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The Evening Wrap: Centre admits COVID spread to rural areas

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The Evening Wrap

Sunday | 16 May, 2021

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Centre admits COVID spread to rural areas, issues SOPs

COVID's ingress is now being seen in peri-urban, rural and tribal areas as well, the Health Ministry admitted on Sunday, weeks after a rising number of cases have been reported from rural areas of Uttar Pradesh, Bihar and Gujarat among other States.

The Ministry in its document "SOP on COVID-19 Containment and Management in Peri-urban, Rural and Tribal areas" said there is a need to enable communities, strengthen primary level healthcare infrastructure at all levels to intensify COVID-19 response in these new areas, while continuing to provide other essential health services.

The Ministry said with the larger spread of COVID-19 cases, it is important to ensure that these areas are equipped and oriented to manage COVID-19 cases. "In every village, active surveillance should be done for influenza-like illness/ severe acute respiratory infections(ILI/SARI) periodically by health workers," noted the Ministry in its latest SOP.

The Ministry said that depending upon the intensity of surge and number of cases, as far as feasible, contact tracing should be done as per Integrated Disease Surveillance Programme's (IDSP's) guidelines for contact tracing of COVID-19 cases in community settings amid reports of several bodies of suspected COVID-19 victims having been found abandoned and floating in the Ganga.

The Ministry has also directed that staff should be trained in performing Rapid Antigen Testing (RAT) and that provision for RAT kits should be made at all public health facilities including sub-centres (SCs)/ Health and Wellness Centres (HWCs) and Primary Health Centres (PHCs). These patients should also be counselled to isolate themselves till test results are available.

"Those asymptomatic but having history of high-risk exposure to COVID patients (exposure of more than 15 mins without a mask within 6 feet distance) should be advised quarantine and tested as per ICMR protocol," notes the Ministry.

The document further notes that on discharge, patients should be counselled for post-COVID management at home and leaflets regarding danger signs (e.g. breathlessness, chest pain, recurrence of fever, low oxygen saturation, etc.), precautions and various respiratory exercises.

"Patients with other co-morbidities should also be followed up and primary assessment of other co-morbidity (e.g. measuring blood pressure, blood glucose level) should be arranged and any modification treatment, if necessary, should be decided by a primary health centre medical officer," says the document.

The Ministry has advocated for use of telemedicine services for providing post-COVID follow-up care.

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Second batch of Sputnik V arrives

India on Sunday received the second consignment of Sputnik V, the Russian vaccine that recently joined the country's arsenal against COVID-19.

"Second batch of Sputnik V arrives in Hyderabad, India!," the vaccine developers tweeted.

Russia's Ambassador to India Nikolay Kudashev said in a tweet: "given the recent launch of the Russian vaccine in the Indian vaccination campaign, this second delivery has become very timely." Describing Sputnik V as a Russian-Indian vaccine, he told news agency ANI "we expect that its production in India will be gradually increased up to 850 million doses per year... There are plans to introduce single-dose vaccine soon in India-Sputnik Lite."

Dr. Reddy's Laboratories, the marketing partner of Sputnik V in India, tweeted that "the consignment that arrived today in Hyderabad contains 60,000 doses of the second dose component of the #SputnikV vaccine. Samples from the consignment will be sent for release to the Central Drugs Laboratory."

The first consignment consisting of 1.5 lakh doses that arrived in Hyderabad on May 1 was cleared for use on May 13 by the Central Drugs Laboratory in Kasauli.

Samples drawn from all consignments would be sent to the central facility in Himachal Pradesh and the vaccine used on getting clearance. Dr. Reddy's CEO-API and Services Deepak Sapra said this at a media briefing on May 14, following the soft launch of the vaccine by the company as part of a limited pilot. The first dose was administered in Hyderabad.

The maximum retail price of the vaccine is ₹995, including a 5% GST. The company said this was the rate at which it would be supplying the vaccine to the government and private sector.

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DRDO developed drug to be distributed in Delhi

An anti-coronavirus drug developed by Defence Research and Development Organisation (DRDO) will be launched tomorrow, with Union Defence Minister Rajnath Singh distributing around 10,000 doses to some hospitals in Delhi.

The drug, called 2-deoxy-D-glucose or 2-DG, was developed by a DRDO lab in collaboration with Hyderabad-based pharma giant, Dr Reddy's Laboratories. Drugs Controller General of India (DCGI), the country's top drug regulator, has approved the medicine for emergency use.

The drug had shown promising results in its phase 2 and phase 3 clinical trials. It was also found to be effective in cutting short the hospital stays of patients and reducing supplemental oxygen dependence.

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Already booked appointments for Covishielf second dose will remain valid

The Union health ministry on Sunday clarified that already booked online appointments for second dose of Covishield vaccine will remain valid and the same will not be cancelled on Co-WIN platform.

It, however, said requisite changes have now been done in the Co-WIN digital portal, as a result of which further online or on-site appointments will not be possible if the period after first dose date for a beneficiary is less than 84 days.

The Centre had on May 13 extended the gap between the first and second doses of Covishield vaccine to 12-16 weeks based on the recommendations by the COVID Working Group chaired by N.K. Arora.

"The Government of India has communicated this change to states and UTs. The Co-WIN digital portal has also been reconfigured to reflect this extension of interval for two doses of Covishield, manufactured by Serum Institute of India (SII) to 12-16 weeks," the Ministry said.

