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Preventing Local Transmission

State must leave no holes unplugged to protect Goan population from virus

W ith the number of COVID-19 cases rising in the state, there is a rising level of concern among the local population, even though all the patients are from among the persons who have come from other parts of the country or the world. There has been no local person reported infected after April 3, which is now close to seven weeks. The sense of reprieve local people felt when Goa was proclaimed a green zone slowly began to give rise to a feeling that they were safe – a feeling that has been dented by the surge of what Chief Minister Pramod Sawant prefers to call “imported cases.” The state government has a big responsibility to restore the feeling of safety among local people by formulating a comprehensive and clear strategy to take them successfully through phase II of the fight against COVID-19 as they did phase I. There should be total clarity from the government as regards to additional measures and facilities to deal with the challenges of sudden increase and prevention of local transmission.

In order to prepare for the surge the state government has got 200 beds ready at the ESI hospital at Margao which has been designated as COVID-19 hospital. Each bed has oxygen and there are ventilators too. The state government must provide the hospital with whatever other equipment it needs, so it does not have to depend on Hospicio. The government claims to have doctors and paramedical personnel for the hospital, yet they must see that their numbers are adequate and they get enough rest to be able to do their work with concentration the next day. Phase II of COVID-19 is going to be very challenging to the government, as it has to meet two objectives: one, to provide care to a rising number of patients owing to the return of an unspecified and unpredictable number of Goans from other states and other countries; and two, to keep the defences impregnable to keep the virus from touching anyone from the local population.

As it seems, meeting the second objective might prove to be a greater challenge to the state government than the first. The first objective can be met successfully if everyone coming through legal borders is put to rapid test, and those testing positive are sent straight away to hospital where there would be medical and paramedical personnel to take care of them. However, the second challenge demands a very close coordination between the formal and informal administrative and health manpower infrastructure to stop illegal entries from other states, to impose an effective home and institutional quarantine and to be alert to an active case. It would be naïve to expect the vast infrastructure of the government being used to prevent local transmission, with officers and employees of different levels of intelligence, commitment, work ethic and integrity, to work vigilantly and effectively in a uniform manner in every part of the state, in every village or ward or street. The Ministry of Home Affairs has been laying stress on effective quarantine and detection of active cases. Such responsibilities cannot be entirely left to the lower-level formal government employees or informal agents such as ASHA or Anganwadi workers. The supervisory levels cannot afford to fully depend on them, as a variety of factors might affect the lower-level workers’ feedback or participation.

Everything that needs to be done to prevent any hidden symptomatic or asymptomatic person from mingling with the local population must be done by the state government. The state should set up an incident response system in place as suggested by the union health ministry, besides a coordination mechanism for COVID-19 containment plan, stringent surveillance and hospital preparedness and clinical management. There is also an urgent need for the state government to enforce the guidelines issued by the Ministry of Health and Family Welfare for preparedness and response in the informal settlements within cities. As slums are vulnerable places all efforts should be made to contain the spread of the deadly virus in such settlements as they are crowded. The state government must focus on such settlements as housemaids, skilled artisans and technicians reside in them and they come in contact with their employers.

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