to trust them," it said.
The trained manpower available on www.covidwarriors.gov.in will be contacted for their readiness to deployment at short notice.
The document said a coordination committee will be formed under the leadership of the "incident commander" and would comprise representatives from departments like health, women and child development, elected representatives and NGOs already serving the area. The guidelines called for all risk-communication intervention to address psycho-social and stigma issues, particularly in local languages, and to put up posters outside community toilets and water points, and use of cable TV channels to create awareness.
Social media should be used with appropriate messages to target these population and for refuting fake news. Community groups should also popularise adoption of Aarogya Setu application, it said.
The document was released on Saturday as Health Secretary Preeti Sudan, Rajesh Bhushan, OSD, Health Ministry, and other senior officers held a review meeting with principal health secretaries, municipal commissioners, DMs and other officials from the 30 municipal areas contributing almost 80 per cent of the country's COVID-19 cases.
These 30 municipal areas are BrihanMumbai, Pune, Kolkata, Jaipur, Nashik, Jodhpur, Agra, Greater Chennai, Ahmedabad, Thane, all Delhi MCs, Indore,Howrah, Kurnool, Bhopal, Amritsar, Villupuram, Vadodara, Udaipur, Tiruvallur, Aurangabad, Cuddalore, Greater Hyderabad, Surat, Chengalpattu, Ariyalur, Palghar, Berhampur, Solapur and Meerut.
The guidelines further said the surveillance system will be strengthened in these areas and a strict perimeter control will be maintained in containment zones with Section 144 enforced to ensure people remain in their dwelling units.
The document acknowledged the disease surveillance system in most cities or towns is not as well organised as in rural areas and this is more pronounced in urban settlements.
According to the 2011 Census, there are 2,613 towns/cities with such settlements. Nearly 6.54 crore people reside in 1.39 crore households in these areas, representing 17.4 of all urban population.
The Health Ministry has also brought out two updated containment plan documents: one for large outbreaks (15 or more cases), and one for others.
According to the plan for large outbreaks, a geographic quarantine or near absolute interruption of movement of people will be applicable to such areas and strict perimeter control in containment zones will be applied with active search for cases through physical house-to-house surveillance.
The plan, however, said a number of variables determine the success of the containment strategy through geographic quarantine such as number and size of clusters, effectiveness of geographic quarantine, how efficiently the virus is transmitting, taking into account environmental factors like temperature and humidity, public health response in terms of active case finding, testing of large number of cases, immediate isolation of suspect and confirmed cases and quarantine of contacts.
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