"However, there have been reports in a section of the media suggesting that people who had pre-booked their appointments for the second dose in less than 84 days on Co-WIN are being turned back from vaccination centres without getting the second dose of Covishield," it said.

"Additionally, already booked online appointments for second dose of Covishield will remain valid and are not being cancelled by Co-WIN. Further, the beneficiaries are advised to reschedule their appointments for a later date beyond the 84th day from the date of first dose of vaccination," the Ministry added.

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'Entire globe is a unit' government says while justifying vaccines export

The "entire globe is a unit" during a pandemic. This is how the government justified in the Supreme Court its decision to export vaccines amidst a surging second wave of Covid-19.

A page in the Ministry of External Affairs' website shows that between January and April 2021, India exported 663.698 lakh "Made in India Covid-19 vaccine supplies" to over 90 countries and UN health workers and peacekeepers.

"Once an epidemic takes (the) form of a pandemic, its management has to be done keeping the entire globe as (a) unit," a March 11 affidavit of the Health Ministry informed the apex court. The document sheds further light into the much criticised-move to export COVID-19 vaccines.

In fact, according to the affidavit, the government reasoned it was not possible to take a country or States-specific approach. The government envisaged vaccine export as part of a "global action to vaccination". The Centre reasoned that it was necessary to protect the high-risk population in other countries to "break the chain of transmission" and "minimise chances of import of COVID-19 cases to India".

"India is not immune to the pandemic till the world at large has contained the disease," the Centre argued.

It said the export was "limited" and done giving "highest priority to domestic needs".

But this is not all. The government, in the affidavit, gives another "dimension" to why it exported vaccines and opted for staggered immunisation.

It said both were done to avoid disproportionality between the production of COVID-19 vaccines and the country's "available" health infrastructure and manpower. Simultaneous vaccination without priority classification would have led to "commotion", the Centre told the Supreme Court.

The affidavit highlights the need for "adequate manpower" and "sufficient infrastructure" to "cope" with the immunisation drive. The document indicates that the available health infrastructure and manpower may not match up.

"To illustrate, having received one crore vaccine doses for a particular State or city, the vaccine drive would need sufficient number of medical staff who can administer the vaccines and infrastructure like hospitals, primary health centres, etc… It is needless to mention that manufacturing of vaccine would not be proportionate to the available manpower and infrastructure facilities in the country," the government justified.

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Rahul Gandhi tweets 'offending' poster, dares Delhi Police to 'Arrest me too'

Challenging the arrests of 24 persons by the Delhi police for posters that surfaced across the city questioning Prime Minister Narendra Modi's decision to donate vaccines to neighbouring countries, former Congress president Rahul Gandhi posted the 'offending' poster on his Twitter account daring the police to arrest him.

All the posters uniformly pose the question: "Modiji humare bachon ka vaccine videsh kyon bhej diya?" (Why did you send vaccines meant for our children abroad?). Mr Gandhi said, "Arrest me too."

Nearly six crore doses of vaccines have been sent out to various countries. So far, a little over four crore persons have got both doses in India and 14 crore people have got a single dose as per the latest numbers on the centralised vaccination website CoWin.

The persons were arrested under a rarely used law of "Prevention of Defacement of Property Act" and most of them have been released on bail. "Celebrate, India is a free country. There is freedom of speech, except, when you ask a question of the Honourable Prime Minister," senior Congress leader and former Home Minister P. Chidambaram wrote on Twitter. He said the poster asks a simple question and before PM Modi could answer the Delhi police had answered with arrest.

Congress Chief Whip in the Rajya Sabha Jairam Ramesh pasted the poster next to his nameplate at his official residence opposite the Lodhi Garden. "I am shocked and stunned. May vehemently disagree but under what authority, what law, what power can you arrest those who put up posters," Rajya Sabha MP Abhishek Manu Singhvi said. He said this "smacks of a lawless state gone amuck".

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Plea in SC to use PM-Cares fund for vaccines, oxygen plants

A plea was filed in the Supreme Court seeking a direction to utilise the PM-CARES fund for immediate procurement of vaccines and establishment of oxygen plants, generators and their installation in 738 district hospitals across the country.

The petition, filed by advocate Viplav Sharma, said the government needs to loosen its PM-CARES purse strings and use the money to help common people urgently access medical care and oxygen.

"These government hospitals are easily accessible at no cost to common people of every district in the country who are desperately seeking medical oxygen as basic life-saving support," the petition said.

The petition also asked for a stay on an April 24 notification of the Centre granting exemption on "import duty of medical equipment relating to oxygen generation" owing to its acute and rising demand. The petition said the exemption has been wrongfully capped for only three months. People may need this equipment for more than that period. "Three months' cap on the exemption period is too short a period from the standpoint of logistics involved in importing this highly sophisticated medical equipment in India by over 300 hospitals," it said.

The plea asked the court to issue directions to States and Union Territories to ensure that private and charitable hospitals have actually procured, installed and commissioned medical plants or equipment with essential backup for medical oxygen for COVID-19 patients.

The petition said States and UTs should ensure the setting up of electric and other kinds of crematoriums in cities and improve the existing ones. It also sought the preparation of a 'National Plan' in consultation with Chief Secretaries and States.

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Covid watch: Numbers and Developments

The number of reported coronavirus cases from India stands at 2,48,89,196 at the time of publishing this newsletter with the death toll at 2,73,442.

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Evening Wrap will return tomorrow.

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